Depression/Overdose with Psychosis
UNFOLDING Reasoning
Jenna Taylor, 18 years old
Primary Concept
Mood and Affect
Interrelated Concepts (In order of emphasis)
1. Safety
2. Psychosis
3. Clinical Judgment
4. Communication
5. Collaboration
© 2016 Keith Rischer/www.KeithRN.com
This study source was downloaded by 100000836546216 from CourseHero.com on 06-11-2022 06:11:51 GMT -05:00
https://www.coursehero.com/file/129480992/Keith-RN-Case-Study-Depression-Psychosis-OD-Unfolding-Reasoning28992pdf/
, Depression/Overdose with Psychosis
History of Present Problem:
Jenna Taylor is an 18-year-old woman who is brought to the emergency department by ambulance after she admitted to
her mother that she had taken a “handful” of dextroamphetamine/amphetamine (Adderall) this morning. Mom noted that
there are 20 tablets missing. Jenna admits that she has been hearing voices telling her that she is worthless and would be
better off dead. She denies visual hallucinations.
As the primary nurse explores these comments further, Jenna states, “The devil is in the place! I can feel it! The
voices are telling me that I am going to hell forever.” Jenna appears fearful, anxious and does not maintain eye contact.
When she briefly glances and looks your way, she appears to be looking through you.
Personal/Social History:
She was hospitalized three weeks ago for depression and suicidal ideation and was discharged ten days ago. Jenna lives
with her mother. Her parents were divorced 12 years ago. She graduated from high school, has few close friends, and has
no current plans for her future.
What data from the histories is RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Patient has taken a handful of Adderall The patient has taken more than the appropriate dosage of
the medication, which can pose a high risk for their health
Patient is hearing voices and overall well being. The patient can overdose and
expereience toxic effects.
Patient is appearing fearful, anxious, The patient is hearing voices and is a concern because it can
and has limited eye contact. cause the patient to be a danger to themselves or others.
With the patient being fearful and anxious, it may be harder
to understand what they are going through and be difficult to
treat
RELEVANT Data from Social History: Clinical Significance:
Hospitalized three weeks ago for The patient was hospitalized for suicidal ideation which is
depression and sucicidal ideation signifigant to know because it can alert the care takers to
keep the patient on a one on one monitor for their safety.
Divorced parents It is important to note that the patient has divorced parents
because it can be an added stressor in their life.
No current plans for the future No current plans for the future is also signifigant because the
patient does not seem to care about the future or their overall
well-being, which can be dangerous to their health.
What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds?
(Which medication treats which condition? Draw lines to connect.)
PMH: Home Meds: Pharm. Classification: Expected Outcome:
Attention deficit 1. Dextroamphetamine/amphetamine XR 1. CNS Stimulants 1. Treats ADHD by
hyperactivity 20 mg PO daily 2. Benzodiazapam allowing patient to
disorder (ADHD) 2. Clonazepam 0.5 mg PO BID 3. Anti depressant focus on tasks.
Depression with 3. Bupropion HCL SR 100 mg PO BID 2. Patient will have a
psychosis decrease in anxiety
Anxiety attacks
3. Patient will have a
decrease in
anhedonia.
One disease process often influences the development of other illnesses. Based on your knowledge of
pathophysiology, (if applicable), which disease likely developed FIRST, then initiated a “domino effect” in Jenna’s
life?
Circle the PMH problem that likely started FIRST.
Underline at PMH problem(s) FOLLOWED as domino(s).
© 2016 Keith Rischer/www.KeithRN.com
This study source was downloaded by 100000836546216 from CourseHero.com on 06-11-2022 06:11:51 GMT -05:00
https://www.coursehero.com/file/129480992/Keith-RN-Case-Study-Depression-Psychosis-OD-Unfolding-Reasoning28992pdf/
UNFOLDING Reasoning
Jenna Taylor, 18 years old
Primary Concept
Mood and Affect
Interrelated Concepts (In order of emphasis)
1. Safety
2. Psychosis
3. Clinical Judgment
4. Communication
5. Collaboration
© 2016 Keith Rischer/www.KeithRN.com
This study source was downloaded by 100000836546216 from CourseHero.com on 06-11-2022 06:11:51 GMT -05:00
https://www.coursehero.com/file/129480992/Keith-RN-Case-Study-Depression-Psychosis-OD-Unfolding-Reasoning28992pdf/
, Depression/Overdose with Psychosis
History of Present Problem:
Jenna Taylor is an 18-year-old woman who is brought to the emergency department by ambulance after she admitted to
her mother that she had taken a “handful” of dextroamphetamine/amphetamine (Adderall) this morning. Mom noted that
there are 20 tablets missing. Jenna admits that she has been hearing voices telling her that she is worthless and would be
better off dead. She denies visual hallucinations.
As the primary nurse explores these comments further, Jenna states, “The devil is in the place! I can feel it! The
voices are telling me that I am going to hell forever.” Jenna appears fearful, anxious and does not maintain eye contact.
When she briefly glances and looks your way, she appears to be looking through you.
Personal/Social History:
She was hospitalized three weeks ago for depression and suicidal ideation and was discharged ten days ago. Jenna lives
with her mother. Her parents were divorced 12 years ago. She graduated from high school, has few close friends, and has
no current plans for her future.
What data from the histories is RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Patient has taken a handful of Adderall The patient has taken more than the appropriate dosage of
the medication, which can pose a high risk for their health
Patient is hearing voices and overall well being. The patient can overdose and
expereience toxic effects.
Patient is appearing fearful, anxious, The patient is hearing voices and is a concern because it can
and has limited eye contact. cause the patient to be a danger to themselves or others.
With the patient being fearful and anxious, it may be harder
to understand what they are going through and be difficult to
treat
RELEVANT Data from Social History: Clinical Significance:
Hospitalized three weeks ago for The patient was hospitalized for suicidal ideation which is
depression and sucicidal ideation signifigant to know because it can alert the care takers to
keep the patient on a one on one monitor for their safety.
Divorced parents It is important to note that the patient has divorced parents
because it can be an added stressor in their life.
No current plans for the future No current plans for the future is also signifigant because the
patient does not seem to care about the future or their overall
well-being, which can be dangerous to their health.
What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds?
(Which medication treats which condition? Draw lines to connect.)
PMH: Home Meds: Pharm. Classification: Expected Outcome:
Attention deficit 1. Dextroamphetamine/amphetamine XR 1. CNS Stimulants 1. Treats ADHD by
hyperactivity 20 mg PO daily 2. Benzodiazapam allowing patient to
disorder (ADHD) 2. Clonazepam 0.5 mg PO BID 3. Anti depressant focus on tasks.
Depression with 3. Bupropion HCL SR 100 mg PO BID 2. Patient will have a
psychosis decrease in anxiety
Anxiety attacks
3. Patient will have a
decrease in
anhedonia.
One disease process often influences the development of other illnesses. Based on your knowledge of
pathophysiology, (if applicable), which disease likely developed FIRST, then initiated a “domino effect” in Jenna’s
life?
Circle the PMH problem that likely started FIRST.
Underline at PMH problem(s) FOLLOWED as domino(s).
© 2016 Keith Rischer/www.KeithRN.com
This study source was downloaded by 100000836546216 from CourseHero.com on 06-11-2022 06:11:51 GMT -05:00
https://www.coursehero.com/file/129480992/Keith-RN-Case-Study-Depression-Psychosis-OD-Unfolding-Reasoning28992pdf/
