NUR 2407 Assignment Case Study Depression

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NUR 2407 Assignment Case Study Depression

NUR 2407 Assignment Case Study Depression

The following patient comes to the college health center:
R.J. is a 21 year-old female college student earning her Master’s Degree in
Electrical Engineering and is one of three females in the cohort of 80 males.
This past semester she felt she was “stressed-out”. She was not sleeping well
at night, due to worry about her assignments. This causes her to fall asleep
during the day and miss class. She has lost her motivation to complete her
assignments and has episodes of crying “Because she is going to disappoint her
parents.” She denies thoughts of suicide, but has started drinking a a shot of
alcohol at night to see if it helps her sleep.

R.J. is referred to a
counseling center

The prescriber on duty is
considering starting R.J. on amitriptyline, fluoxetine, or venlafaxine


Explain the pathophysiology of

Name three nursing priorities?

List a short-term (during the
visit) and a long-term (within one Module) SMART goal for the patient?

What is the classification,
action, and therapeutic effect (reason) for each medications?

List drug interactions or
contraindications to be concerned about for each drug?

What adverse effects/side
effects does the nurse need to monitor for each medication?

Would a monoamine oxidase

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inhibitor be appropriate for this patient? Why or why not?

This clinical case study regards a 22-year-old male who suffers from depression. This client was chosen for this case study since he presented with issues of adult depression, a disorder for which the use of cognitive-behavioral theory with brief treatment has been shown to be effective. The use of a cognitive perspective allows for the inclusion of emotional and behavioral reactions in the change process. Cognitive-behavioral therapy concepts and procedures are short-term, problem focused, and straightforward. The goal of this therapy is to change dysfunctional thoughts, replacing them with positive and coping thoughts which then changes negative emotional and behavioral reactions. Although this approach is problem oriented rather than based on psychodynamic aspects, a review of early and current attachment processes can assist in uncovering resulting dysfunctional thoughts and emotions (Shean, 2003). Thus the case study will utilize the theoretical approaches of Beck’s cognitive-behavioral theory and treatment, Greenberg’s emotion-focused theory of emotional schemas and treatment, and Bowlby’s attachment theory. Presentation of a brief therapy approach allows for a more comprehensive examination of therapy sessions and their content. This analysis further allows for examination of the application of theory within the sessions and the session outcomes.

The client referenced above, Angel, is of average height and weight. He arrived promptly for all evaluation sessions appropriately dressed and well groomed. However, he appeared downtrodden, walked with his head down, and avoided direct eye contact. In general, the client presented as reserved and cooperative with polite demeanor and related in a candid manner. Rapport was easily established even though eye contact was avoided. Throughout the evaluation process Angel remained responsive and clearly concerned with answering all questions as honestly as possible.

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