Kasey is a 26-year-old male who is referred for emergency psychiatric evaluation in the local community emergency room
These symptoms indicate that Kasey is likely suffering from a depressive disorder, most likely related to his disconnection with others. We can also begin to address his feelings of hopelessness and worthlessness in therapy. You could start by providing antidepressants to help offset this depression, however we want to be certain that the medication is working before starting psychotherapy; in fact, some clinicians would argue that it is critical to evaluate the individual for suicidal intent first. Many people with depression do not actually have suicidal impulses; instead, the intense sadness about loss of what has been identified as “depressed behaviors” is prompted by a sense of isolation. This sense of isolation may stem from not having positive connections with family or friends, as was evident in Kasey’s case.
As the nurse completes her assessment of Kasey, she utilizes a number of assessment tools to determine the reason and extent of his psychiatric symptoms.
The suicide attempt, complicated grief, and depression are all psychiatric diagnoses that you need to determine if this 24-hour emergency admission is indicated for. You must consult with your resident to see if there are any acute medical problems that need to be addressed in addition to the psychological conditions.
I have been a practicing nurse since 1998, and since that time I have worked in various acute and outpatient mental health facilities. My specialty is in pediatrics and I am interested in the provision of psychiatric services to this population.
Kasey is a 26-year-old male who is referred for emergency psychiatric evaluation in the local community emergency room. His girlfriend came home from work unexpectedly and found him in the bathtub with multiple longitudinal cuts on both wrists. She called 911 and he was stabilized in the ED; the injuries were not serious, and now he is pending psychiatric evaluation. When the PMHNP came into the room, he noticed that Kasey unbuttoned and rebuttoned his shirt four times before settling down to the interview. He presented as depressed and tearful, and admitted to feelings of hopelessness and worthlessness. He admits that he doesn’t really feel connected to anyone; he has always been a loner, and last night he tried to kill himself because life just was not worth living. In addition to his suicidal ideation, the PMHNP recognizes that he needs to be further evaluated for: