Psychiatric Medications Q 2
The primary nursing diagnosis for a female client with a medical diagnosis of major depression would be:
A. Situational low self-esteem related to altered role
B. Powerlessness related to the loss of idealized self
C. Spiritual distress related to depression
D. Impaired verbal communication related to depression
Correct Answer: D. Impaired verbal communication related to depression
Depressed clients demonstrate decreased communication because of a lack of psychic or physical energy. The common features of all depressive disorders are sadness, emptiness, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function. Initially, provide activities that require minimal concentration (e.g., drawing, playing simple board games). Depressed people lack concentration and memory. Activities that have no “right or wrong” or “winner or loser” minimizes opportunities for the client to put himself/herself down.
Option A: Assess the self-esteem level of the patient. Signs of low self-esteem include withdrawal from social relationships, feeling of inadequacy, neglect of personal hygiene and dress, and rejecting self which all may indicate a negative thought pattern. Allow the patient to engage in simple recreational activities, advancing to more complex activities in a group environment. The patient may feel overwhelmed at the start when participating in a group setting.
Option B: The investigation into depressive symptoms begins with inquiries of the neurovegetative symptoms which include changes in sleeping patterns, appetite, and energy levels. Positive responses should elicit further questioning focused on evaluating for the presence of the symptoms which are diagnostic of major depression.
Option C: Assess what spiritual practices have offered comfort and meaning to the client’s life when not ill. Evaluates neglected areas in the person’s life that, if reactivated, might add comfort and meaning during a painful depression. Suggest that the spiritual leader affiliated with the facility contact the client. Spiritual leaders are familiar with dealing with spiritual distress and can offer comfort to the client.