NURS 3122 - Nursing Care Plans Exam Questions
With Complete Answers
Depression - Patient & Family, Assessment - ANSWER Patient Assessment:
(depends on the case study)
Symptoms of depression can vary among age groups, although irritability, sadness, and
anhedonia (inability to experience pleasure) are common at all ages.
Differences
include the following:
• Infants experiencing depression may fail to eat and grow.
• Toddlers can show regressive behaviors in toileting and
other activities.
• Preschoolers have less symbolic and other play activities, and demonstrate
self-destructive play themes. They may whine and show irritability, disinterest, and lack
of
confidence.
• School-age children may show a decrease in academic
performance, increased or decreased physical activity, somatic complaints, and loss of
friends.
The older school-age child may talk of running away or show signs of boredom and low
self-esteem.
• The adolescent can have a wide array of symptoms such as anxiety, decreased social
contact, poor school performance, lack of involvement in typical activities, poor
self-care, difficulty with parents and teachers, or focus on
violence.
Depression - Patient & Family, Priorities - ANSWER 1. Safety
2. Assess and monitor emotional state
3. Clinical therapy
,Depression - Analysis (what are the physiological implications of what you found?) -
ANSWER What is depression?
Psychological distress that can range from mild to severe.
What causes depression?
Theories have been proposed to explain the cause of depression in children and
adolescents. Depression may be biological in origin or a result of learned helplessness,
cognitive distortion, social skills deficit, or family dysfunction. The physiologic theory
focuses on monoamine neurotransmission. These amines include indolamine, serotonin,
norepinephrine, and dopamine, and decreases are sometimes found in depression.
Depression - Analysis (what are the physiological implications of what you found? 2 -
ANSWER Who is at risk?
Parental depression is a strong predictor of childhood depression. Abuse and neglect,
family conflict, parental death, and low socioeconomic status predispose children to
depression. Other psychiatric diagnoses are common in children with depression; these
include conditions such as ADHD, anxiety disorder, bipolar disease, or substance abuse
(Shatkin, 2015).
What are some clinical manifestations?
Characteristic findings of major depression in children and adolescents include
declining school performance, withdrawal from social activities, sleep disturbance
(either too much or too little), appetite disturbance (too much or too little), multiple
somatic complaints (especially headaches and stomachaches), decreased energy,
difficulty concentrating and making decisions, low self-esteem, and feelings of
hopelessness. There is much variation among children in the symptoms displayed, and
they often have
some but not all of the major criteria.
Depression - Plan/Goals
must be STROMMC
(singular, client centered, time-limited, observable, realistic, mutual, measurable) -
ANSWER If we want to target safety: We want to ensure that the child remains free from
self-harm and injury throughout the shift.
If we want to assess and monitor mental status: Regularly assess the child's mood,
affect, and emotional well-being. Use the appropriate screening tool according to age.
, If we want to target clinical therapy: ensure that the child will take prescribed
medication on time and without resistance throughout the shift. If the child is prescribed
antidepressants or other medications, it's important to ensure adherence and monitor
for side effects.
Depression - Interventions or Implementation
Focused on Nursing Scope and with rationale for interventions - ANSWER Safety
interventions:
Assess the child for signs of suicidal ideation or self-harm behaviors.
Maintain a safe environment (e.g., remove harmful objects).
Establish a suicide prevention plan if necessary.
Monitor the child closely, especially during high-risk times (after stressful events or
changes in mood).
Mental status interventions:
Use tools like mood charts or age-appropriate depression screening instruments.
Ask about feelings of sadness, irritability, or hopelessness.
Monitor for changes in mood, energy levels, or behavior.
Once depression or major depressive disorder is diagnosed, comprehensive
assessment of the child should occur to rule out physical illness that can be linked to
depressive symptoms, such as diabetes, cancer, and obesity (U.S. Preventive Services
Task Force, 2016).
Clinical therapy interventions:
Educate the family about prescribed medications, including potential side effects.
Monitor the child for adverse reactions, such as changes in behavior, sleep, or appetite.
Ensure the family follows up with the prescribing physician regularly.
Depression - Evaluation (expectations-what do you expect your interventions will
achieve and why) - ANSWER The child is expected to follow prescribed therapies,
including medications, counseling sessions, and any specific treatment interventions
like cognitive-behavioral therapy (CBT) or family therapy.
