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Abstract
KT is a 23-year-old female that arrived on the mental unit some time
recurrent major depressive disorder but without psychotic features. Due to many life
stressors, that will be explained in this case study, KT stated she tried to take her life and
had suicidal thoughts. She did not ingest anything and was driven to Trumbull Memorial
hospital by her boyfriend. She was then transferred to St. Elizabeth Youngstown by the
hospital. The date of care of this case study was taken on the 28th of September 2017
where she was given a discharge time of noon that same day. In this case study, the
patients life stressors, DSM axes I to IV and behaviors during her stay will be discussed
along with plans of discharge and care for the patient after she is off the unit.
MENTAL HEALTH CASE STUDY: PATIENT KT Augustine3
Objective Data
On September 25th 2017 KT, a 23 year old female from Warren, Ohio was taken
to Trumbull Memorial Hospital ER by her boyfriend where she was then transferred to
St. Elizabeth Youngtown Mental unit. Patient stated that she got there a little before
midnight that day and was scared and nervous for what it would be like on the unit, but
willing to participate in group activities and was actively trying to get better. Patient
explained that she was having suicidal thoughts and tried to take her life by ingesting the
rest of her anti-depressant pills (did not know approximately how many) but nothing was
ever ingested when her boyfriend found her crying in the kitchen. KT was very complaint
with nursing care and obtaining any information. When discussing information with her
on the 28th of September, KT had stayed approximately 3 days. KT also stated that her
doctor would discharge her that day and she would be able to leave by noon. Patient
stated that she feels much better than when she first came in and she had learned many
new coping skills from the staff and other patients on the unit. Overall, KT admitted that
she was glad that she had come. Her demeanor that day was calm and happy, she looked
nice and well-kempt. She was diagnosed with ‘severe episodes of recurrent major
IV: bereavement overload (that started at 13 years old) with stroke of older
brother, death of friend and death of cousin; too many hours at work and
Security and safety measures were obtained for the whole unit. The unit made
sure that the doors were locked, any objects that could be hazardous for these patients
have been assessed thoroughly along with watching them closely. Activities likes
drawing and reading were utilized by KT in order to keep herself busy and calm. The
patient’s PRN medication are many that are hospital protocol (ex. Haldol when agitated)
but no PRN medications were given during her stay in the unit. She received buspirone
(Buspar) 10mg tablet 3 times a day for anxiety and Paroxetine (Paxil) 20mg capsule
daily, an SSRI for depression, and will be going home on both of those medications after
Summary
disorder in many. Losing interested in activities that once gave pleasure, problems with
sleeping and a general negative outlook on life are the common manifestations of this
disorder due to a mix of stressors and imbalances in the brain (American Accreditation
(also known as URAC) has a list of symptoms that may also affect the patient. The
patient may be feeling hopeless, helpless, guilty and over all self-hating. Theese moods
can also affect sleep and cause fatigue and loss of energy. It can also affect their appetitie
and cause weight gain/loss (URAC, 2017). These feelings can stay throughout a person’s
whole lifetime with high rates of reoccurring. Research suggests that patietns with
MENTAL HEALTH CASE STUDY: PATIENT KT Augustine5
chronic MDD benefit best when on long-term treatment to maintain their depression
(Keller, 2013). The cause of depression and MDD is unknown but studies show that
synaptic and structural alteration in the brain may prevent the brain from adapting to
certain stimuli, causing a mood disorder than is very hard to change back without
Identify
KT stated that she began feeling depressed when she was 13 years old when her life
stressors began all the way up to the present. KT believes that a lot of her anxiety and
nervousness comes from her past and current life stressors had made it hard to cope. At age 13,
her brother had a stroke at age 35 and had to move back in with her and her parents. KT’S
brother had no control over his right side, so he has been in a wheelchair for the rest of his life.
The family was very supportive, including the patient, to help him live his life but it also caused
some strain. KT explains that she would help her brother with fixing and working on his car ( an
activity he enjoyed doing) but there was a lot of strain and fighting when she would do
something wrong. She began cutting herself on her arm to relieve stress and pain she was having.
