Mrs. Jones, 78 years old, arrived in the emergency department (ED) via ambulance. She was alert and oriented, but was having episodes of lost consciousness. She was put on the cardiac monitor and her vital signs were obtained. Her cardiac rhythm was normal. Her vital signs were as follows: Temperature 97.3°F, Pulse 43, respirations 26, blood pressure 100/58 and O2 saturation of 94% on room air. Additionally, Mrs. Jones was vomiting and had 2 loose, incontinent stools. She was pale, cool to touch and diaphoretic. Auscultation of her lungs revealed expiratory wheezes.
Her brother reported finding her in her living room on the couch. He reported that she was difficult to rouse, and becoming concerned, he called 911. Prior to the ambulance arriving, Mrs. Jones vomited several times and her brother noted a significant amount of partly dissolved pills in the emesis. Upon checking her medicine cabinet, he found several prescription bottles empty and some over the counter medications open in the cabinet. He brought these medication bottles to the ED. Poison control was contacted and they recommended giving her activated charcoal to absorb the medications. The charcoal was offered and Mrs. Jones refused, stating that she wanted no treatment and had attempted to kill herself for a reason.
Upon speaking to her brother, it was learned that her husband had died about one year earlier and that she had several new diagnoses in the last few months; including: Diabetes mellitus, anorexia (with marked weight loss), sleep disturbances, and mild dementia. She had been having difficulty with the management of these new illnesses and was still grieving for her husband.
Because it was an attempted suicide, a crisis management team was c...
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...e depression from dementia. The Nurse
Practitioner, 28(3), 18-27. Retrieved from www.tnpj.com on 2/19/04.
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risk factors and approaches to prevention. Pediatric Drugs, 5 (4), 243-265.
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antidepressants among US youths. Pediatrics, 109 (5), 721-727. Retrieved via Academic Search Primer on 3/25/04. http://web3.epnet.com
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
There was probable evidence that Mollie’s caretaker withdrew care without making alternative arrangements (Fulmer, 2008). The findings indicate that Molly remained alone for many hours on end, without food or water and without a method of contacting anyone for assistance. Mollie’s hypertension and diabetes were not monitored. Medications were not administered.
Mrs. A is a 71-year-old widow with CCF and osteoarthritis who has recently been exhibiting quite unusual behavior. Her daughter is concerned about her mother 's ability to remain independent and wishes to pursue nursing home admission arrangements. She fears the development of a dementing illness. Over the last two to three months Mrs. A has become confused, easily fatigued and very irritable. She has developed disturbing obsessive/compulsive behavior constantly complaining that her lace curtains were dirty and required frequent washing. Detailed questioning revealed that she thought they were yellow-green and possibly moldy. Her prescribed medications are:
Depression is becoming more common among adults due to the stresses that accompany everyday living. Along with the increasing numbers of adults suffering from depression, an ongoing rise in depression among the youth is also becoming a growing concern. Depression induced by peer pressure, bullying or other stresses can contribute to the growing numbers of adolescents taking antidepressants. According to Dr. Vincent Iannelli, there is an estimate that 3 percent of children and about 12 percent of teens suffer from depression. What most people are misinformed about is that they believe that antidepressants will prevent users from having depression or stop it completely. This is a misconception about antidepressants that can be misleading. The idea of taking a supplement to combat an internal emotional conflict should be severed out as a means of treatment unless ultimately necessar...
...g. Due to all of the different weird “treatments” that her husband, John, made her do she became crazy. The story starts out with her talking about the illness. “John is a physician, and perhaps—(I would not say it to a living soul, of course, but this is dead paper and a great relief to my mind--) perhaps that is one reason I do not get well faster. You see he does not believe I am sick! And what can one do? If a physician of high standing, and one’s own
Waters, Rob. “Antidepressants May Cause Suicide and Violent Behavior in Children and Teenagers.” Treating the Mentally Ill. Ed. Kyla Stinnett, San Diego: Greenhaven Press, 2004. Web. 28 Jan. 2014
In her paper entitled "Euthanasia," Phillipa Foot notes that euthanasia should be thought of as "inducing or otherwise opting for death for the sake of the one who is to die" (MI, 8). In Moral Matters, Jan Narveson argues, successfully I think, that given moral grounds for suicide, voluntary euthanasia is morally acceptable (at least, in principle). Daniel Callahan, on the other hand, in his "When Self-Determination Runs Amok," counters that the traditional pro-(active) euthanasia arguments concerning self-determination, the distinction between killing and allowing to die, and the skepticism about harmful consequences for society, are flawed. I do not think Callahan's reasoning establishes that euthanasia is indeed morally wrong and legally impossible, and I will attempt to show that.
