ati video case study mood and affect depression

Mental Health: RN Video Case Study   Mood and Affect:...

Mental Health: RN Video Case Study

Mood and Affect: Depression Classroom or Clinical Experience (live/virtual)

        Estimated time to complete

BASED ON ACTIVITIES SELECTED THE TIME TO COMPLETE CAN RANGE FROM 20 MINUTES TO 6 HOURS 25 MINUTES

Pre-Video Case Study Activity: 2 hours 30 minutes Video Case Study Activity: 20 minutes to 35 minutes Debrief Video Case Study Activity: 3 hours

        Materials 

• Video Case Study
• Reference books
• CMS Review Module
• Active Learning Templates
• Engage Mental Health

        Learning Objectives 

After completion of this lesson, the learner will be able to:

• Describe the various types of depressive disorders.
• Apply effective therapeutic communication techniques when caring for a client diagnosed with depression.
• Explore pharmacological and non-pharmacological interventions related to depression.
• Identify primary care and safety concerns for a client diagnosed with depression.
• Explain risks and potential complications for a client diagnosed with depression.
• Discuss the role of the nurse when caring for a person experiencing depression.

        Scenario Overview 

This Video Case Study focuses on the concept of mood and affect and appropriate nursing care for a client experiencing depression. The case study gives the learner the opportunity to explore relevant client information that includes depressed mood and affect, suicidal ideation, and use of therapeutic communication. The learner can also practice using clinical judgment through formulating appropriate nursing responses and identifying safety concerns when caring for a client experiencing depression.

Copyright ©2022 Assessment Technologies Institute, L.L.C. All rights reserved. This resource is copyright protected material of ATI and is provided for use solely under license by ATI. Copying, distributing, or posting this material on the internet or social media is strictly prohibited. Posting on institution

LMS requires ATI's prior written permission.

        Learning Activities 

This learning experience requires faculty to be actively engaged with all aspects of the learning experience. The following activities are recommended for theory or clinical replacement and may be assigned to students individually or in groups. The discussion questions may be used in face-to-face or online instruction, using discussion boards, or synchronous video conference.

Select one or more activities from each of the following sections (pre-video case study activity, video case study, post-video case study activity) to incorporate into your learning environment. The number of activities selected will determine the number of hours needed to complete the lesson.

PRE-VIDEO CASE STUDY ACTIVITIES

PREPARATION                                                               EVALUATION COMPONENTS

• Become familiar with recommended Pre-Video Case Study Activities.
• Assign the Pre-Video Case Study Activities to the students.
• Lesson test
• Active Learning Template
• Individual Question Responses

CMS REVIEW MODULE

Navigate to the eBook Library, open Mental Health eBook and read the following:

• Chapter 13 Depressive Disorders
• Chapter 22 Medications for Depressive Disorders

ACTIVE LEARNING TEMPLATE

• Selective Serotonin Reuptake Inhibitors

ENGAGE MENTAL HEALTH

• Select lesson on Mood Disorders and Suicide.
• Complete end of lesson test.

INDIVIDUAL ASSIGNMENT

• Instruct learners to respond to the following questions. Learners should provide an evidence-based rationale for their response.
• Describe a situation you were involved caring for client who is suspected of having depression.
• How was the diagnosis confirmed?
• What interventions did you or other care providers implement?
• Were the interventions effective? Support your decision by describing the client response to the intervention(s).
• What concerns do you have when caring for a client who presents with suicidal ideation? Be specific.

VIDEO CASE STUDY ACTIVITY

• Review the Video Case Study.
• Assign the Video Case Study to students individually, to their small groups, or in their clinical group.
• Use the directions provided in this lesson plan to student for the small group assignment.
• Individual video challenge response
• Group video challenge response

VIDEO CASE STUDY: Mood and Affect :Depression

• Submit a well thought out response to the video challenge question and submit to your instructor.
• View the expert response.

SMALL GROUP ASSIGNMENT

• Share your response to the video challenge question with your small or clinical group.
• Compare your responses to the response of others in your group.
• Do a collaborative group response for the video challenge question. Submit the small group response to your instructor.

DEBRIEF VIDEO CASE STUDY ACTIVITIES

• Have students meet as their assigned small group to form responses to the questions.
• Use the questions to create a discussion.
• Be prepared to guide students with their understanding of content.
• Small group responses
• Group discussion response

FACULTY LED DISCUSSION or SMALL GROUP ACTIVITY

• The following question scan be used to guide group discussion in the classroom, as online discussion questions or assigned as a small group activity.
• Describe the pathophysiology related to depressive disorders.
• Explain the concept of depression.
• Describe the signs and symptoms of depression.
• Describe suicidal ideation.
• In the Video Case Study, what was the client's primary problem related to depression?
• What assessment findings(manifestations, vital signs, laboratory values, diagnostic test results, etc.) do you anticipate related to the client's primary problem?
• What potential complications is a client who is experiencing depression at risk for developing?
• Identify a minimum of three nursing actions that should be included in the plan of care to address the client's primary problem.

