A nurse is providing social support and counseling to an older adult client who has depression and lives alone.
Which of the following interventions would be most appropriate for the nurse to implement?
Encourage the client to join a support group or a community center for older adults.
Arrange for home health care services or respite care for the client.
Educate the client about the signs and symptoms of depression and when to seek help.
Refer the client to a psychiatrist or a psychologist for further evaluation and treatment.
All of the above.
The Correct Answer is E
The correct answer is E.
All of the above.
Here is why:.
• Encouraging the client to join a support group or a community center for older adults is an appropriate intervention because it can help the client reduce social isolation, increase social support, and enhance self-esteem and coping skills.
• Arranging for home health care services or respite care for the client is an appropriate intervention because it can help the client maintain independence, safety, and quality of life at home, as well as provide relief for caregivers who may be stressed or overwhelmed.
• Educating the client about the signs and symptoms of depression and when to seek help is an appropriate intervention because it can help the client recognize and monitor their own mental health status, increase their awareness of available resources, and empower them to seek professional help when needed.
• Referring the client to a psychiatrist or a psychologist for further evaluation and treatment is an appropriate intervention because it can help the client access evidence-based pharmacological and psychological therapies for depression, such as antidepressant medications and cognitive-behavioral therapy.
Choice A is wrong because it is not enough to address the multifaceted needs of older adults with depression.
Choice B is wrong because it does not address the psychological aspects of depression.
Choice C is wrong because it does not address the social aspects of depression.
Choice D is wrong because it does not address the physical aspects of depression.
Normal ranges for depression screening tools vary depending on the tool used, but generally a higher score indicates a higher risk or severity of depression. For example, on the Geriatric Depression Scale (GDS), a score of 0 to 4 indicates normal mood, 5 to 8 indicates mild depression, 9 to 11 indicates moderate depression, and 12 or more indicates severe depression. On the Nurses’ Global Assessment of Suicide Risk (NGASR), a score of 0 to 3 indicates low risk, 4 to 6 indicates moderate risk, 7 to 9 indicates high risk, and 10 or more indicates extreme risk.
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Correct Answer is E
Explanation
The correct answer isE.
All of the above.
Here is why:.
• Choice A is wrong because antidepressant medications usually takeseveral weeksto show their full effects on mood and functioning.
Telling the client that they should start feeling better within a few days might create unrealistic expectations and discourage adherence to the treatment plan.
• Choice B is correct because alcohol can interact with antidepressant medications and cause adverse effects such as increased sedation, impaired coordination, increased risk of bleeding, and decreased effectiveness of the medication.
The client should avoid drinking alcohol while taking this medication to prevent these complications and optimize their recovery.
• Choice C is correct because stopping antidepressant medications abruptly can cause withdrawal symptoms such as nausea, headache, dizziness, anxiety, and mood swings.
The client should not stop taking this medication without consulting their doctor, who can advise them on how to taper off the medication safely and monitor their response.
• Choice D is correct because some antidepressant medications can cause stomach upset, nausea, or vomiting as side effects.
The client should take this medication with food to prevent or reduce these symptoms and improve their tolerance of the medication.
Therefore, the nurse should include all of these statements when providing psychoeducation to the client who has depression and is prescribed an antidepressant medication.
Correct Answer is E
Explanation
The Geriatric Depression Scale (GDS) is a screening tool used to identify symptoms of depression in older adults.
It was originally developed by J.A.Yesavage and colleagues in 1982.
It consists of questions that assess a person’s level of enjoyment, interest, social interactions, and more.
• Choice A is correct because the GDS consists of 30 yes/no questions that assess the client’s mood and cognitive function.
• Choice B is correct because the GDS has a cut-off score of 10, indicating a high risk of depression.A score of 0 to 9 indicates normal mood, while a score of 10 to 19 indicates mild depression and a score of 20 to 30 indicates severe depression.
• Choice C is correct because the GDS can be administered by the nurse, the client or a family member.
The GDS is a self-report instrument that uses a “yes/no” format, which makes it easy to complete by different people.
• Choice D is correct because the GDS takes about 15 minutes to complete and score.The GDS is a brief and simple tool that can be used in various settings, such as acute, long-term, and community settings.
• Choice E is correct because it summarizes all the previous choices.
Therefore, the GDS is a valid and reliable tool for screening depression in older adults.It has several advantages, such as being specific for psychiatric rather than somatic symptoms, being appropriate for healthy as well as medically ill adults and those with mild to moderate cognitive impairments, and being available in different forms and languages.
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