Psychiatric Nurse Practitioner
Psychiatric Nurse Practitioner
Respond of your colleagues who were assigned to a different case than you. Explain how you might apply knowledge gained from your colleagues’ case studies to you own practice in clinical settings as a Psychiatric Nurse Practitioner.
NOTE: Positive comment
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The three questions this writer would as the patient are:
Did your depressive symptoms worsen after the death of your husband?
How many hours per night do you sleep on average?
Do you sleep throughout those hours of sleep or do you wake constantly?
Do you ingest any stimulants like coffee or chocolate before bed?
Do you sleep during the daytime?
The rationale behind question one is to gauge the timeline of the patient’s depression. She appears to have been suffering with untreated depression for a long time, however the additional symptoms of insomnia and tearfulness seemed to worsen after his death. With this information the nurse practitioner will know if her depression is in an acute state and the severity of her illness.The patient is reporting sleeplessness; however the nurse practitioner needs to gauge if the patient is participating in restful sleep. Sleep of two hours or less may only consist of REM sleep (Boland et al., 2020). If the patient is not getting restful sleep, she is not benefiting from the bodily repair that takes place during sleep (Fitzgerald et al., 2017). This can place her at an increased risk for other illnesses and heighten depressive symptoms (Uchmanowicz et al., 2019).Knowing if the patient sleeps consistently throughout those hours of sleep will provide information to the nurse about the kind and amount of sleep the patient is getting. Ingesting certain stimulants like caffeinated drinks, coffee or chocolate can affects the client’s sleep by providing wakefulness (Ulke et al., 2017). If the patient is sleeping during the daytime, her circadian rhythm could have been reversed where she will need less sleep during the night time hours (Fitzgerald et al., 2017).
The people this writer would interview are:
The patient’s aide
The patient’s son
The patient aide may be able to provide more information about observed sleepiness during the daytime. In addition, she will be able to provide information on the patient’s dietary patterns and physical activity. The questions to the aide would be:
Does she easily nod off during the daytime?
Does she easily become fatigued?
Does she consume a well-balanced diet?
Question one would illicit answers about her getting sleep.
It appears that she in fact getting sleep but because of a revered circadian rhythm she is not able to get the sleep at the night which is the desired time. Question two will help the nurse practitioner gauge the extent of the effects that non sleep has taken on the patient’s life. The patient, if constantly fatigued throughout the day has a life that has been highly impacted by the lack of sleep. The aide would be able to provide a clear, picture of the patient’s diet. The aide would be able to reveal if the patient consumes a vast amount of sugar or caffeine which could interrupt sleep.
Questions to the son would surround the family’s psychiatric history. These questions will help the nurse practitioner construct the family history of the patient and rule out or consider familial history as a cause for her symptoms.
Can you recall any maternal family members with psychiatric disorders including depression and insomnia?
Did the symptoms start after the death of the client’s husband?
This would help the nurse practitioner rule out depressive symptoms as the cause of her insomnia.
Physical Examinations and Tests
Sleep Study:
Polysomnogram – The sleep study or polysomnogram measures the brain waves, blood oxygen, leg movements and breathing during sleep (Meghdadi et al., 2019). The Nurse Practitioner would be able to rule out physiological reason’s ad the cause for the patient’s insomnia.
Actigraphy: This is where a small device is worn on the wrist and it measures the person’s sleep wake cycle for a specified period (Meghdadi et al., 2019). This is convenient for this client and the Nurse Practitioner would be able to monitor the client’s sleep health and gauge the severity of the disruption of her sleep.The nurse practitioner could also physically examine the patient’s nares for septal occlusion.
