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in this discussion please respond to discussion posts with substantial details that demonstrate an understanding of the concepts and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation.Share your opinions and comments,Do you agree ? Why? Discussion: 1.I cared for an elderly male patient in a Memory care unit facility. The man was thought to have dementia, given his forgetfulness and a family history of dementia. He would forget to take his medications and will often sit in a place for hours and would not eat his food; he was struggling with ADLs he usually does himself and would often appear altered. He became forgetful and aggressive, and it got worse as the months went by. Although he had days, he was happy, lucid, kind, and himself, but those days were few. Whenever he is lucid, he will ask questions about his family and how unhappy he is; he sometimes wishes he could just die. He would wallow so much self-pity that he stopped participating in his favorite activities. Upon medical assessment, it was diagnosed with major depressive disorder (MDD), and a consult was put in place to see a psychiatrist. The psychiatrist recommended psychotherapy and prescribed risperidone and sertraline to help manage his condition. Risperidone is used for mood and behavior, and sertraline is used for depression. According to American Psychology Association (2019), psychotherapy intervention and second-generation antidepressants (selective-serotonin reuptake inhibitors SSRIs, selective-norepinephrine reuptake inhibitors SNRIs or norepinephrine-dopamine reuptake inhibitors — NDRIs) are recommended treatment for depression in older adults.The psychiatrist declined to meet with him in person. All consults were virtual and lasted about 5 minutes. For a patient in his 60s, an in-person meeting would have been better. Many older generations find technology confusing, but he eventually got used to it because someone would stay with him while these sessions were ongoing.A nursing intervention led us to discuss his day and feelings. Although it seemed basic, but it worked like a miracle; he was excited that someone wanted to know about his day and how he was doing. Regular and scheduled activities benefited him; he was less lonely and participated in most activities. With the medications, psychotherapy, and scheduled activities, he became livelier and returned to his old self. The patient was made to feel safe in the facility and was given the care and support he needed 2. Working as an LPN, I have encountered many patients with mental health issues, but one particular patient stands out to me. My first job as an LPN was in a mental care facility. A young Hispanic patient in his mid-twenties was admitted to the facility following a maniac episode that resulted in an altercation with his mother. The patient had recently been diagnosed with bipolar disorder and Schizophrenia.  The patient was on several medications, and I don’t remember off hand what he was prescribed as it was quite a while ago. Although mood stabilizers like lithium and valproic acid, which is an anticonvulsant, are effective in reducing mania symptoms and mood swings (Smith, Robinson & Segal, 2019). Antipsychotics such as Seroquel or Abilify can also be used(Smith, Robinson & Segal, 2019).  One problem he faced after his diagnosis was the inability to continue his medication regimen despite the diagnosis. He would feel better and stop taking his medications. He was in denial and unwilling to accept that he had this disorder. He thought he could manage his condition without medication. Following several one-on-one talk therapy sessions, he became more receptive to understanding the diagnosis and was able to reconnect with his family finally. Eventually, he understood the medications were necessary to stabilize his mood and hallucinations. Keeping his environment calm was one intervention that worked for him. This prevented him from being overstimulated and having outbursts. Other interventions provided were psychological support and therapeutic communication. His trust in the staff at the facility helped him build a therapeutic relationship with them. After being admitted and taking his medication, he did not suffer mood swings or aggressive behaviors towards staff or other residents, as he initially did. I do feel that the patient was kept safe. The mental health facility was appropriate for him because the staff knew how to handle people with his disorder. The doctors, nurses, and social workers tried their best to help him understand his condition and why he felt the way he did. 3. Working as a TMS technician I have encountered this treatment not being beneficial to one of my patients who have bipolar disorder. TMS is a great treatment for those who suffer from depression, anxiety, OCD, PTSD, etc. But this specific patient was manic. The psychologist, medical doctor, and psychiatrist encouraged the patient to try TMS in the hope that it will help him but it did not. I took care of the patient for the first week and automatically reported to the medical doctor that TMS was not a good fit for the patient. Pt was speaking very quickly, aggressive, and easily distracted and there was no change in behavior after one week of treatment. That being said, the patient was sent to be evaluated and was sent impatient due to verbal aggression and behavior. Since this facility is only outpatient we are not equipped to have employees become supervisors, we do not have security to help with episodes of aggression and we do not have the room to bring a patient in when these episodes happen. That being said, I do feel like the client is safe and was sent to Alexian brother’s behavioral for better and higher help than what our facility can offer. I knew this was a better choice for the patient because then they would have been spending money on a service that was not going to benefit them.  4. Describe a client from your clinical setting or previous experience who experienced depression or mania. Include a brief history and 3-5 most pertinent medicationsMany patients I’ve worked with have suffered from mental illness, but none especially stand out to me. A patient who had just fallen was brought in for treatment. As a result of the bipolar condition, the patient experienced excessive mania. He was in his mid-to-late-50s, and he would suddenly start cursing and shouting at anybody who entered his room. Sometimes he’d seem cool as you walked in the door, but once he saw you, he’d explode with wrath and a barrage of insults directed toward the staff (Amatangelo, 2020).There were many drugs the patient was taking, and it has been so long since I wrote down the specifics that I have forgotten what they were. Antipsychotic drugs like Quetiapine (Seroquel) and Aripiprazole (Abilify) may be taken in addition to traditional mood stabilizers like Lithium or valproic acid (an anticonvulsant that has been demonstrated to alleviate manic symptoms and lessen mood swings).Identify one problem that was not resolved with the treatment regimen. What are the reasons it may not have been successful? Include nursing as well as other team members.Prescription adherence was one strategy that initially failed with this patient since he consistently refused to take his medication. When I first met the patient, I made sure they were in a comfortable place and then used communication techniques to help them heal. The few times I had to work while he was there, at least I could keep him from completely losing it. Last but not least, when he was in our care, we attempted a nursing intervention similar to this: “Relapse prevention planning entails the detection of early warning indicators; family members may be very useful here.” These first symptoms, such as elevated energy levels and a positive outlook, may need treatment, such as anti-manic medicine (Abreu, 2021). A practical solution was making sure she was in a soothing setting. Initially discharged from the hospital, she needed to avoid stimulation lest she has a manic episode. We painted her room a restful periwinkle color when she got home from school. Friends and relatives took the TV out of her room and tried to clear the clutter. It needed to be a calm and peaceful environment for her. After her discharge, we ensured she had a routine and wouldn’t feel overwhelmed.Overall, do you feel this client was kept safe? Why or why not? The patient was kept secure, at least not while he was alone. His history of medicine refusal, prescription skips, and verbal and physical abuse of others speaks volumes about his risk to those around him. The nursing school is no different from the others in that we cannot promise you a job at a particular healthcare institution upon graduation. There are several considerations, particularly on the part of our clinical partners, that must be taken into account when planning student rotations. As a result, the quality and quantity of your clinical encounters will vary depending on variables like the accessibility of nursing personnel and the severity of your patient’s conditions (Ruiz Hernández, 2021). Families benefit from intervention as well since it helps them learn how to meet their child’s individual requirements and helps them structure their child’s education in manageable chunks. Children like learning and are motivated to continue their education when they have clear goals, are able to achieve those goals, and have clear expectations for their performance. It is important for interventions to include several points of entrance and departure so that they may be tailored to each person’s specific situation. Students may advance more quickly if they participate in an intense, highly-effective program like Leveled Literacy Intervention (LLI). It is the way that is needed to be taken to resolve the issues (Chae, 2020).

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