Concept Map and Analysis

Mental Health Case
Laura is a 46-year-old married mother of three children experiencing depression. She has begun to feel low in mood over the past three months and has visited her G P, who prescribed antidepressant medication and referred her to a mental health nurse (RM N) who liaises with the surgery. The R M N used some of the principles from a cognitive behavioral therapy (C B T) approach to inform her work, including agenda setting, homework, therapeutic techniques of activity scheduling, sleep hygiene, and progressive muscle relaxation.
The mental health nurse used a structured assessment in order to gain a detailed understanding of Laura\’s background, current circumstances, and mental state. The areas the assessment considered included: Laura is a 46-year-old married mother of three children, experiencing depression. She has begun to feel low in mood over the past three months and has visited her G P, who prescribed antidepressant medication and referred her to a mental health nurse (RM N) who liaises with the surgery. The R M N used some of the principles from a cognitive behavioral therapy (C B T) approach to inform her work, including agenda setting, homework, therapeutic techniques of activity scheduling, sleep hygiene, and progressive muscle relaxation.
Additional Information: She was married for ten years, three children 5yrs, 18 months & 6 months.
Medications prescribed Trazodone 25 mg QHS, and the issue is the low mood for three months.
Lab work: No diagnostic lab work to diagnose depression.

Here are the Nursing Diagnosis and interventions I have completed below they can go the concept map

Goal: Client will use effective coping strategies.
1. Observe contributing factors of ineffective coping as poor self-concept, grief, lack of problem-solving skills, lack of support, recent change in life situation, maturational or situational crises.
Rationale: Situational factors must be identified to gain an understanding of the patient’s current situation and to aid patient with coping effectively (Wayne, 2019).
2. Assess for suicidal tendencies. Refer for mental health care immediately if indicated.
Rationale: A high-risk patient will need constant supervision and a safe environment (Halter, 2019).
3. Assess the patient’s needs for self-care and offer support when appropriate.
Rationale: To explore the patient\’s self-care limitations and needs while allowing them to express their personal thought and feelings related to ADLs (Ackley et al., 2020 pg. 794).
4. Teach the patient to recognize negative thinking and thoughts.
Rationale: Negative ruminations add to feelings of hopelessness and are part of a depressed person’s faulty thought processes (Halter, 2019).

Goal: Client will verbalize feelings
1. Assess for, monitor, and document the potential for suicide.
Rationale: Hopelessness is a potential predictor for depressive and suicidal symptoms. (Ackley et al., 2020 pg. 475).
2. Assess for hopelessness with modified Beck Hopelessness Scale.
Rationale: The modified Beck Hopelessness Scale is a valid and reliable tool to measure hopelessness (Ackley et al., 2020 pg. 475).
3. Assist the client to explore the meaning of his or her life and life goals.
Rationale: Research shows that a higher meaning of life buffers the association between suicide risk factors and hopelessness (Ackley et al., 2020 pg. 476).
4. Encourage participation in a support or therapy group where others experience similar thoughts, feelings, and situations.
Rationale: Participation in such a group can decrease feelings of isolation and provide an atmosphere where positive feedback and a more realistic appraisal of self are available (Halter, 2019, pg.121).

Goal: Client will verbalize signs and symptoms of depression, recognize need for medications, and understand treatments.
1. Assess the influence of cultural beliefs, norms, and values on the patient\’s present illness perceptions.
Rationale: Interventions need to be specific to each patient considering their individual differences and backgrounds (Wayne, 2019).
2. Teach about the illness depression and how to identify early signs of relapse.
Rationale: Awareness of the early signs of relapse and specific triggers is essential in helping the patient seek care (Stuart, 2017, pg. 317).
3. Teach the action and side effects, and special instructions regarding antidepressant medications.
Rationale: Despite treatment success achieved with antidepressant drugs, they have limitations. Their therapeutic effects usually begin only after 2 to 6 weeks. Therefore, teaching patients about the increased risk of suicidal thoughts or any unusual behavior helps to observe toxicity manifestations (Stuart, 2017, pg. 317).
4. Teach the client the benefits of psychotherapeutic approaches and follow-up appointments.
Rationale: Cognitive-behavioral therapy, interpersonal therapy, and behavioral therapy have been proven effective in treating depression (Halter, 2019, pg. 126).

Lastly, listed below are my references I used you may use others as well but these go with my nursing diagnoses and rationales.

Ackley, B.J., Ladwig G.B., Makic, M.B.F., Martinez-Kratz, M., Zanotti, M. (2020). Nursing diagnosis handbook an evidence-based guide to planning care. Edition 12. Elsevier

Halter, M. J. (2019). Manual of Psychiatric Nursing Care Planning. St Louis, MO: Elsevier

Wayne, G. (2019). Nurseslabs. Ineffective coping nursing care plan. https://nurseslabs.com/ineffective-coping/

Wayne, G. (2019). Nurseslabs. Knowledge deficit nursing care plan. https://nurseslabs.com/deficient-knowledge/

SAMPLE SOLUTION