Assign the Debrief Virtual Simulation Activities to students or debrief in teacher led group.

• Review the initial and unfolding case study information, revise as needed to address learning outcomes.
• Share the case study with your students.
• Have students pair up or assign them to small groups to discuss the clinical judgment questions.
• Use the clinical judgment as a faculty led discussion in the classroom or clinical conference.
• Group discussion responses

CASE STUDY WITH CLINICAL JUDGMENT QUESTIONS

Assign students to work in small groups to review the case study provided below and respond to the discussion questions.

Case Study:  The client presents in the emergency department reporting thoughts of suicide following the recent break-up with their fiancé. The client has no known physical medical history. Client attempted suicide in high school by acetaminophen overdose. Client was hospitalized at this time and attended outpatient therapy for two years. Client had been sober (alcohol) for three years but recently began drinking again. No known allergies. Current medication: sertraline 75 mg po daily.

Nurse's Notes: 1900 Client is a 29-year-old male graduate student who works part-time in the university library. Client reports their fiancé unexpectedly broke off the engagement two weeks ago. Since that time, client has lost 8 pounds and is sleeping "all the time... I just can't deal with this." Due to lack of energy, client is missing classes and assignment deadlines. The client has called out of work four times in the past week. Admits to excessive alcohol use as way to cope. Client reports feelings of hopelessness and thoughts of suicide with planned overdose of acetaminophen.

Vital Signs: Pulse: 68; Blood Pressure 110/76; Respirations: 18; Temperature: 98.3 po

Labs: Blood Alcohol Level(BAL): 0.02%

Provider Orders:

• Admit to in-patient mental health unit
• Suicide precautions / 1:1 Observation
• Sertraline 75 mg po daily
• What are the relevant factors contributing to the client's condition?
• What is the SAD Persons score for this client?
• What potential complications is the client at risk for if suicidal ideation continues?
• What are the physiological aspects contributing to the depression?
• What are the client's three priority problems?
• What client outcomes should the nurse plan for related to the three priority problems?
• What evidence-based approach should the nurse use to reinforce to client education?
• What actions should the nurse perform related to the client's problem(s)?
• What information should the nurse provide to the client?
• What should the client be monitored for based on the nursing actions performed?

Case Study: Hospital Day 6

Nurse's Notes: Client is actively participating in the therapeutic milieu, including individual and group therapies. Reports improved mood; denies suicidal ideation, intent, or plan. Client expresses future-oriented plans, stating they are eager for scheduled discharge tomorrow and want to begin looking for a new position after graduation next month. Compliant with medication regimen. Reviewed aftercare arrangements including beginning outpatient therapy next week. Client able to 'teach back' re: prescribed medication and name/location of outpatient therapist.

Vital Signs: Pulse: 72; Blood Pressure 118/80; Respirations: 18; Temperature: 98.6 po

Medications: Sertraline 100 mg po daily

• Explain whether the client met, partially met, or did not meet the expected outcome. Support your response with client information provided.
• Will the nurse need to revise the plan of care? If yes, describe how the plan of care should be modified.
• A successful discharge
• Re-integration to home and out-patient care
• Termination of the nurse-patient relationship
• Determine desired method to disseminate questions to students (i.e. handout, online discussion board) and provide to students.
• Reflection question responses
• What stigma surrounding mental health concerns you when working with a depressed patient?
• What is one thing you can do to advocate for mental health care?
• Do you anticipate working with many patients with mental health issues in the medical-surgical setting? Why or why not?

