Discuss about the Depression Case Study for Aggression and Violent Behavior.
The nurse who would be attending the patient named Berry need to outline the strategies for conducting proper assessment of the major symptoms that the patient is suffering. Researchers are of the opinion that the interpersonal communication that needs to be set for a mental health patient is a bit different from the patients who are coming with physical issues. The first important aspect that needs to be developed with the patient is a bond of trust (Hall et al., 2015). The nurse had to communicate in a way by which the patient can rely on the nurse, open himself up, and reveal different personal and professional problems he is having. The issues that he mentions and the ways that the issues are portrayed will give the cues to the nurse about the symptoms of a particular disorder. The nurse should have critical thinking skill and reasoning skill so that she can correctly link the symptoms with the disorder and thereby conduct her diagnosis. In order to develop trust, the nurse should first try to build up a rapport with the patient in order to make him comfortable and free from restlessness (Williams, LLten & Bower, 2016). In order to develop a rapport, the nurse should communicate with compassion and empathy and try to show her genuine concern for the patient. Researchers are of the opinion that patients try to concentrate on the body language of the nursing professional as such, cues help them to develop assumption about the genuine feeling of the nurse. Non-verbal communication skills also play great role in establishing communication with a patient and therefore, nurse should try their best to display a positive and caring body language. Body posture, eye contact, facial expression, touch and many other all have significant effects in the initial interaction with the patient (Baby, Gale & Swain, 2018). Therefore, the nurse who would be assigned to Berry would make sure that her body language makes Berry comfortable and make him feel that he can rely and trust her with his confidential information and also on the nurse’s ability to treat him. The approach of the nursing professional should be person centred where the patient should be kept in the focus of the interaction (Sheridan et al., 2015). The nurse should approach in a way by which she makes Berry feel that she is always present for him, have patience to listen to him and to make him better by assuring him that she is there to help Berry. The control of overcoming the preconceived ideas and biasness about a person is another interpersonal skill that a nurse should be careful. While interacting with Berry, the nurse should keep herself in the in a place of extreme respect for the patient, especially for the things that he would be revealing in the session. With the help of active listening skills and proper two way mode of communication skills, the nurse should try to understand Berry, donor his wisdom as well as their integrity and thereby understand what is better for Berry and how he is leading life. Open-ended questioning with the aim of getting the answers required for clinical reasoning is an important interpersonal skill that would help the nurse to correctly assess condition of Berry and diagnose his illness.
One of the most important symptoms that are identified in the case study is the shortness of breath. Researchers are of the opinion that panic disorders often accompany shortness of breath (Barrosos et al., 2018). This symptom is found to be quite similar to that of Berry. This is mainly caused by change in the normal breathing pattern when panic attacks a human being. When such attacks occur along with anxiety, the breathing of the individual becomes shallow as well as restricted (Murphy et al., 2016). The lungs do not get filled with full complete breath rather quick and short breath also occur. This condition is known as hyperventilation. Berry is also seen to go through same situations. Over-breathing causes the carbon-dioxide levels to get decreased in the blood. This reduction of the blood can cause many physical symptoms that include tingling, cheat pain, dry mouth and numbness (Barrosos et al., 2018). Similar issue has been also seen to be present with Berry and therefore the nurse can identify these attacks. Another issue that is also observed in the patient is the troubled sleeping and inability of coping with problems and improper problem solving. Researchers have conducted out experiments where they have found out the depressed people despite of being slower in demeanour as well as in motivation; depressed people are often seen to lay awake at night ((Burkhalter et al., 2015). They are also seen to fail in concentrating on a particular task and apply critical thinking ability to resolve problems. These are also seen in case of Berry. As Berry has stated of this symptom along with other symptoms of depression, therefore, he can rightly be diagnosed as a patient suffering from depression. Another important symptom that can be stated as a sign of mental health disorder is the digestion issues that the patient is facing. Researchers have found out an interesting fact where they have stated that there is an interconnected relationship between the brain and that of the digestive system. This is actually facilitated by a number of nerves as well as brain chemicals (Feldman et al., 2016). They are also of the opinion that anxiety and depression are two mental health issues that have the capability to alter the balances of the messenger chemicals in the brain. This in turn is seen to throw the systems of the individuals in turmoil. The brain starts receiving erroneous sensory perceptions that are thereby responsible for sending signals that affects physical functioning (Burkhalter et al., 2015). It has been found that under stress as in condition of Berry, decertification of blood flow results that causes blood to flow to the muscles to help the individuals fight out the crisis and therefore blood flow to non-emergency task like digestion decreases. Under stress brain also decreases to release chemicals needed for immunity and hence inflammation takes place due to viral and bacterial activity rising up. Balance of good and bad microbes in the gut is also destroyed (Bartoszek et al., 2015). Such prolonged situation changes the environment in the digestion system. Researchers also state that 80% of the serotonin is prepared in gut and when digestive system cannot work well enough serotonin cannot be produced (Spadaro et al., 2016).. All these lead to mental disorders and in this situation of Berry, the mental health disorder can be identified as depression and anxiety as similar situations occur in this disorder only.
