The 70-year-old woman shows several signs and symptoms related to mental illness such as depression. She is often sad due to her loneliness. Her husband died years ago, and the son no longer lives with her. Also, she experiences several unexplained pains and aches in different parts of her body.
Her movement is substantially limited thus denying her a chance to join other people in society and participate in communal activities. Besides losing interest in doing things that she previously liked, she is also experiencing insomnia. She also admitted having experienced symptoms of Major Depression Disorder; thus indicating that she had historical family depression. Her mother suffered from the disease, despite the external family having the issues of Alcohol Use Disorder. The recent development of the hearing problem due to Major Depression Disorder (MDD) for both of her ears has dramatically affected her ability to communicate and interact with others. MDD has contributed to her sadness and the choice to remain alone rather than in a crowd (Stahl, 2013).
Questions and Rationales
Given the explanation of the signs experienced by the woman, the following are some of the questions the psychiatric mental health nurse practitioner (PMHNP) would consider asking patient as a way of establishing the cause and extent of her illness.
1. Have you been diagnosed with depression before? This way, it is easy to conclude whether the woman has a mental disorder or not (Ball, Dains, Flynn, Solomon, & Stewart, 2015).
2. Any other member of the family, apart from your mother, both nuclear and extended suffering or who have ever suffered from depression? The question is to help establish if the disease is genetic or not. Again, it would be the best way to develop the most effective medication to give to the patient, probably those that might have worked for the family members before. For instance, in the case of Major Depression Disorder (MDD), treatment is likely to be based on the medication that seemed useful for the family (Dains, Baumann, & Scheibel, 2016).
3. Do you suffer from any drug abuse? The family has a history of continued drug use disorder that might influence the development of depression due to inability to access the drugs (Ball et al., 2015). Therefore, it will be easy to draw a base and ground from which one can help uplift her spirit on awful days.
People in Patient’s Life to Give a Feedback
The first person that the psychiatric mental health nurse practitioner (PMHNP) would consider to reach and ask questions about the patient is the son (Stahl, 2013). Despite not being around his mother on a daily basis, he is the only family support that she has. Therefore, it is possible that he knows his mother’s condition in-depth. Again, he always accompanies her to her regular clinics for checkups. What this means is that the doctor keeps him updated on the improving or deteriorating state of his mother. He is a reliable source as the mother is also unlikely to hide any kind of pain and discomfort that she feels. The specific question to ask the son will be, when did you first notice a change in behavior in mother? The rationale is to establish a time frame of illness and to determine if the mother is an excellent historian and if what she said tallies with what happened. Another question will be what do you think may have triggered this behavior? Rationale, to assess if the trauma of losing her spouse engendered current illness and do you notice at any time if your mother used or is using street drugs or abusing any other substance? The reason is to rule our substance induced illness. Tell the PMHNP more about your mother? An open-ended question and answer that is free-flowing may reveal truths that the PMHNP may never have thought of asking (Ball et al., 2015). Another credible person as well is the home caretaker who takes care of the patient. He/she is responsible for catering to all the needs of the patient, thus understanding the progress of the woman regarding the mental sickness. The helper can also assist in identifying other psychological symptoms that the patient might have forgotten to mention. The PMHNP, without violating patient’s privacy will ask the caretaker, at any point in your care of the patient have you ever stumbled across any paraphernalia suggesting substance use by the patient? The PMHNP is still in search of the cause of patient’s illness to know how to assist client further. What does patient do during in her leisure time if any? The PMHNP want to gain insight into the patient’s daily behavior to determine the intensity of depression (Dains et al., 2016). The last individual the PMHNP will approach as he tries to understand the problems of the woman is the personal therapists who help her to fight against the mental disorder. Specific questions like what are the things you two talk about that change the patient’s mood from sad to happiness? There is a possibility of indicating activities and topics that they consider enjoyable to engage in that may be helpful to the PMHNP come up with a successful care plan. Also as the being the healthcare provider who has been caring for the patient, the therapist might be aware of the issues that might be considered to trigger the problem or even a medication that can help diagnose the further diseases. The progress of her illness is also essential since the therapist is always in constant communication with the patient. Therefore, the therapist might know more than anyone else could. People tend to be open with their health care providers because they tend to understand them better than all others (Davidson, 2016).
Physical Exams and Diagnostic Tests
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