Psychosocial Predictors of Postpartum Depression †MyAssignmenthelp

Question: Discuss about the Psychosocial Predictors of Postpartum Depression. Answer: Introduction The current assignment focuses upon nursing care and management for a patient suffering from con-morbid conditions. Here, the patient named Peter Mitchell is a 52 years old man and was suffering from a number of co-morbid conditions such as type 2 diabetes, morbid obesity, sleep apnoea, depression. Since peter was suffering from co-morbid conditions managing his daily life activities became difficult for him. Additionally, the huge body weight made conducting his daily job of a fork lift driver at the coal mine difficult for him. He also secluded himself from the society owing to his abnormally huge body size which resulted in sleep apnoea and depression. Therefore, he has put on a series of medications including metformin, Metoprolol etc. In this assignment a nursing management plan has been designed for Peter Mitchell with respect to the different attributes of the clinical reasoning cycle. The activities and limitations of the care management programs at each step have been discu ssed in detail. In order to design an effective care plan for the patient the nurse needs to follow an effective cycle. Here, peter was a 52 year old man who was suffering from type 2 diabetes diagnosed 9 years ago. Peter had been referred by his GP on showing a number of symptoms such as shakiness, diaphoresis, increased hunger, high blood glucose levels and difficulty during sleeping. The sudden trauma experienced by the patient over here could be attributed to rise in blood glucose level. On gathering of further information it was understood that the patient had been suffering from a number of co-morbid health conditions and was prescribed a huge lot of medications such as insulin Novomix 30 BD, Metfromin 500 mg BD, Lisinopril 10 mg daily, Nexium 20 mg daily, Metroprolol 50 mg BD, Pregabalin 50 mg nocte. The Metfromin was introduced to reduce the glucose tolerance in patients with type 2 diabetes. It was administered to peter to decrease hepatic glucose production along with improving insulin sensitivity. The Nexium 20 mg was administered to reduce the effect of GERD in the patient. The patient was also a suggested to take pregabalin 50 mg nocte. This was administered to reduce the incidents of depression and low mood disorder in the patient. Obesity could be linked to the development of the type 2 diabetes. In this respect, the patient was depressed and had feelings of increased hunger. Thus, increased hunger could often be related to low mood which triggers binge eating (Brown, Edwards, Seaton Buckley, 2017). The binge eating has been seen to trigger the conditions of obesity further in the patient. As mentioned by Munshi et al. (2016), difficulty in maintaining the energy balance between stored energy to that of energy expenditure can result in unnecessary weigh gain in the patient. As mentioned by Brown, Edwards, Seaton Buckley (2017), high levels of fatty acids in blood serum has been seen to down regulate the production of insulin. Thus, he was suggested low energy high protein diet (LEHP) by the doctor. Obesity triggers negative image about self within the patient. Hence, people with large amount of visceral fat often suffers from obstructive sleep apnoea, which can further worsen the condition of type 2 diabetes by releasing stress hormones which in turn increases the concentration of blood glucose level (Davies et al., 2015). Peter was also a chain smoker which could have resulted in narrowing of trachea further aggravating symptoms of sleep apnoea. Here, the patient has been suffering from type 2 diabetes, which is been marked by high levels of blood glucose. Peter was further recommended by his GP to the acute care unit owing to display of a number of health symptoms such as increased sweating, shakiness and difficulty in breathing during sleep. The sudden uneasiness in the patient could be attributed to excessive high levels of blood glucose level (Snoek, Bremmer Hermanns, 2015). Therefore, it was required to put the patient under immediate care and support services. As reported by Abrams, Nathanson, Silver, Ramirez, Toner Teresi (2017), leaving a hyperglycaemic patient unattended could often lead to lethal outcomes such as diabetic coma. Therefore, as a nursing professional looking after the care concerns of Peter Mitchell it was required that blood glucose level of the patient is effectively monitored. The entire process would be divided into 3-months cycle. The nurse will be taking data for improvements brought about in the overall health condition of the patient at an interval of every three months. Therefore, some of the ways in which it can be done is by closely monitoring the medication pattern of the patient along with managing his daily activities. Peter had been often prescribed light to heavy exercises by his consultant physician. Additionally, counselling sessions could be undertaken by the patient to improve his self image regarding body weight (Valkanova, Ebmeier Allan, 2013). The outcome of the nursing plan implemented for the care and management of the patient could be evaluated using a number of clinical assessment procedures. The nurse will be taking a note of the recovery of the patient on a regular basis. A time limit will be set up by the nurse such as six months for reducing the effects of hyperglycaemia in the patient along with reducing the impact of the co-morbid conditions. The nursing plan would focus upon implementation of exercises along with healthy diet for maintaining the blood glucose level and agility in the patient. The results would be evaluated through clinical assessments such as blood glucose tests and urine analysis along. The sleep improvement patterns in the patient would also be monitored. During the process of dealing with Peter I have felt that developing knowledge regarding the interval time periods which needs to be maintained during the administration of two consecutive insulin doses is important. Thus, repeating the medicine doses within a small interval of time can disrupt the normal metabolic process of the patient alongside leading to more fatal consequences (Palmer, Vorderstrasse, Weil, Colford Dolan?Soto, 2015). Discussion of depression using clinical reasoning cycle In this respect, Peter Mitchell was a 52 years old divorcee and used to live on his own. His deteriorating health and morbidly obese condition had made continuing work difficult for