Beruflich Dokumente
Kultur Dokumente
Cody Wohlgemuth
Abstract
There is a large population within the United States with mental illness. Family members of the
ill may not even realize that a loved one could be diagnosed with a mental illness. The patient is
diagnosed with Major Depression Disorder. There were stressors leading up to the admission to
the psychiatric health floor. The symptoms of this disorder can be shrugged off as just having a
bad day or feeling blue. Education is a huge role in understanding the disease process. As time
progresses mental illness is taken more seriously, but there is still a stigma on mental illness.
With education society will understand that the people diagnosed with mental illness are not just
Objective Data
Friday the sixth of October which stab wounds to the lower left quadrant of her abdomen. The
patient stated that she “has been drinking and does stupid things when she drinks.” The father
was contacted and came to the emergency department and questioned the patient who did this to
her. This lead to the patient saying she was alone and neither her fiancé or current boyfriend
were in the house when this occurred. With the concern of the father it would lead to further
questions regarding domestic violence. The patient was becoming agitated with the staff who
were trying to help and take care of her. She was using profanity and telling the staff to quit
The patient was admitted to the hospital for the stab wounds and spent five days on the
floor before coming to the mental health floor on October eleventh. We started with small talk to
develop a relationship. She told me how she went to a university in Pennsylvania and she has
three kids already. Talking to her about her school and her outside life a person would not realize
that she was diagnosed with major depressive disorder. During our conversation the patient told
me she came to the mental health floor voluntarily, because she knew she would be forced to
come and it looks better if she voluntarily came. This lead to more questioning about her past.
She said she has attempted suicide before, but has not been admitted onto the mental health floor.
The medical diagnosis would be the stab wounds on her abdomen. There are six different
wounds. Wound care would be a top treatment for her medical diagnosis. Proper wound care
would prevent infection. There was no major organ damage with the stab wounds.
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When I talked to the patient the morning after being admitted to the psychiatric floor she
was not prescribed any psychiatric medication. I asked if she has seen the psychiatric doctor on
the floor and she said no. the doctor was making rounds later that morning. The patient also had
a positive pregnancy test. Most psychiatric medications need to be withheld while being pregnant
so this will limit the doctor on which medications if any are prescribed. There were as needed
medications prescribed per the hospital policy. The two medications that are prescribed on the
floor is Cogentin and Haldol. Cogentin can develop tardive dyskinesia and if this occurs the
nurse must discontinue the drug and contact the health care provider. Haldol is prescribed for
agitation and aggression. If the patient terminates the pregnancy I would look for some common
The DSM IV is not used at our facility. Axis I would be the psychiatrist diagnosis of
major depressive disorder. Axis III is the medical diagnosis which would be the stab wounds
Summarize
According to Mayo Clinic, major depression disorder is very common and there about 3
million cases in the United States. Major depression disorder is defined as: the persistent feeling
of sadness or loss of interest that characterizes. This feeling has to be for two weeks all day every
day without any changes. Depression can affect any age group, but predominantly starts in the
twenties or thirties (Mayo Clinic, 2017). This patient was right in the middle of the age range.
There were probably signs of depression earlier, but family members and friends do not
recognize these signs as depression. Most people will think it is just one of those days and before
Signs and symptoms are different for everyone. According the National Institute of Mental
Health, these are some of the symptoms of a person dealing with depression: persistent sad,
worthlessness, or helplessness, loss of interests, weight changes, and suicidal ideations (NIH,
2016).
According to Michael Kerr, the treatments for major depression disorder are medications,
psychotherapy, and life style changes. Selective Serotonin Reuptake Inhibitors are first line
defense this includes Celexa and Prozac. Psychotherapy can help some people, but it may not
help everyone. Sometimes the patient needs somebody to talk to and have somebody that is
willing to listen. The professional can help the patient by teaching them positive coping
strategies. Life style changes can help depression. Most people turn to alcohol when they are
feeling down, but as a central nervous depressant alcohol can make the depression symptoms
worst. Exercising, eating right, and getting enough sleep at night has a huge effect on mood
(Kerr, 2017)
Identify
The current hospitalization precipitated from alcohol intoxication and stab wounds to the
abdomen. The stab wounds are considered self-inflicted which lead to the admission on the
psychiatric floor. The stressor that could have led to the self-harm but not limited to is finding
out the patient was pregnant and not knowing who the father is. Already engage with three
children and having a new-found love interest can be stressful by itself. The patient described the
new pregnancy and an unwanted surprise and planned on termination. The patient is also
attending online classes through a university. College can be very stressful trying to maintain a
Discuss
The patient has had a history of alcohol abuse and depression in the past. The depression
lead to previous suicide attempts. The patient knows that she has a substance abuse problems and
quit drinking for a while. When new stressors developed mentioned above she went back to her
old habits and began drinking again. The father has been supportive of the patient and worries
that the patient will commit suicide one day. The patient said there was nobody in her family that
Describe
milieu. The floor is very clean and organized which limits distractions to the patients. There is a
schedule posted on the wall of when the groups are, meal times, and visiting hours. Around nine
in the morning a staff member comes out and asks each patient a goal of the day and talks about
the schedule of the day emphasizing the first group that starts in an hour.
The floor is a horse shoe shape with rooms on each side and a common room in the
middle in front of the nurse station with exercising equipment. The group rooms are found on the
backside in two private rooms. Most of the patients can be found sitting in the common area
watching television, coloring talking to other patients or using the equipment. The common area
allows the staff to have eyes on all the patients. If the patient decides to stay in their room there
will be a staff member that does a check on that room every 15 minutes.
The rooms are not like the typical hospital room. Everything is heavy on the floor or
bolted. This prevents the patients from throwing these items. The bathroom door is thickened and
slanted so the patient cannot attempt to hang themselves. The mirror is not glass so the patient
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cannot break it and inflict harm to themselves or another person on the floor. The patients are not
Analyze
The patient did not discuss any cultural or spiritual influences that impacted the patient.
The patient could explore spiritual influences and this may help with the depression. Religion
can be a positive coping mechanism with prayer and being a part of something.
Evaluate
When I had the conversation with the patient she was only on the floor for about twelve
hours. She met the goal of meeting the staff and being able to recognize them. Another goal she
met was having a good night sleep. One of the goals she planned on meeting was going to the
groups throughout the day. The goal for the day of care that she came up with was to be more
patient. This is an excellent goal for the first full day of care, because there is a lot of changes
that she will have to encounter. The patient stated that she was going to do certain activities to
ensure she would get out of there quick enough to not miss any class work. This is concerning
because she should be focused on herself and getting better. This could be related to lack of
Summarize
The patient should attend an outpatient facility after discharge. Instead of having two love
lives the patient needs to break it off with one of the two men or end the relationship with both.
The patient stated that she wanted to get help with her alcohol problem. The patient will be
educated to alcoholic anonymous prior to discharge. This is a great first step in recovery. Weekly
psychiatric visits will be implemented. If the patient decides to terminate the pregnancy
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medication regimen will be addressed. Patient will find a positive coping strategy that will deter
from drinking. The patients father was involved in her life and was a great support system.
quadrant abdomen.
drinking problem.”
community resources.
3. Encourage patient to verbalize positive coping patterns post discharge related to poor
Works Cited
Depression (major depressive disorder). (2017, August 16). Retrieved October 18, 2017, from
https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-
20356007
https://www.nimh.nih.gov/health/topics/depression/index.shtml
Kerr, M. (2017, June 27). Major Depressive Disorder (Clinical Depression). Retrieved October