Nursing care process. An emergency approach to a patient with depressive disorder

Abstract

Depression is the mental disorder with the highest prevalence and degree of disability, with great deterioration of functioning and quality of life, in which effective crisis intervention is vital to avoid fatal outcomes. We present the case of a 27-year-old woman who is admitted to the emergency area of a psychiatric hospital, unkempt, with mutism, sleep and appetite disturbances, feelings of guilt, anhedonia and persistent suicidal ideas of three weeks’ evolution; this is a second depressive crisis in eight months, with a previous suicide attempt and no previous professional care, so she is transferred to intensive observation for high suicide risk. After assessment by the 13 domains and prioritization by means of Daniel Pesut’s reasoning web, the diagnoses of risk of suicide, ineffective impulse control and impaired mood regulation were formulated, with their NOC outcomes and NIC interventions (suicide prevention and mood management). After the first 72 hours, an improvement in physical appearance, in the sleep cycle and control of suicidal ideation was observed, joining the hospitalization unit and individual and family psychotherapy.