him. Additionally, he felt that his large body size had made him socially unacceptable. Therefore, he secluded himself socially which further contributed towards the development of depression in the patient. The patient was also no having sufficient family support as he was a divorcee who used to live alone. Additionally, his sons used to stay away from him providing him with little or no help amidst his physical ill health. Peter was suggested nexium 20 mg daily by the doctor. It was suggested for the lowering of the feelings of depression in the patient. However, excessive intake of nexium could trigger weight increase in the patient (Yim, Stapleton, Guardino, Hahn-Holbrook Schetter, 2015). This could further complicate the situation as the patient was morbidly obese. Nexium was suggested to reduce mood disorders in the patient was suffering from clinical depression where he had little or no wish to intermix with the society. However, administration of nexium would have severely affected the adrenal secretions in the long run worsening the condition of sleep apnoea in the patient. In the current scenario, depression developed in the patient under a range of circumstances such as unemployment, number of health issues, social isolation and negative self image due to obesity. Due to overweight the patient was unable to manage his daily tasks which further developed frustration in the patient (Davies et al., 2015). Thus, fear about negative social image further resulted in psychosocial complications in the patient (Kok, Williams Zhao, 2015). Peter feels uncomfortable about his size, which has resulted in enhancing the thoughts of depression in the patient. As peter feels uncomfortable about his size he rarely goes out or feels like participating in exercises. Therefore, in the lack of sufficient support from the patient it becomes difficult for the nursing professional to provide the patient with sufficient support programs (Esser, Legrand-Poels, Piette, Scheen Paquot, 2014). The morbid obesity in the patient makes depression management difficult, as the administration of steroid derivatives for controlling mood disorder could have negative consequences on the overall health of the patient. The nursing professional needs to adopt effective counselling process which will help the patient in reducing negative self image (Valkanova, V., Ebmeier, K. P., Allan, 2013). Additionally, setting up of social support channels for the patient where he will be a part of a larger community. As commented by Moreno-Indias, Cardona, Tinahones Queipo-Ortuno (2014), taking part in community based healthcare programs can also help in developing increased self motivation and social acceptance in the patient. The effect of the counselling sessions can be measured in the form of positive behaviour changes in the patient such as greater participation, less social inclusion (Birkenfeld Shulman, 2014). I think in order to deal effectively with the condition of peter I could have used therapeutic communication skills. Therefore, using such skills would have helped me in communicating with the patient better, as well as understand the emotional complexities in the patient. Conclusion In this assignment, the nursing management strategies for a patient suffering from a number of health co-morbidities have been discussed. One of the biggest issues faced by the nursing professional was management of both obesity and type 2 diabetes in the patient. This is because one is related to the other and alteration in one parameter could produce drastic effects over the other. Obesity symptoms can down regulate insulin production in the body. On the contrary overdoses of insulin can promote weight gain in the patient. Therefore, lifestyle management along with effective health education programs can help in managing the overall health of the patient. The assignment discusses the different nursing interventions in steps which help in effectively evaluating the condition of the patient. References Abrams, R. C., Nathanson, M., Silver, S., Ramirez, M., Toner, J. A., Teresi, J. A. (2017). A training program to enhance recognition of depression in nursing homes, assisted living, and other long-term care settings: Description and evaluation.Gerontology geriatrics education,38(3), 325-345. Birkenfeld, A. L., Shulman, G. I. (2014). Nonalcoholic fatty liver disease, hepatic insulin resistance, and type 2 diabetes.Hepatology,59(2), 713-723. Brown, D., Edwards, H., Seaton, L., Buckley, T. (2017).Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems. London: Elsevier Health Sciences, 55-75. Davies, M. J., Bergenstal, R., Bode, B., Kushner, R. F., Lewin, A., Skjth, T. V., ... DeFronzo, R. A. (2015). Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial.Jama,314(7), 687-699. Esser, N., Legrand-Poels, S., Piette, J., Scheen, A. J., Paquot, N. (2014). Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes.Diabetes research and clinical practice,105(2), 141-150. Kok, J. L. A., Williams, A., Zhao, L. (2015). Psychosocial interventions for people with diabetes and co-morbid depression. A systematic review.International journal of nursing studies,52(10), 1625-1639. Moreno-Indias, I., Cardona, F., Tinahones, F. J., Queipo-Ortuo, M. I. (2014). Impact of the gut microbiota on the development of obesity and type 2 diabetes mellitus.Frontiers in microbiology,5, 190. Munshi, M. N., Florez, H., Huang, E. S., Kalyani, R. R., Mupanomunda, M., Pandya, N., ... Haas, L. B. (2016). Management of diabetes in long-term care and skilled nursing facilities: a position statement of the American Diabetes Association.Diabetes care,39(2), 308-318. Palmer, C., Vorderstrasse, A., Weil, A., Colford, C., Dolan?Soto, D. (2015). Evaluation of a depression screening and treatment program in primary care for patients with diabetes mellitus: insights and future directions.Journal of the American Association of Nurse Practitioners,27(3), 131-136. Snoek, F. J., Bremmer, M. A., Hermanns, N. (2015). Constructs of depression and distress in diabetes: time for an appraisal.The Lancet Diabetes Endocrinology,3(6), 450-460. Valkanova, V., Ebmeier, K. P., Allan, C. L. (2013). CRP, IL-6 and depression: a systematic review and meta-analysis of longitudinal studies.Journal of affective disorders,150(3), 736-744. Yim, I. S., Stapleton, L. R. T., Guardino, C. M., Hahn-Holbrook, J., Schetter, C. D. (2015). Biological and psychosocial predictors of postpartum depression: systematic review and call for integration.Annual review of clinical psychology,11, 101-125.