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Case study

Stacy Smith is a 28 year-old, single, black female who comes to the Employee Health Clinic

complaining of a migraine headache and fatigue. She has been an employee in the Information Technology Department for the past 6 years, having started immediately after graduating with honors from college. She is currently working as an interim department manager while her supervisor is out on medical leave. She lives alone in her own apartment, she often spends time by herself and stopped going to the gym saying ” I used to go to the gym 4 times a week but I don’t have any interest or motivation to go anymore”. She used to eat healthy foods but is eating a lot of fast food and has gained 10 pounds in the last month. Although she has experienced migraines on occasion in the past, they are now having more frequently (1-2 per week) and are becoming more severe (7/10 on a self-report of pain accompanied by nausea and light sensitivity). She has been feeling extremely stressed and fears being unable to cope with the responsibilities of her job. She has had several recent conflicts with the employees under her supervision. She is having increasing trouble sleeping and has recently begun to have 2 or 3 glasses of wine before going to bed every night. She feels edgy and destressed and wants to be given “something like Ativan” to help calm her nerves and get her through the day. She has no other medical problems and no known allergies.

Objectives

1. How would you communicate with a distraught client like Stacey? What communication techniques would be effective and why?

2. Stacey is diagnosed with a Major Depressive Disorder? Enumerate the signs and symptoms to support this diagnosis.

3. Complete the substance abuse assessment on the “hypothetical client” using the CAGE Questionnaire. (See questionnaire next page).

4. Complete the Zung Self-Rating Depression on a “hypothetical client” (See questionnaire next page).

5. What are the non-pharmacological interventions would you use to reduce the clients level of stress and why?

6. What are the psycho-pharmacological interventions for Stacey’s diagnosis (major depression), write the indication, side effects, adverse effects and nursing consideration.

SCIENCE
HEALTH SCIENCE
NURSING

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