OPTIONAL/ADDITIONAL ACTIVITIES

CONCEPT MAP

• Divide students into small groups of 4 to 5 students.
• You can use the case study provided above if desired.
• Provide initial client data for the students to respond to; this may be hospital day 1. Then unfold the case study (this may be hospital day 3) so students can move through evaluate outcomes.
• Provide an image of the sample concept map template. One has been provided below.
• Identify relevant subjective and objective assessment information related to the client's condition and place it in an Assessment Information box. (Recognizing cues)
• Based upon assessment information, identify, and prioritize the top 3 client problems. Place each of the three client problems in a different Problem box. (Analyze cues; Prioritize Hypothesis)
• Below each Client Problem box, enter the Supporting Assessment Information.
• Identify a potential client outcome per client problem. (Generate Solutions)
• Do an intervention box below each client problem box. Identify important nursing interventions that should be taken to address each client problem and enter them in the related Intervention box for the associated client problem. (Take Actions)
• Have subsequent groups add information that was not presented during the initial report out.
• Have subsequent groups indicate agreement by making a star or check mark next to existing data.
• Have students work in small groups to respond to the following discussion questions:

Recognize Cues

• What additional factors should the nurse include in the plan of care for this client? (e.g., age, religious, nursing knowledge, literacy, or cultural preferences)

Analyze cues

• Identify potential client problems.

Prioritize Hypothesis

• What is the client's primary problem?
• What findings require immediate follow-up?
• Identify the client's primary problem. Provide rationale for your decision.

Generate solutions

• What safety considerations should be included when planning care for this client? (e.g., fall risk, medication, age, mobility)

Take actions

• What interventions should the nurse perform to address the client priority problem(s)?
• What education should the nurse provide for this client?
• Self-care, health promotion, disease management (e.g., medication, diet, activity, ADLs).

Evaluate outcomes

• How will you determine if expected client outcomes are achieved?
• Discuss ways to modify or revise the plan of care when client outcomes are not met.
• Each group may share a different discussion question.
• May use the questions to create large group discussions in the classroom.
• Choose additional activities.
• Assign the chosen additional activities to students.
• Have students pair off to discuss the question posed.
• Then have each pair share their response with another pair of students.
• Be prepared to fill in knowledge gaps when identified.
• Discussion question response

THINK-PAIR-SQUARE-SHARE

• Give students 2 minutes to reflect on the differences in the clinical manifestations of a client experiencing vague suicidal ideation to a client with a suicidal plan with active means and intent.
• Give the students 2 minutes to compare their reflection with the student next to them.
• Have a pair of students share their reflections with another pair of students. The group of four students should synthesize their response and write down the most important points.
• Do large group discussion by having a student share each group's response.

TEACHING PLAN

1.  Develop teaching guide for the client experiencing major depression.

Answer & Explanation

### Mental Health: RN Video Case Study Lesson Plan Outline

**I. Introduction (15 minutes)** - Welcome and introduction to the topic of depression and mental health nursing. - Briefly explain the importance of understanding depression and effective nursing care.

**II. Pre-Video Case Study Activities (2 hours 30 minutes)** - **CMS Review Module (20 minutes)**  - Read relevant chapters on depressive disorders and medications in the Mental Health eBook. - **Active Learning Template (45 minutes)**  - Complete active learning templates related to depression and medication. - **Engage Mental Health (1 hour)**  - Participate in the Engage Mental Health lesson on Mood Disorders and Suicide. Complete end-of-lesson test. - **Individual Assignment (25 minutes)**  - Respond to specific questions about experiences with depressed clients and suicidal ideation. Submit responses.

**III. Video Case Study Activity (20 minutes)** - **Individual Video Challenge Response (20 minutes)**  - View the Mood and Affect: Depression video challenge.  - Submit a thoughtful response to the video challenge question.

**IV. Small Group Assignment (15 minutes)** - **Small Group Discussion (15 minutes)**  - Share individual responses within small groups.  - Collaboratively form a group response to the video challenge question.  - Submit the small group response to the instructor.

**V. Debrief Video Case Study Activities (3 hours)** - **Faculty-Led Discussion or Small Group Activity (45 minutes)**  - Use guided questions to facilitate discussion on pathophysiology, signs, symptoms, and nursing actions related to depression and suicidal ideation. - **Case Study with Clinical Judgment Questions (1 hour 15 minutes)**  - Work in small groups to analyze the provided case study.  - Discuss relevant factors, potential complications, client problems, interventions, and outcomes. - **Reflection (15 minutes)**  - Answer reflective questions regarding mental health stigma, advocacy, and expectations about working with mental health patients.

**VI. Optional/Additional Activities (1 hour 20 minutes)** - **Concept Map (1 hour 20 minutes)**  - Divide students into small groups.  - Create a concept map based on a case study about a client experiencing hopelessness or major depression.  - Discuss cues, client problems, solutions, actions, and evaluation of outcomes.

**VII. Conclusion (15 minutes)** - Recap the key points discussed during the session. - Emphasize the importance of empathy, effective communication, and evidence-based nursing interventions in mental health care.

**VIII. Teaching Plan Development (30 minutes)** - Devote time to developing a teaching guide for nursing students on caring for clients experiencing major depression.