The nursing professionals would be first using the presence of touch, demeanour as well as verbalisation to make the patient feel that he is not alone and should encourage the expression as well as the clarification of his own needs, concerns, and questions. The nursing professionals should then help Berry to identify the different participants that are causing anxiety and panic attacks as these would help the nursing professional to assess the interventions (Kim et al., 2015). Researchers are of the opinion that gaining insights may help the patient to identify the threat or develop new ways of dealing with it. Encouraging the client to develop and use positive self-talk like “anxiety would not kill me” of “I have the power to breathe properly” and replacing negative self-talks are also helpful. Different strategies to remove or overcome the source of panic or anxiety can be proposed to him. Researchers are also of the opinion that when nurses educate the patients about the disorder by continuously empowering him to overcome barriers, the patient may also slowly be able to overcome symptoms of panic. This would reduce his shortness of breath issue (spadaro et al., 2016).
The nurse can also explore coping skills by listening to the patients’ fears and expectation and helping them to encourage taking charge of their lives. In case of Berry, the nurse can also use therapeutic touch and healing touch technique. Besides, present day studies also state importance of music and pet therapy (animal assisted therapy) that may also help him to overcome panic attacks and hence reduce his shortness of breath. The other intervention that the nursing professionals can also advice the patient is by the development of different anxiety reducing skills. Researchers have come across different types of anxiety reducing techniques that that are observed in various randomised control trails in the different parts of the globe (Furu et al., 2015). These are effective breathing procedures, relaxation, deep breathing, positive visualisation and reassuring self-statements. They have also stated that when patients discover new forms of coping techniques, they are able to handle their anxiety and manage it in an effective way. Therefore, by the above-mentioned techniques, two symptoms like shortness of breath and coping issues with problems can be reduced.
Venlafaxine is mainly seen to treat depression and anxiety. Researchers are of the opinion that this medicine acts by helping in restoration of the balance of certain natural substances like serotonin and nor-epinephrine in the brain. It functions as serotonin-nor epinephrine reuptake inhibitor called SNRI. It mainly helps in improvement of the mood as well as energy level that ultimately would help Berry to restore his interest in daily living. The nurse should therefore tell Berry about the different side effects that these drugs possess so that he does not get scared or upset when the side effects occur (Paulzen et al., 2018). These are nausea, dizziness, drowsiness, loss of appetite. Constipation, nervousness, blurred vision, unusual sweating and others. Therefore, when all these symptoms persist or worsen, Berry should immediately consult doctor gain. Moreover, it also increases blood pressure and therefore he should constantly monitor blood pressure. In rare conditions, severe side effects may also occur like serious cough, chest pain, severe pounding headache, eye pain, swelling, redness and widened pupils and others. Black bloody stools may also become quite common and vomits looking like “coffee grounds” are also seen to occur. Seizures are also stated to occur by certain patients who have suffered from side effects.
Many other important precautions are also needed to be taken by Berry before he starts his prescribed medication of venlafaxine. The patient should first reveal that whether he has any previous history of any kind of allergies. Some of the ingredients in the medication can cause active allergic reactions with other chemicals in the body of the patient. Therefore, consultation of the pharmacist should be ensured. Secondly, the patient should also reveal his medical history like if he has any bleeding issues, family history of glaucoma, heart problems, high blood pressure, liver diseases, kidney disorder, high cholesterol and many others. Seizure diseases and thyroid diseases should also be revealed (Fann et al., 2015). This drug already makes the person dizzy as well as drowsy and therefore use of alcohol and marijuana should be prevented, as they would increase the dizziness and drowsiness off the patient. Many researchers are also of the opinion that drug interactions change the ways by which this medication acts and can thereby increase the risk of different types of side effects. For example, aspirin can increase the risk of bleeding when it interacts with this medication. Therefore, proper analysis of all the medicines taken by berry should be done and then only, it should be assigned to Berry.
References:
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