A nurse is assessing a patient with major depressive disorder (MDD). Which assessment tool can the nurse use to measure the severity and impact of depression on the patient’s functioning?

Choice A rationale:

The patient's thought content and organization. Rationale: While monitoring thought content and organization is important in psychiatric assessment, it is not directly related to observing and documenting the patient's mood state. Thought content and organization involve assessing the coherence, relevance, and logic of the patient's thoughts, which can provide insights into their cognitive functioning and potential psychiatric conditions like schizophrenia.

Choice B rationale:

The patient's physical vital signs and laboratory tests. Rationale: This choice is unrelated to the assessment of the patient's mood state. Vital signs and laboratory tests are essential in medical assessments, but when evaluating a patient with bipolar disorder, the focus should be on their psychological and emotional state rather than physical parameters.

Choice C rationale:

The patient's cognitive abilities, memory, and concentration. Rationale: While cognitive abilities, memory, and concentration are important factors to consider in a comprehensive mental status assessment, they are distinct from the patient's mood state. Cognitive assessment provides information about cognitive impairments that might accompany mood disorders, but it does not directly reflect the patient's current emotional state.

Choice D rationale:

The patient's mood state, such as euphoric, irritable, depressed, or mixed. Rationale: This statement is correct. Assessing and documenting the patient's mood state is crucial when evaluating individuals with bipolar disorder. The mood state can provide valuable information about the phase of the disorder (e.g., manic, hypomanic, depressive) and guide treatment decisions. Mood variations are a hallmark of bipolar disorder, and accurately identifying the patient's mood at the time of assessment is essential for effective care.

Choice A rationale:

Taking the medication with alcohol is not recommended. Alcohol can interact negatively with antidepressants, including SSRIs (Selective Serotonin Reuptake Inhibitors). It can increase the risk of side effects and potentially reduce the effectiveness of the medication. In some cases, alcohol can also worsen depression symptoms.

Choice B rationale:

Avoiding taking the medication with food is not the best advice. While some medications might require specific instructions regarding food intake, SSRIs are generally taken with food to help minimize potential stomach upset. Therefore, instructing the client to take the medication with food would be more appropriate.

Choice C rationale:

(Correct Choice) Instructing the client to report any side effects or suicidal thoughts is crucial when starting antidepressant treatment. SSRIs and other antidepressants can have side effects, some of which might be serious or bothersome. Additionally, there's a potential risk of increased suicidal ideation, especially in the initial stages of treatment. Monitoring for any changes in mood, behavior, or physical symptoms is important for ensuring the client's safety.

Choice D rationale:

Stopping the medication if symptoms improve within a week is not recommended. It takes time for antidepressants to start showing their full effects. Improvements within the first week are unlikely to be significant, and stopping the medication abruptly can lead to a recurrence of symptoms or even withdrawal effects. The client should be advised to continue taking the medication as prescribed and to follow up with their healthcare provider if there are concerns.