### Additional Notes: - **Interaction and Engagement:** Encourage active participation, group discussions, and sharing personal experiences related to the topic to enhance engagement and understanding. - **Facilitator's Role:** Facilitators should guide discussions, address questions, and ensure that students are on track with the activities. - **Flexibility:** Depending on the pace of the class and depth of discussions, be flexible with the timing allotted for each activity.

### I. Introduction (15 minutes) - **Welcome and Introduction:** Begin the class by welcoming the students and introducing the topic of depression and its significance in mental health nursing. Explain that the session will delve into various aspects of depression, including its types, therapeutic communication techniques, interventions, and nursing care.

### II. Pre-Video Case Study Activities (2 hours 30 minutes) #### CMS Review Module (20 minutes) - **Reading Material:** Direct students to read specific chapters in the Mental Health eBook related to depressive disorders and medications. This foundational knowledge will provide context for the case study discussions.

#### Active Learning Template (45 minutes) - **Interactive Templates:** Have students work individually to complete active learning templates on depression and medications. This hands-on activity ensures that students engage deeply with the material, reinforcing their understanding of key concepts.

#### Engage Mental Health (1 hour) - **Interactive Lesson:** Guide students to participate in the Engage Mental Health lesson focusing on Mood Disorders and Suicide. This interactive session helps students reinforce their knowledge through active participation and testing.

#### Individual Assignment (25 minutes) - **Reflective Exercise:** Instruct students to respond individually to specific questions related to their experiences with depressed clients and handling situations involving suicidal ideation. This assignment encourages students to reflect on their practical experiences, enhancing their critical thinking skills.

### III. Video Case Study Activity (20 minutes) #### Individual Video Challenge Response (20 minutes) - **Video Interaction:** Have students watch the Mood and Affect: Depression video challenge individually. After viewing, ask students to submit a well-thought-out response to the video challenge question. This activity tests their understanding of real-life scenarios.

### IV. Small Group Assignment (15 minutes) #### Small Group Discussion (15 minutes) - **Collaborative Learning:** Form small groups where students can share their individual responses to the video challenge question. Facilitate a discussion where they compare their answers and collaboratively formulate a group response. This promotes teamwork and diverse perspectives.

### V. Debrief Video Case Study Activities (3 hours) #### Faculty-Led Discussion or Small Group Activity (45 minutes) - **Guided Discussion:** Lead a discussion session using specific questions related to depression, suicidal ideation, and nursing actions. Encourage students to analyze pathophysiology, signs, symptoms, and prioritize nursing interventions. Guide them in critical thinking and evidence-based reasoning.

#### Case Study with Clinical Judgment Questions (1 hour 15 minutes) - **Case Study Analysis:** Divide students into small groups to analyze a detailed case study involving a client with suicidal ideation. Facilitate discussions where they identify relevant factors, potential complications, client problems, interventions, and outcomes. This activity enhances their clinical judgment and decision-making skills.

#### Reflection (15 minutes) - **Critical Thinking:** Pose reflective questions about mental health stigma, advocacy, and expectations regarding working with mental health patients. Encourage students to critically analyze their attitudes and beliefs, fostering self-awareness and empathy.

### VI. Optional/Additional Activities (1 hour 20 minutes) #### Concept Map (1 hour 20 minutes) - **Collaborative Mapping:** Divide students into small groups and provide them with a case study about a client experiencing hopelessness or major depression. Guide them in creating a concept map, incorporating assessment cues, client problems, solutions, actions, and evaluation of outcomes. This activity encourages teamwork and comprehensive understanding.

### VII. Conclusion (15 minutes) - **Recap and Emphasis:** Summarize the key points discussed during the session, emphasizing the importance of empathy, effective communication, and evidence-based nursing interventions in mental health care. Reiterate the practical relevance of the topics covered.

### VIII. Teaching Plan Development (30 minutes) - **Educational Focus:** Allocate time for faculty to develop a teaching guide for nursing students, providing them with comprehensive resources and structured information about caring for clients experiencing major depression. This ensures that educators are equipped to guide their students effectively.

### Additional Notes: - **Interaction and Engagement:** Encourage active participation, group discussions, and sharing of personal experiences to enhance engagement and understanding among students. - **Facilitator's Role:** Facilitators should guide discussions, address questions, and ensure that students are actively participating in the activities. Their role is pivotal in creating an interactive and conducive learning environment. - **Flexibility:** Be flexible with the timing allotted for each activity based on the pace of the class and the depth of discussions. Adjustments can be made to ensure that students grasp the concepts thoroughly.

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