According to the FDA, about 2.5% of children and around 8% of adolescents are affected by depression (Temple). A common way to treat depression is by taking antidepressants. Children and teens have also been prescribed antidepressants for various reasons other than depression such as OCD and anxiety disorders. While it is legal for teenagers and children to take antidepressants, many people are concerned with the issues that taking antidepressants have. Children and teens should be allowed to take antidepressants only when other forms of therapy don’t work. Antidepressants are serious drugs that have severe warnings when children and teens use them. There is also an increased risk of worsening depression and suicide in children and teens, especially in the when they begin to take it. Even the less severe side effects can make quite a negative impact on life.
The patient is a 55-year-old man admitted to the hospital for dehydration secondary to vomiting. The physical examination of the patient revealed dry mucous membranes and vital signs as follows: Pulse 110, blood pressure 100/60, and respirations of 20.
I was talking care of an 80 years’ elderly lady, who had sudden onset of fever and wheeze. Nursing notes from night before stated that patient has small choking episode at meal time. Upon assessment, patient had temp of 39.2, resp 32, SPO2 @ 82%, BP 170/110, pulse 110. Due to cognitive impairment, patient was unable to report any pain or discomfort but she was frowning, resisted getting changed or dressed. I requested
Mrs. Jones was admitted to the hospital for evaluation due to hyperglycemia related to diabetes. Her blood sugar was 350 and her physical exam revealed dry skin and mucous membranes.
Hritzak, Kimberly, and Nicole S. Culhane. "Sertraline Effective for Children and Adolescents with Major Depression." Journal of Family Practice 53.1 (2004): 11-12. Academic Search Premier. Web.
Suicide is a very tragic life event for the victim, victim’s friends and family members and to society as a whole. We often hear about suicide deaths that occur in younger and middle-aged adults in the media but rarely is such attention given to elderly suicide (65 and older). In the United States there is a higher rate of suicide amongst the elderly than in any other part of the population. There are many factors to this problem, however depression among the elderly was recorded as the major contributing factor that lead them to suicide. Every elderly that committed suicide was reported to have been depressed. Understanding the contributing factors that lead to depression amongst the elderly might shed light on the issue. Many studies have shown that depression coupled with risk factors increase tendency of suicide ideation among the elderly. Risk factors such as chronic illness, pain, physical and mental disabilities, isolation, loneliness, role change (retirement), lack of financial security and social support, bereavement, alcohol abuse, hopelessness and dependability have been pointed out as major contributing factors for the high number of depression experienced by the elderly. Society has identified depression and suicides among the elderly are a social problem, but little have been done to educate the public.
When speaking in terms of legalized euthanasia, and self-determination, Callahan feels that people should make decisions for themselves according to their own beliefs as to what comprises the good life. (pg. 226) He also states that we will, one way or another, die of some disease and that death will have dominian over all of us. (pg. 227) The meaning of this is no matter what we are all destined to die. In the case of death he first looks at suicide. This is when a person takes his or her own life, without the assistance of another. Euthansia, is a decision made between 2 people, the one being killed and the one doing the killing. He takes the stand that the very idea someone would waive their right to life, and then give another the power to take that life, requires a justification yet to be provided to him or by anyone. ( pg. 226) Should anyone want to end their life for any reason it can definitely be achieved.
“Suicide is a major public health issue; it takes the life of over a million people a year.” (“Suicide Widely”) Suicide is a growing epidemic that has very negative effects and views against it. Suicide is immoral because it is said to taint your soul. Numerous side effects from it can help you understand why it is wrong. Families and friendships are torn apart by the destructive acts. Understandably, people considering killing themselves aren’t immoral because at that point you’re able to go get help and tell someone how you’re feeling. I hope to encourage more awareness for this issue to save more lives and encourage more communication.