Three months later after the stroke accident, a family friend shot himself. KT stated that she had
no clue that he was suicidal with any plans of suicide and feels guilty for not noticing sooner. A
few months after this death, a friend of her brother moved in. He was like an older brother and
she opened up to him with a lot of her depression issues. Two weeks later after moving in,
they’re was a 4-wheeling accident and he broke his back instantly. Patient stated she was very
distraught because she felt a bad feeling about them going out 4-wheeling but didn’t say
anything. She also had the same feeling when she had 3 friends staying over at her house. KT
and another friend warned a mutual friend that she should not go out in the middle of the night
MENTAL HEALTH CASE STUDY: PATIENT KT Augustine6
because KT had another bad feeling. KT’s friend went anyways and got into a car accident.
Patient stated she felt guilty and friend was angry that they let her go but later apologized for
blaming it on KT and her friends. This car accident happened approximately. 2 weeks before KT
was admitted into the hospital. KT admits that stress from working too many hours at work has
also caused issues. She has put school on hold for now while she works as a manager at a store
but she often works hours where she does not have any time to see her friends and socialize. The
patient believes that work, putting school on hold and the car accident has all contributed to the
Discuss
Patient stated that there is no history or her parents, grandparents or siblings with
depression nor has she seen any signs or symptoms of the disorder in any of her relatives. Her
family and friends are very supportive of her history with depression and have reached out to
Describe
The unit at St. Elizabeth Youngstown utilizes the evidence based practices of staying on a
schedule day to day to ensure the patients have a steady and predictable routine. They have 2
group sessions that allow the patients to learn different coping mechanisms and talk about how
they are feeling. Each team member of the health care is utilized, the doctor and social worker
makes their rounds along with a nurse who plans the group sessions. Medications are given by
the LPN’s and they are to check up on the patients every 15 minutes. They allow an open room
for drawing, watching TV and socializing. There is a library for reading and each patient has a
room with a roommate so they do not have to be constantly around others. The unit’s floor is
MENTAL HEALTH CASE STUDY: PATIENT KT Augustine7
mainly white and bright. If a patient is agitated to the point they need to be medicated, they have
protocols for medication that can be given PRN and an isolation area to prevent other patients
Analyze
When talking to the patient about god and religion, the patient stated that she has a much
more agnostic outlook on life. KT believes that there is a higher being of life but is unknown of
who is may exactly be. She gets much of her support from her friends and boyfriend. Patient
stated that she had a hard time talking to her parents about issues but they are more than willing
Evaluate
The patient stated that she has learned new coping skills along with beneficial
relationships in and out of the unit. She met many people who have influenced her in a positive
way and here stay in the unit has strengthened her bond with her family and her boyfriend. Her
co-workers are also supportive and willing to work with her to lower her stress level. KT was
very nervous and scared when first admitted in the report but she is much more relaxed and
ready to use better coping mechanisms and use the support around her to stay positive.
Summary of discharge
Patient’s boyfriend had planned to come by and visit around noon, KT stated that her
doctor will discharge her and she wants to surprise her boyfriend when he gets there. While on
the unit, she talked to family members and parents and she and her boyfriend plan on moving in
with her parents. Over the course of the week she and her boyfriend are going to move out of the
house they rent with their roomates and move in with her parents and her brother. She plans on
MENTAL HEALTH CASE STUDY: PATIENT KT Augustine8
seeing a therapist after discharge thought she did not specify who. The patient was suggested
Turning Point and she plans on looking into this organization after discharge.
- Risk of Injury d/t depression EAB feelings of hopelessness, tempted suicide, history of
- Caregiver role strain d/t stroke patient relative EAB history of strain between family
members
- Disturbed thought process d/t depression EAB anxiety, panic attacks and problems
- Impaired social interaction d/t depression EAB withdrawal from social activities, pt
states she never has time for friends or family while working
- Altered grieving process d/t bereavement overload EAB brother has stroke, death of 3
family/friend all within the same year, evidence of still grieving for lost ones that passed
away 10 years ago and patients states she is still grieving. feelings of guilt concerning
References
Keller, M. (2013, September 10). Clinical & Research. Retrieved October 11, 2017, from
http://psychnews.psychiatryonline.org/