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DISCUSSION POST # 1 Reply to Moruph
A difficult case this week is about a patient who presented with ongoing chronic depression. At the start of the case, the MD told me during our briefing that the patient was severely depressed. At first, we thought he might decline to have a student in the room when the medical assistant went to seek his consent. However, he said yes-he was okay with having a student. I then looked up his medical record and utilized Epocrates to look up depression. I also used my textbook and other online resources and one of the non-pharmacological recommendations is to engage in talk therapy.
What makes this patient an interesting case to me is that I still remember how he was shaking with repetitive leg movements as he sat on the examination table. I empathize with him. In addition, he was saying, “I am not okay that sometimes I don’t do my ADLs, and it’s hard for me to get out of bed in the morning.”
According to Belsiyal et al., (2022), depression can be devastating in older adults because it affects their quality of life. This patient’s quality of life has been affected by depression. He also said that he was sad because his wife and his mother-in-law, who lives with them always speak a foreign language in the house and he doesn’t know what they are saying in their conversation. And I started asking him questions. I asked, “What do you think caused your depression? He said that it’s his family’s finances that he is worried about, and he thinks he was the cause of his family’s financial problems.
I asked him, “Why do you think you caused it? He said, “I am supposed to protect my family, but I made a bad financial decision”. I also asked him, “What do you do for fun? He said I don’t do anything. I then asked him, “If his wife or son asked you to go out to eat in a restaurant, would you go with them?” He said yes, he would go but he just turned his wife down yesterday when he asked him to go out with her. Then he said, “This is a very interesting student, no one has ever asked all these questions before”. ‘This is the most I would ever talk about at a doctor’s visit”. In other words, he said that I was able to elicit more information from him. If I were to see the patient again, I would not do anything differently because I think the talk therapy helped him to feel relief by getting some of his feelings all out.
DISCUSSION POST # 2 Tiffany
In this particular instance, I was helping a male patient who was 45 years old and was taken to the hospital with an aggravation of chronic obstructive pulmonary disease (COPD) brought on by his smoking. The patient’s smoking history spanned 30 packs a year, and he had tried and failed to quit smoking in the past. The medication-assisted treatment, cognitive-behavioral therapy, and nicotine replacement therapy were all components of the all-encompassing smoking cessation strategy that the nurse practitioner devised. The patient was given information on the negative impacts of smoking as well as the positive outcomes of stopping smoking. In order to provide assistance for the implementation of the smoking cessation program, I utilized evidence-based guidelines. The most recent research on smoking cessation was used as the basis for the development of these guidelines, which included the use of medication-assisted treatment, cognitive-behavioral therapy, and nicotine replacement therapy. A referral to a community-based smoking cessation program was also provided to the patient as part of the treatment. After being discharged, the patient was followed up on, and aftera few weeks, the patient stated that he had stopped smoking, that his COPD symptoms had improved, and that his quality of life had improved. I used evidence-based practice to build an all-encompassing smoking cessation plan for the patient that was customized to meet the patient’s requirements and fulfill their preferences. Along with receiving instruction and assistance throughout the process, the patient was also presented with a plan that was developed using the most latest findings from research on how to quit smoking. In conclusion, evidence-based practice is necessary in the field of healthcare in order to guarantee that patients receive the highest standard of care that is also the most time and resource efficient. In order to give the best possible care to our patients, nurses and other medical professionals need to be current on the most recent medical research and treatment standards. This case demonstrates the significance of evidence-based practice in the field of smoking cessation therapy and the beneficial effect that practice can have on patient outcomes(Mallampalli, 2021).