RESPONDING TO ALTERED HEALTH CARE NEEDS – MENTAL HEALTH CASE SCENARIO
You are expected to provide a 3000-word written response to the below case scenario. Please ensure you use the Harvard referencing and adhere to the usual academic writing guidelines for this assignment.
Evidence from literature/clinical guidelines should be used to underpin/support your answers.

Case scenario:
Gabriella is a thirty-eight-year-old woman, who has worked as a health care support worker on a local mental health rehabilitation unit for the past twenty years. She has two children, Lola (eight) and Jack (two). She separated from their dad, Rob, two years ago and he has not had contact with the children for six months. Her mother died last year following a period of palliative care at home. Gabriella provided care for her mother and was with her when she died. Her father and brother live locally, but she has not had a lot of contact with them since her mother’s death.
Gabriella has a history of depression which was first diagnosed with when she was twenty-seven. Over the last few months, her mood has become increasingly low and she has been having suicidal thoughts. Gabriella took an overdose of prescribed medication seven days ago and received inpatient medical treatment prior to being transferred to an acute psychiatric inpatient ward. This is her first admission to a psychiatric ward. Since her admission, Gabriella has found decisions very difficult to make and has become tearful when her opinion on matters has been sought. She has been slowed in her movements, thoughts and speech. She has not attended to her personal hygiene. Her appetite is poor, but she tries to eat when prompted. Her fluid intake is dependent upon prompting too. She spends long periods of time lying on her bed. She has been found to be awake when checked and it is thought that she is managing to get only four hours sleep a night.
Gabriella is diagnosed with recurrent depressive disorder, current episode severe without psychotic symptoms (ICD-10 – F33.2). She has been commenced on sertraline 50mg, once daily (this replaces the paroxetine which Gabriella took in her overdose). Gabriella has been taking her medication when asked to do so but the nursing team have doubts that this implied consent constitutes informed consent due to her presentation. She is being nursed on level two, ten-minute therapeutic observations.
Gabriella’s children are being looked after by her friend Stephanie. Stephanie is their god parent and they have a good relationship with her. She has two children of her own who are similar ages to Lola and Jack. The four children all attend different schools and nurseries which is posing difficulty for Stephanie logistically. Stephanie and her husband are mental health nurses who work for the local Trust.

In relation to the above scenario:

1. Define and discuss the psychiatric condition the patient is presenting with, including the relevant related pathophysiology. (500 words)
2. Using a systematic approach, discuss the assessment and the priorities of nursing care related to the scenario demonstrate an understanding of the biopsychosocial factors that may influence the patient’s care. (1500 words)
3. Critically discuss the impact of the acute illness on the patient and family. (1000 words)