Discussion Post Answers Comprehensive Nursing Paper Example

Discussion Post Answers Comprehensive Nursing Paper Example

Post #1

Hello,

Thank you for a comprehensive and insightful post. Pregnant women are highly vulnerable for various reasons, including inadequate psychosocial resources, mental health issues, and the significant changes occurring in the body due to the pregnancy (van der Zande et al., 2017). I agree that prescribing for pregnant women should be done with caution due to the risk of certain medications impacting the pregnancy and contributing to adverse outcomes like preterm births, low birth weight, congenital disabilities, learning and development problems, miscarriages, stillbirths, and sudden infant death syndrome (Brygger Venø et al., 2022). Pregnancy increases the risk of developing depression during pregnancy and after giving birth. The body is often under physical strength during pregnancy and experiences significant changes, including hormonal that impact emotional regulation and reception. About 7% of pregnant women develop depression, and rates might be higher in areas with inadequate support resources, and women suffer from a lack of employment, financial resources, familial support, and inadequate food supply (Mayo Clinic, 2019).(Discussion Post Answers Comprehensive Nursing Paper Example)

Notably, depression among pregnant women can go unnoticed due to similarities between pregnancy and depression symptoms, including changes in sleep patterns, energy levels, appetite, weight, and libido. Therefore, some healthcare providers might attribute these symptoms to pregnancy, implying that depression will go unnoticed and untreated, which might result in long-term effects on the mother. Additionally, these women can shy away from discussing their health and changes due to the stigma linked to depression. Early identification of depressive symptoms is vital to early treatment to improve quality of life. You have identified some medications for treating depression in pregnant women, like Wellbutrin. I like the evidence provided to support the efficacy of Wellbutrin in treating depression in pregnant women. I agree that SSRIs are discouraged due to their ability to cross the placenta into the child, increasing the risk o adverse events like learning and development problems (Dubovicky et al., 2017). I would also recommend cognitive behavioral therapy to help address the problematic thinking and behavioral patterns that might arise due to changes resulting from pregnancy. Your post has been interesting, and I immensely appreciate it.(Discussion Post Answers Comprehensive Nursing Paper Example)

References

Brygger Venø, L., Pedersen, L. B., Søndergaard, J., Ertmann, R. K., & Jarbøl, D. E. (2022). Assessing and addressing vulnerability in pregnancy: General practitioners perceived barriers and facilitators – a qualitative interview study. BMC Primary Care, 23(1). https://doi.org/10.1186/s12875-022-01708-9(Discussion Post Answers Comprehensive Nursing Paper Example)

Dubovicky, M., Belovicova, K., Csatlosova, K., & Bogi, E. (2017). Risks of using SSRI / SNRI antidepressants during pregnancy and lactation. Interdisciplinary toxicology, 10(1), 30–34. https://doi.org/10.1515/intox-2017-0004(Discussion Post Answers Comprehensive Nursing Paper Example)

Mayo Clinic. (2019). Understand the symptoms of depression during pregnancy. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/depression-during-pregnancy/art-20237875(Discussion Post Answers Comprehensive Nursing Paper Example)

van der Zande, I. S. E., van der Graaf, R., Oudijk, M. A., & van Delden, J. J. M. (2017). Vulnerability of pregnant women in clinical research. Journal of medical ethics, 43(10), 657–663. https://doi.org/10.1136/medethics-2016-103955(Discussion Post Answers Comprehensive Nursing Paper Example)

Post # 2

Hello,

Your discussion offers valuable insights into prolonged grief disorders, populations most affected, diagnosis, associated risks, alternative diagnosis in major depressive disorder, and [potential pharmacological and non-pharmacological interventions. Individuals respond to grief differently, with some people’s symptoms decreasing over time and others experiencing prolonged grief symptoms like identify disruptions, avoidance, severe emotional pain, challenges with reintegration, emotional numbness, feelings of hopelessness and meaninglessness, and severe loneliness. The American Psychiatric Association provides that about 7-10% of adults experiencing loss will develop prolonged grief disorder, and 5-10% of the children will develop depression, post-traumatic stress disorder, and prolonged grief disorder (Appelbaum & Yousif, 2022). Older adults are at an increased risk of developing the disorder (Thiemann et al., 2021). Other vulnerable populations include caregivers caring for a partner and individuals who experienced depression or bipolar disorder before. Sudden death might also contribute to an increased risk of developing the disease.(Discussion Post Answers Comprehensive Nursing Paper Example)

