The Inpatient psych unit on a voluntary admission

Diane J. is a 69 yr. old Caucasian female admitted earlier today to the inpatient psych unit on a voluntary admission after an attempted suicide and lavage in the ER. Ms. Jones became a resident of a local ALF/ANF 2 months ago for wound care following surgery for a broken hip from fall during pick ball.

“I was running late and got lost on the way there, so I was already frazzled, that is why I fell.” Prior to the fall she lived independently, when asked about her selfcare, she says “I can take care of myself, I stopped cooking, the recipes are too confusing, plus you can order out easily, are you hungry?

Chart indicates she was scheduled to be discharged from the ALF to home next week. Diane says, “no one told me that”

Diane endorses feeling sad most of the day nearly every day, for the last two months. She is speaking slowly “I am not sure why I am here… I mean. no one needs me”

She also reports no interest in the things she used to enjoy, “I just don’t care about anything, its all so hopeless.” She says that she has no energy and finds it difficult to both fall asleep and stay asleep, “it is so hard to sleep, all I do is think about how my life is over. “I can’t turn it off” She is out on FLMA from her job as a pharmaceutical representative for Alkermes Selling Lybalvi “but let’s be honest, I am never going back,

They made me be part time, they are pushing me out.” She is periodically crying and staring out the window during the interview. She endorses taking (swallowing) the things the… You know, the wacha-call-its…(pills) in my luggage, I mean briefcase”. I ingested an unknown number of samples of Lybalvi.

A few times during the interview she struggled to find a word or stopped talking midsentence. She denied any SI/HI now “I just wanted it all to stop and drift off to a peaceful place”. She is dressed in loose fitting clothes, somewhat disheveled, no body odor; she sighs frequently during the interview.

Chart indicates 15lb weight loss in the last 2 months: the food there is awful like it is dipped in the toilet” When asked about A/V he stated that “I think I saw my end, it wasn’t so nice” and then begins a long story about a green field where she grew up and her dad pushing her on a swing.

That is where I am from, salt of the earth, hard work.” Reports taking Amitriptyline twenty years ago for an episode during her divorce. When pressed she says “I was very sad, and it helped, if you are going to give me medicine, I would like to take Elavil again, it seems like the best one.

” Denies any previous psych hospitalization, says she feels restless a lot, but she thinks its just that place (the ALF), there is a lot of old smelly people there and its time the staff is trying to kill them” VS stable. Able to name the season but not day or month.

Personal History

Diana J is a registered nurse (AND), during nursing school she reports having to sit out a semester ” I was in a funk, I couldn’t think, I didn’t even care.” After receiving care and counselling she went back to finish her associates degree. She married in college and had three children.

Cannot recall middle child’s name she and her husband moved to Granbury, TX about twenty tears ago “I figured we could finish working there and just stay; but he met someone else and now I am stuck in that stupid town” She stated that her divorce was … all my fault. I should have stayed home and not worked so much”. She left nursing after the divorce and began working in pharmaceutical sales.

Her children live in Tyler, and “never visit, they’re too busy living life”. When asked what they do for work she said, “they do what they want to do”. Daily ETOH use “one beer to wind down at night, I have a prescription for it (at the ALF) Takes one Avalide 150 mg/12.5 mg daily; loratadine ODT daily; ad Synthroid daily “I cant remember the dose, it’s the orange pill.

What are  the diagnosis

What is the treatment plan