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Scenario
Patient’s main complaints
The disease began gradually with the development of a depressive state after a failed pregnancy. There was weight loss and cessation of menstruation with sleep disturbances and prolonged insomnia. Suicidal thoughts arose several times due to detachment from the outside world, feelings of guilt, and derealization. The period lasted for two months, after which the patient had an increase in strength, appetite, and unhealthy agitation.
Social history
Severe psychological strain in the workplace after leaving maternity leave. Additional pressure from husband and other relatives. The patient had higher education in marketing, a stable income, high position.
Family medical history
The mother has chronic depression in diagnosis, and the father has hemolytic anemia.
Past medical history
According to the patient, she had no previous history of psychological disorders.
The patient is currently taking aspirin for headaches, two tablets of 150 mg, about once every two days. Quetiapine can be prescribed to support the condition during a depressive episode (Shen, 2018). However, it cannot be discharged without certification, so the patient should be referred to another NP. The plan for dealing with the current symptoms will consist of prescribing relaxants and vitamins to reduce agitation and improve concentration.
Community Resources
The patient will need support above primary treatment if:
- she will have symptoms of a mixed phase of treatment;
- additional illnesses will join;
- rapid phase cycling due to improper medication selection.
Community resources prior to primary admission:
- SAMHSA’s Behavioral Health Treatment Search
- New Jersey Association of Mental Health and Addiction Agencies
- Open Counseling, The North Jersey Consultation Center.
The NJ Mental Health Cares Association is available for patients to help refer individuals with limited resources to a counselor (The mental health challenge, 2022). Patients can apply for social assistance through their employer’s insurance company. If a patient needs urgent assessment and intervention, the patient can call 866-202- HELP (4357), where specialists will arrange an appointment and initial orientation. In addition, every New Jersey Country has 24-hour critical care support resources.
State and Federal Rules
In New Jersey, nurses can write prescriptions as long as they are affiliated with Doctors of Medicine. New Jersey is a favorable state for nursing practice, but one cannot write prescriptions for behavioral health drugs without certification (The New Jersey state nurses association, n.d.).
The Affordable Care Act (ACA) includes providing mental health support to the public.
Medication support is critical for patients with mental health problems. In New Jersey, patients can get help through the ACA from a doctor or a nurse, so they have more options to keep their condition stable. In the proposed scenario, the woman needs medication, and living in New Jersey will make that easier. It allows patients with behavioral health problems to get help promptly and contact advanced nurse practitioners to get prescription medications.
Legal and Ethical Aspects
Legal Issues
As for legal issues, there can be unintentional harm that may cause the patient to seek legal redress for medication harm. This is dangerous on the doctor’s side because it is challenging to prove the complexity of treatment choices.
Ethical Issues
As for ethical issues, explicit and complete consent to medication and therapy must be obtained. There can be a problem with considering the patient’s opinion about potential adverse reactions to medications.
Subsequent Monitoring
The patient should be screened for symptoms of the depressive stage after two months, as well as medication and therapy (McIntyre & Calabrese, 2019). The patient may be offered self-monitoring diaries to track status, emotions, and feelings, easing the client’s morale.
Reducing Potential Risks
Potential risks can be reduced by monitoring the patient’s environment and assessing external factors that may exacerbate the course of the mental disorder.
The patient will need to build relationships within the family, so family therapy may be recommended to renew trust (McIntyre & Calabrese, 2019). It is essential to determine how the client responds to treatment promptly through checkpoints and tests. The patient should be advised to refrain from stressors and aggression at work and home because they have pushed her to a mixed episode.
References
McIntyre, R. S. & Calabrese, J. R. (2019) Bipolar depression: The clinical characteristics and unmet needs of a complex disorder. Current Medical Research and Opinion, 35(11), 1993-2005.
Ostacher, M.J. (2019). Ethical issues in the diagnosis and treatment of bipolar disorders. Focus, 17(3), 265-268.
Shen Y. C. (2018). Treatment of acute bipolar depression. Tzu-chi Medical Journal, 30(3), 141–147.
The mental health challenge: Real questions, expert answers. (2022). NJ Spotlight News. Web.
The New Jersey state nurses association. (n.d.). Guidelines for collaborative practice for the NJ advanced practice nurse. The Society of Psychiatric Advanced Practice Nurses. Web.
Do you need this or any other assignment done for you from scratch?
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