It is critical to note that prolonged grief disorder, depression, and PTSD can co-occur, significantly impacting the individual and affecting their functionality, including social and occupational functioning (Wen et al., 2022). Depressive symptoms and those of prolonged grief disorder are most similar, including extreme feelings of sadness, emotional pain, hopelessness, loneliness, and meaninglessness. PTSD can occur if the patient is an eyewitness to the death, and the images or the memory is stuck with them forever, especially if an accident or murder was the cause of death. You have proposed combining prolonged grief disorder therapy and citalopram to address prolonged grief disorder. Research indicates combining pharmacotherapy and psychotherapy improves patient outcomes (Guidi & Fava, 2021). Indeed complicated grief therapy is also effective in this situation, helping the patient cope with the emotions surrounding death and progressively accept the death. I would inquire more about prescribing an opioid to an individual experiencing prolonged risk disorder due to the risk of dependence or addiction.(Discussion Post Answers Comprehensive Nursing Paper Example)

References

Appelbaum, P., & Yousif, L. (2022, May). Psychiatry.org – Prolonged Grief Disorder. Psychiatry.org. https://www.psychiatry.org/patients-families/prolonged-grief-disorder(Discussion Post Answers Comprehensive Nursing Paper Example)

Guidi, J., & Fava, G. A. (2021). Sequential combination of pharmacotherapy and psychotherapy in major depressive disorder. JAMA Psychiatry, 78(3), 261. https://doi.org/10.1001/jamapsychiatry.2020.3650

Thiemann, P., Street, A. N., Heath, S. E., Quince, T., Kuhn, I., & Barclay, S. (2021). Prolonged grief disorder prevalence in adults 65 years and over a systematic review. BMJ supportive & palliative care, bmjspcare-2020-002845. Advanced online publication. https://doi.org/10.1136/bmjspcare-2020-002845(Discussion Post Answers Comprehensive Nursing Paper Example)

Wen, F., Prigerson, H. G., Chou, W., Huang, C., Hu, T., Chiang, M. C., Chuang, L., & Tang, S. T. (2022). How symptoms of prolonged grief disorder, post-traumatic stress disorder, and depression relate to each other for grieving ICU families during the first two years of bereavement. Critical Care, 26(1). https://doi.org/10.1186/s13054-022-04216-5(Discussion Post Answers Comprehensive Nursing Paper Example)

Post #3

Hi,

Your comprehensive discussion provides informative perspectives regarding prescription medicine for pregnant women. I agree that pregnant women experience significant body changes that impact their physical and mental health and well-being. These individuals can develop health issues that require medication to treat or alleviate symptoms. However, pregnant women are a vulnerable population and maximum care and risk assessment should be performed before prescribing medication. About 70 per cent of pregnant women take more than one drug, and the risk of drug interactions is more during pregnancy (March of Dimes, 2022). Additionally, some drugs like SSRIs can penetrate through the placenta into the baby, affecting it and possibly contributing to learning and development issues, birthing defects, stillbirths, low birthweight, and preterm births. Therefore, the provider should carefully assess which medication the patient is taking, how much medicine the patient is taking, the stage of pregnancy, and potential health conditions.(Discussion Post Answers Comprehensive Nursing Paper Example)

You have discussed the medication recommended for managing PTSD in pregnant women. I agree that Sertraline is an SSRI and is not recommended for use in pregnant women despite its efficacy in treating PTSD because SSRIs can potentially reach the baby. I suggest careful risk assessment when using SNRIs in pregnant women to avoid adverse events like learning and development issues (Dubovicky et al., 2017). I would adopt psychotherapy as the first line of treatment of mood and stress disorders in pregnant women, including cognitive behavioral therapy, which will help identify problematic thoughts and behavioral patterns and inform strategies to adopt desired or positive thoughts and behaviors. Indeed combining medication and psychotherapy would help achieve optimal outcomes, but you need to be careful when prescribing SSRIs and SNRIs. A risk assessment would help determine the potential side effects and adverse events associated with a particular medication (Page, 2019). You have addressed the clinical practice guidelines for addressing PTSD, which is interesting as it offers a baseline for providers to align with and focus on to ensure appropriate treatment.(Discussion Post Answers Comprehensive Nursing Paper Example)

References

Dubovicky, M., Belovicova, K., Csatlosova, K., & Bogi, E. (2017). Risks of using SSRI / SNRI antidepressants during pregnancy and lactation. Interdisciplinary toxicology, 10(1), 30–34. https://doi.org/10.1515/intox-2017-0004(Discussion Post Answers Comprehensive Nursing Paper Example)

March of Dimes. (2022, July). Prescription medicine during pregnancy. You can help improve the health of all moms, babies and families. | March of Dimes. https://www.marchofdimes.org/find-support/topics/pregnancy/prescription-medicine-during-pregnancy

Page, L. (2019). Prescribing for pregnancy: managing prescribing for women with mental health diagnoses. Drug and Therapeutics Bulletin, 58(1), 8–11. https://doi.org/10.1136/dtb.2019.000006(Discussion Post Answers Comprehensive Nursing Paper Example)

https://www.ncbi.nlm.nih.gov/