A 75-year-old client is admitted for treatment of abdominal pain. ...

[MirandaLo]

A 75-year-old client is admitted for treatment of abdominal pain. Despite the administration of prescribed pain medication, the client reports no relief of pain and continues to describe multiple somatic complaints.
 
  The nurse identifies the need for which of the following? 1. Further assessment and treatment for depression
   2. Review of the client's lab values
   3. Obtaining an order for different pain medication
   4. Contacting the family to talk to the patient

Question 2

A client tells the nurse that his wife passed away 3 years ago and he has nothing to do except visit with acquaintances at the neighborhood bar. The nurse realizes this client is demonstrating evidence of:
 
  1. Bipolar disorder.
   2. Depression.
   3. Extended grief.
   4. Sadness.

[janeli1]

Answer to Question 1

1. Further assessment and treatment for depression

Rationale:
A major clue to depression in the older person includes multiple somatic complaints and reports of persistent chronic pain. Many older people have more physical than emotional complaints. Therefore, further assessment for depression is warranted. The lab values are not indicated in this case, and obtaining different pain medication would not treat potential psychological problems. The family may also be ineffective in determining the client's psychological need.

Answer to Question 2

2. Depression.

Rationale:
Risk factors for the development of depression include a history of the loss of a close family member and substance abuse. Bipolar disorder is characterized by periods of mania with periods of depression. The client is not describing or demonstrating these periods. The client may or may not be experiencing extended grief. There is not enough information to determine if the client is demonstrating sadness.