The Client Is A 68-Year-Old Female Who Presents Herself At ✓ Solved

The Client Is A 68 Year Old Female Who Presents Herself At

The client is a 68-year-old female who presents herself at the clinic. Her major symptoms include disturbed sleep pattern, difficulty concentrating, anhedonia, low self-esteem, guilt, decreased appetite, and disordered thought process. After careful assessment of the symptoms, the client is diagnosed with major depressive disorder. The likely appropriate medication for the client is fluoxetine (Prozac) because research indicates that it is one of the most effective antidepressants for patients aged 65 and above (Kashani et al., 2017). Fluoxetine is a selective serotonin reuptake inhibitor (SSRIs), and doctors prefer to prescribe them to patients with major depressive disorder since it is safe and has fewer side effects compared to other antidepressants.

When administering fluoxetine to a client, the nurse should inform her about the expected side effects from the use of the medication such as headaches, dizziness, upset stomach, and vomiting. The patient should report back to the clinic if there are worsening or new symptoms. Also, the patient needs to comply with the medication directions including dosage and taking the medication at the right time. After using fluoxetine for 2 months, it is expected that the symptoms will improve both in frequency and severity. As the body gets used to fluoxetine, some of the side effects will improve gradually.

If the client does not respond to the medication prescribed, a combination of medication and psychotherapy such as cognitive-behavioral therapy (CBT) may be suggested. If the condition persists, brain stimulation therapies such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) can be suggested. ECT and TMS are used if a patient is not responding to medication (Livingston et al., 2016). In ECT, an electrical current is used to impact the functioning of the brain and relieve depression, while for TMS treatment, a coil is placed on the scalp to send magnetic pulses and stimulate nerves in the brain that control mood and depression.

Paper For Above Instructions

Understanding and addressing major depressive disorder (MDD) in older adults, particularly in females, necessitates a careful examination of symptoms, potential treatments, and considerations unique to this demographic. This paper focuses on a 68-year-old female patient presenting with symptoms that suggest major depressive disorder and explores the implications of treatment through medication, psychotherapy, and stimulation therapies.

Overview of Major Depressive Disorder

Major depressive disorder is a significant mental health condition characterized by persistent sadness, loss of interest in activities, and a range of emotional and physical symptoms. In the elderly, these symptoms can manifest differently, often complicating diagnosis and treatment due to overlapping symptoms with typical aging or other medical conditions (Kumar & Vigil, 2020). In the case of our client, her symptoms included a disturbed sleep pattern, difficulties with concentration, anhedonia, low self-esteem, guilt, decreased appetite, and a disordered thought process—all of which align with the DSM-5 criteria for MDD.

Medication Management

An essential approach for managing MDD in this patient involves medication, with fluoxetine (Prozac) being the likely prescription. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is often chosen for elderly patients due to its favorable safety profile and lower incidence of side effects compared to older antidepressants (Peters et al., 2019). Research supports fluoxetine's efficacy in older adults, making it a suitable choice for this client, especially given the potential for improved mood and reduced depressive symptoms (Kashani et al., 2017).

When initiating treatment with fluoxetine, it is crucial for healthcare providers, particularly nurses, to educate patients about potential side effects. Clients should be informed about common side effects such as headaches, dizziness, upset stomach, and vomiting, and encouraged to report any new or worsening symptoms promptly. Adherence to prescribed dosages and timing of the medication is also critical to ensure its effectiveness.

Expected Outcomes and Follow-Up

It is generally expected that with consistent use of fluoxetine for about two months, notable improvements in the client's depressive symptoms should occur, both in frequency and severity (Trivedi et al., 2016). The adjustment period is crucial, as many patients may experience transient side effects as their bodies acclimate to the medication. Continuous monitoring and supportive follow-up care are integral to the treatment plan, ensuring patients feel supported and any concerns are addressed promptly.

Alternative and Adjunct Therapies

Should the client exhibit limited response to fluoxetine, it may be necessary to consider a combination of medication and psychotherapy—typically cognitive-behavioral therapy (CBT). CBT has been shown to be effective in treating older adults with depression by helping them reframe negative thought patterns and develop more effective coping strategies (Buckley et al., 2019).

In cases where both medication and psychotherapy do not yield significant improvements, brain stimulation therapies, such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS), come into play. ECT is particularly useful in severe cases where immediate intervention is required, utilizing electrical currents to stimulate brain function and alleviate depressive symptoms (Fava and Davidson, 2016). TMS, on the other hand, employs magnetic fields to stimulate nerve cells and is frequently used as a non-invasive option for patients who do not respond to traditional treatments (McClintock et al., 2017).

Conclusion

In conclusion, addressing major depressive disorder in older females like our client requires a nuanced approach that considers medical history, symptomatology, and individualized treatment plans. Fluoxetine represents a frontline pharmacological treatment option supported by research, and its administration must be accompanied by education, follow-up, and possible adjunctive therapies when necessary. A holistic approach, taking into account medication, psychotherapy, and, if needed, brain stimulation therapies, is essential for achieving the best outcomes in managing depression in this population.

References

• Buckley, J. P., et al. (2019). Cognitive Behavioral Therapy for Older Adults with Depression: A Meta-Analysis. Journal of Clinical Psychology, 75(4), 679-695.
• Fava, M., & Davidson, K. G. (2016). Definition and Epidemiology of Treatment-Resistant Depression. Psychiatric Clinics, 39(2), 273-279.
• Kashani, J. H., et al. (2017). The Efficacy of SSRIs for Depression in Older Adults: A Review of the Literature. The American Journal of Geriatric Psychiatry, 25(10), 1046-1059.
• Kumar, P., & Vigil, J. M. (2020). Assessment and Treatment of Depression in Older Adults: A Review. Psychiatric Services, 71(2), 135-142.
• Livingston, G., et al. (2016). A Systematic Review of the Efficacy of Brain Stimulation Therapies for Depression in Older Adults. British Journal of Psychiatry, 209(4), 333-335.
• McClintock, S. M., et al. (2017). The Efficacy of Transcranial Magnetic Stimulation in Major Depression: A Meta-Analysis and Systematic Review. Journal of Psychiatric Practice, 23(4), 301-313.
• Peters, D. M., et al. (2019). A Review of Pharmacological Interventions for the Treatment of Depression in Older Adults. Drugs & Aging, 36(7), 575-588.
• Trivedi, M. H., et al. (2016). Efficacy of Antidepressants in Older Adults: A Meta-Analysis. American Journal of Geriatric Psychiatry, 24(1), 33-42.