Suicidal Ideation Evaluation

In the case scenario, Ms. B is diagnosed with depression. Although the physical exam is unremarkable, lab testing should be done. A CBC with differential, chemistry panel, thyroid panel and drug screen should be performed to check abnormalities according to Wells, DiPiro, Schwinghammer, and DiPiro (2015). Along with a diagnosis of depression, a suicidal ideation evaluation should be performed. If there is no suicidal ideation, a frank discussion with Ms. B. and her family about treatment options should occur. Wells et al. (2015) believe medication treatment for depression may take up to two to four weeks before a positive response may be seen. Family support during this time may help Ms. B in medication compliance and also in the plan of care. In addition the initial phase of medication, which can last up to 6-12 weeks, a continuation phase of medication for 4-9 months, and …show more content…
B’s medications, according to Uphold and Graham (2013), the first line agent that should be considered when prescribing for Ms. B would be selective serotonin reuptake inhibitors (SSRIs). Levothyroxine can interact with some SSRI’s. Sertraline (Zoloft) has a low potential for interactions (Uphold & Graham, 2013). There are no major drug interaction with Ms. B’s medications and sertraline (Drugs, 2015). A prescription of “Zoloft 25mg by mouth once a day” would be prescribed (Chisholm-Burns et al., 2013, p. 986). Ms. B would be instructed to not take St. John’s Wort due to the potential of causing serotonin syndrome (Drugs, 2015). Ms. B and her family should be educated on the seriousness of serotonin syndrome. Serotonin syndrome symptoms can be a change in mental status, hallucination, seizure, changes in blood pressure or heart rate, fever, tremor, blurred vision, hyperreflexia, and other autonomic changes (Uphold & Graham, 2013). Ms. B should be counseled to bring all medication, herbal supplements, and vitamins to all appointments to check for