Over time, the child is expected to demonstrate an improvement in depressive
symptoms, such as reduced sadness, irritability, or withdrawal. This is measured
With Complete Answers
Depression - Patient & Family, Assessment - ANSWER Patient Assessment:
(depends on the case study)
Symptoms of depression can vary among age groups, although irritability, sadness, and
anhedonia (inability to experience pleasure) are common at all ages.
Differences
include the following:
• Infants experiencing depression may fail to eat and grow.
• Toddlers can show regressive behaviors in toileting and
other activities.
• Preschoolers have less symbolic and other play activities, and demonstrate
self-destructive play themes. They may whine and show irritability, disinterest, and lack
of
confidence.
• School-age children may show a decrease in academic
performance, increased or decreased physical activity, somatic complaints, and loss of
friends.
The older school-age child may talk of running away or show signs of boredom and low
self-esteem.
• The adolescent can have a wide array of symptoms such as anxiety, decreased social
contact, poor school performance, lack of involvement in typical activities, poor
self-care, difficulty with parents and teachers, or focus on
violence.
Depression - Patient & Family, Priorities - ANSWER 1. Safety
2. Assess and monitor emotional state
3. Clinical therapy
,Depression - Analysis (what are the physiological implications of what you found?) -
ANSWER What is depression?
Psychological distress that can range from mild to severe.
What causes depression?
Theories have been proposed to explain the cause of depression in children and
adolescents. Depression may be biological in origin or a result of learned helplessness,
cognitive distortion, social skills deficit, or family dysfunction. The physiologic theory
focuses on monoamine neurotransmission. These amines include indolamine, serotonin,
norepinephrine, and dopamine, and decreases are sometimes found in depression.
Depression - Analysis (what are the physiological implications of what you found? 2 -
ANSWER Who is at risk?
Parental depression is a strong predictor of childhood depression. Abuse and neglect,
family conflict, parental death, and low socioeconomic status predispose children to
depression. Other psychiatric diagnoses are common in children with depression; these
include conditions such as ADHD, anxiety disorder, bipolar disease, or substance abuse
(Shatkin, 2015).
What are some clinical manifestations?
Characteristic findings of major depression in children and adolescents include
declining school performance, withdrawal from social activities, sleep disturbance
(either too much or too little), appetite disturbance (too much or too little), multiple
somatic complaints (especially headaches and stomachaches), decreased energy,
difficulty concentrating and making decisions, low self-esteem, and feelings of
hopelessness. There is much variation among children in the symptoms displayed, and
they often have
some but not all of the major criteria.
Depression - Plan/Goals
must be STROMMC
(singular, client centered, time-limited, observable, realistic, mutual, measurable) -
ANSWER If we want to target safety: We want to ensure that the child remains free from
self-harm and injury throughout the shift.
If we want to assess and monitor mental status: Regularly assess the child's mood,
affect, and emotional well-being. Use the appropriate screening tool according to age.
, If we want to target clinical therapy: ensure that the child will take prescribed
medication on time and without resistance throughout the shift. If the child is prescribed
antidepressants or other medications, it's important to ensure adherence and monitor
for side effects.
Depression - Interventions or Implementation
Focused on Nursing Scope and with rationale for interventions - ANSWER Safety
interventions:
Assess the child for signs of suicidal ideation or self-harm behaviors.
Maintain a safe environment (e.g., remove harmful objects).
Establish a suicide prevention plan if necessary.
Monitor the child closely, especially during high-risk times (after stressful events or
changes in mood).
Mental status interventions:
Use tools like mood charts or age-appropriate depression screening instruments.
Ask about feelings of sadness, irritability, or hopelessness.
Monitor for changes in mood, energy levels, or behavior.
Once depression or major depressive disorder is diagnosed, comprehensive
assessment of the child should occur to rule out physical illness that can be linked to
depressive symptoms, such as diabetes, cancer, and obesity (U.S. Preventive Services
Task Force, 2016).
Clinical therapy interventions:
Educate the family about prescribed medications, including potential side effects.
Monitor the child for adverse reactions, such as changes in behavior, sleep, or appetite.
Ensure the family follows up with the prescribing physician regularly.
Depression - Evaluation (expectations-what do you expect your interventions will
achieve and why) - ANSWER The child is expected to follow prescribed therapies,
including medications, counseling sessions, and any specific treatment interventions
like cognitive-behavioral therapy (CBT) or family therapy.
Over time, the child is expected to demonstrate an improvement in depressive
symptoms, such as reduced sadness, irritability, or withdrawal. This is measured
