NSG 306 Mental Health Case Study Scenario: Mrs. A. V. is an 80 y/o female who was admitted to the medical unit for the treatment of DKA. Her serum blood glucose has now stabilized and trends around 200 mg/dL. The physician has placed in orders for her to be discharged. You are the nurse caring for the patient and preparing the discharge packet with patient education materials. Mrs. A. V. has been inquiring about a list of various food suggestions because she wants to adopt healthier eating habits. As you enter the room and begin to provide education on the various types of recommended foods, Mrs. A. V. begins to become teary-eyed and sobs. She states, “My husband…he used to be the one who cooked for me all the time.” 1. What would be an appropriate response to her statement? Mrs. A. V. shares that her husband passed away 6 months ago from a heart attack. She cries even more and begins to turn away and place herself into fetal position with the blanket over her head. 2. What are some appropriate steps for you to take next? Explain at least 5 of the therapeutic communication techniques you can utilize at this time. When listing the techniques, provide an example of how you would use it in this case with Mrs. A. V. 3. Explain at least 5 non-therapeutic communication approaches that you would avoid using. 4. What do you suspect Mrs. A. V. could be dealing with? What questions would you ask to further support your inference? Mrs. A. V. then begins to tell you that she does not have many friends left, because most of them have passed away. She has a daughter with two grandchildren, but they live in out of state. She states she has been feeling very down these last few months and has had thoughts of harming herself. 5. What would be your response at this time? What are some priorities? Provide rationales as appropriate. 6. What characteristics place Mrs. A. V. at risk for suicide? 7. List at least five common signs of depression. 8. What are the pharmacological treatment options available? List at least two medication choices for Mrs. A. V. considering her age and background. When listing medications, provide class, mechanism of action, side effects, adverse effects, nursing considerations, and patient teaching. 9. What other treatment is appropriate at this time? List at least one type of treatment – explain what it is and your rationale for choosing it. 10. Would Mrs. A. V. be a candidate for electroconvulsive therapy? Why or why not?