I felt quite confident when reading chapter 19, “the pregnant woman”, as this is where the majority of my nursing practice lies. It felt good to be able to look at a picture and say what it was before reading the caption, unlike previous chapters. Even though my level of comfort was justified by my years’ experience as an obstetric nurse, I feel there is always something to be learned or tweaked to better communicate with the patient.

As an obstetrical nurse, we float to all areas within the family maternity unit. The area that I have the most difficulty with is the behavior and mental health assessments I need to utilize when caring for a patient with substance use disorders. I struggle at times when I work in the neonatal intensive care unit (NICU) interacting with moms and dads with a history of substance use disorder as many factors come into play. I don’t want to be judgmental as I want to give the best nursing care I possibly can; however, seeing these innocent infants go thru withdrawal is tough. Obtaining a neonatal abstinence score (NAS), giving these infants morphine, klonopin, as well as other medications tears me up inside.  

I do find behavioral and mental health issues very interesting; however, at the same time, they are frustrating. It is so wonderful when you can make a difference while caring for these patients, but then they leave the hospital you don’t know what state of mind they are going to be in when they return to see their infant. There is a huge deficit in our country when it comes to caring and resources for patients suffering from mental illness. Many patients suffer from dual diagnosis’ who are not adequately treated, or they refuse treatment. Many primary care physicians try to treat these patients when they need professional individualized psychiatric care (Dains et al., 2016).

References

Dains, J., Baumann, L., & Scheibel, P. (2016). Advanced health assessment & clinical diagnosis in primary care (5th ed.). Mosby Elsevier.

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In reply to Diane Koutavas

Re: Discussion 6

by Dona Clarin – 
Well done. Describe the differences between depression and dysthymia.

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In reply to Dona Clarin

Re: Discussion 6

by Diane Koutavas – 
Thank you Dr. Clarin,
Depression VS Persistent Depressive Disorder
According to the American Psychiatric Association (2020) dysthymic disorder is now called persistent depressive disorder (PDD). PDD is not as severe as major depressive disorder (MDD); however, it is characterized by a low level of depression that lasts longer than MDD (2017). For depression to be classified as PPD, the patient needs to be diagnosed with having depression for a minimum of two years. Children and adolescence can be classified as having PDD if they have moods of irritability or depression continuing for at least one year (2020).
PDD often begins in childhood, adolescence, or early adulthood affecting 0.5% of adults in the United States(2020). Individuals afflicted with PDD may not feel they need help they often describe their mood as feeling “down in the dumps” just being the normalcy for them since this is a continual state of being (2020). The symptoms of PDD cause significant difficulty and distress with social activities, work, and school. The effects of PDD can be greater than the effects of MDD; however, MDD may precede the onset of PDD. Also, one may already have a diagnosis of PDD and then have an episode of MDD occurring which is then superimposed. American Sentinel N522PE Module Six: Mental Health Assessment & Male and Female Urinary and Reproductive SystemsReferences

(2017). Retrieved December 31, 2016, from https://www.nimh.nih.gov/health/statistics/persistent-depressive-disorder-dysthymic-disorder.shtml
(2020). Retrieved December 31, 2019, from https://www.psychiatry.org/patients-families/depression/what-is-depression

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In reply to Diane Koutavas

Re: Discussion 6

by Rebecca Talley-Mullins – 
Diane,
One in eight children under the age of 17 in the United States has at least one parent who has a substance use disorder (Lipari & VanHorn, 2017). The staggering numbers of these 8.7 million children are at risk for neglect, abuse, or maltreatment (Lipari & VanHorn, 2017).

Having worked in the NICU as a full-time RN, I once had a mother overdose at her infant son’s bedside that we were treating for neonatal abstinence syndrome. I admit that it is one of the hardest experiences as a nurse that I have witnessed is the helplessness of these babies withdrawing. I have also seen mothers in post-partum that are in the treatment being prescribed either methadone or suboxone. When giving their medication, they become so lethargic that they can barely care for the infant.

The importance of assessing mental health during assessments is crucial for assessing chest, abdominal, and neurological issues.

Reference

Lipari, R.N., & Van Horn, S.L. (2017, August 24). Children living with parents who have a substance use disorder. The CBHSQ Report. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD.

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In reply to Rebecca Talley-Mullins

Re: Discussion 6
by Diane Koutavas – 
Rebecca,
Thank you for the information and references, it is valuable to have good resources when trying to understand mental illness and addiction, “substance use disorder”. It sounds like we share the same sediments. The statistics are both unfortunate and overwhelming at the same time. As a young RN, in L&D, I had an eye opening experience, one that made me question if I was raising my son appropriately. A patient came in bleeding from an abruption, with her five year old son, (same age as mine at the time) to have an emergency cesarean after smoking crack just moments before arrival by ambulance. It was awful hearing the five year old rattle off statistics of his mother address, insurance, etc. I was astonished back then thinking my son was not as advanced as this child. I went home and hugged my son and husband, thanking God he didn’t have to be put in the same situation. Today, many years later as a seasoned RN, I find it doesn’t get any easier to deal with as it occurs more often than I’d like.

184 words American Sentinel N522PE Module Six: Mental Health Assessment & Male and Female Urinary and Reproductive Systems