Mental Health

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Name: Mr. Victor Chavez Gender: Male
Age: 69 Ethnicity: Hispanic
Education: High School Diploma Income: Social security, retirement, and Medicare
Religious/Spirituality: Practicing Catholic Family: Widowed but is close to his remaining family
Diagnosis: Major Depressive Disorder (MDD) single episode
Chief Complaint
“I am tired and don’t want to go on anymore.”
History of Present Illness
According to pt. daughters, pt. stopped caring for self approximately one week ago. Pt. wife died 6 months ago and he has not “been the same” since. Pt. is actively suicidal but has no plan. Depressed and withdrawn mood has affected pt. ability to care for self and feed self. Pt. states has “no energy to do anything”. Pt. states that nothing makes him feel better and that this feeling is constant.
Past Psychiatric History
No previous psychiatric treatment or hospitalizations. No previous psychiatric medications. No known past suicide attempts or self-harm.
Substance Abuse History
The patient denies a history of tobacco, alcohol or recreational drug use. Pt. daughters confirm.
Family History
Pt. parents deceased over 15 years ago. Both died from natural causes. Has 2 living brothers (ages 65 and 72) and 2 living sisters (ages 63 and 78). His 63-year-old sister has previous suicidal attempts and hospitalizations in psychiatric hospitals for major depressive disorder. No other mental health or substance abuse history in the family.
Social History
Pt. born and raised in Mexico. He immigrated to the U.S. after he graduated high school. Uneventful and stable childhood. Married his wife at the age of 21 and she died when pt. was 68 years of age. Pt. has 2 daughters, 2 sons, and 8 grand-children. He worked in the casino industry his entire life. Retired at the age of 65 and is now collecting social security and retirement. No financial concerns. Pt. is practicing Catholic with a strong faith in a higher power.
Mental Status Exam on Admission
The patient presented to the hospital accompanied by his two daughters. Daughters report the patient has not showered in the last week and is not eating or sleeping regularly. The patient is a 69-year-old English speaking Hispanic male; he is alert and oriented to time, place, person, and situation. Wearing unkempt clothing, hair is not clean or combed, and he exhibits overall poor hygiene. Pt. calm, cooperative and exhibits no unusual behavior. His speech is soft and slow. Depressed affect noted. Upon questioning his mood, the patient stated he felt “sad” and as though he did not want to “continue living”. Active suicidal ideations but no plan. The patient’s daughters state he has access to weapons in the home. No prior suicide attempts. Denies homicidal ideations. Denies being violent. Thought processes are linear. Pt. denies hallucinations or delusions. Short term and long-term memory intact. Pt can recall recent and remote events. Good insight/judgment; the patient states he knows that he needs help/ would mail a letter if he found one on the ground.
Past Medical History
Hypertension onset in mid-50’s
Appendectomy as a child in Mexico
Medications
Lasix 40 mg PO BID
Lisinopril 20 mg PO Daily
Allergies
NKA

This assignment does require scholarly writing.
1. What information is pertinent to you as the nurse?
2. What do you think the problem is?

Sample Solution

There were many reasons for the fall of the Roman Empire. Each one interweaved with the other. Many even blame the initiation of Christianity in 337 AD by Constantine the Great as the definitive cause while others blame it on increases in unemployment, inflation, military expenditure and slave labour while others blame it on the ethical issues such the decline in morals, the lack of discipline of the armies and the political corruption within the Empire. Three major contributions that led to the collapse of the once great empire were: the heavy military spending in order to expand the Empire, the over-reliance on slave labour which led to an increase in unemployment, and the political corruption and abuse of power by the Praetorian Guard leading to the unfair selection of many disreputable emperors and the assassination of those not favoured by the Guard.

One of the main reasons of the collapse of the Roman Empire was the over expenditure on the military to constantly fund wars abroad. In order for the Romans to invade and conquer other provinces they had to spend heavily on their legions. The Roman armies and supply lines became over-stretched resulting in thousands of soldiers being recruited and deployed from Rome into other territories as invaders or defenders. They also depended on soldiers to defend the borders of the lands they had conquered from barbarian attacks which resulted in the increased manufacturing of weapons and more money being spent on soldiers. High military spending left the Romans with very limited resources for other essential government projects such as the building of more public houses and the development of roads and aqueducts as well as leading to inflation. The over-expenditure on the military led the citizens of Rome to refuse the policies and laws enforced by the government and riots were commonplace in Rome during its last century. Due to the Roman citizens growing distrust of the Empire less people volunteered to join their armies which forced the military to hire common criminals and non-Roman mercenaries. The government raised taxes to aid their military expenditure which added to the low morale of the Roman population with every citizen losing a third of their weekly wage. The money raised to spend taxes was wasted on soldiers who constantly had to be replaced until the Romans could no longer afford to send large garrisons of troops abroad leaving their own borders poorly defended and vulnerable to attacks. The non-Roman mercenaries were too proud to serve a weakening empire and they began to conquer parts of the Empire as the Romans were unable to afford to send detachments and reserves to reclaim these areas. The city of Rome was left very poorly defended due to the deployment of troops to other provinces within the Empire which were defeated and taken by the barbarians making it considerably easier for them to conquer Rome. In order to ensure their loyalty, the wages of the soldiers were doubled and they were often promised discharge payments such as land or money. The military also spent loads of money on the transport of food and grain to

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