NURS 6501 Final Exam Review Guide (Weeks 7-11) Walden University

What is the role of the primary care provider in mental health? - - Screen for mental health issues - Improve outcomes and reduce health care costs - Assess and give care to mild-moderate disorders or patients with stable severe mental disorders - From strong links with mental health specialty care for complex cases Sharing patient info (ex: meds used) about PHQ2 - what does it screen for, what are the questions, scoring - - Screens for MDD - It is the first two questions of the PHQ9 - In the last two week, have you been feeling these (not at all, several days, more than half the day, nearly everyday): - Little interest or pleasure in doing things? - Feeling down, depressed, or hopeless? Scoring: A single yes or score >3 (out of 0-6) = possible clinical depression ⇒ due the PHQ9 If the pt screens (+) ⇒ continue to eval with the PHQ9 about PHQ9 - what its used for, questions, scoring - Used for screening, diagnosing, and treating - It asks about functioning impairments which is needed for the DSM-based diagnosis Includes asking about suicide or hurting self Scoring: 0-27 available 0-4: Minimal/none Monitor; may not require treatment 5-9: Mild Use clinical judgment; follow-up in one month 10-14: Moderate Use clinical judgment; may need meds if functionally impaired 15-19: Moderately Severe Warrants active treatment with psychotherapy, meds, or combo 20-27: Severe Warrants active treatment with psychotherapy, meds, or combo What is the appropriate initiation dose for fluoxetine for adults and geriatric adults? - 20mg PO once daily in the AM - May ↑ daily dose after several weeks if inadequate response