Week 7 _ Discussion_Treatment For A Patient With A Common Condition

**THIS DISCUSSION IS DIVIDE IN TWO PARTS –

 

1. MAIN DISCUSSION POST BY WEDNESDAY 1/12/2022 BEFORE 8:00 PM EST

2. TWO REPLIES BY FRIDAY 01/14/2022 BEFORE 8:00 PM EST

 

Discussion: Treatment for a Patient with a Common Condition

 

Insomnia is one of the most common medical conditions you will encounter as a PNP. Insomnia is a common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD (Abbott, 2016). Various studies have demonstrated the bidirectional relationship between insomnia and mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90% of adults with depression experience sleep problems (Abbott, 2016). Due to the interconnected psychopathology, it is important that you, as the PNP, understand the importance of the effects some psychopharmacologic treatments may have on a patient’s mental health illness and their sleep patterns. Therefore, it is important that you understand and reflect on the evidence-based research in developing treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate psychopharmacologic treatments for optimal health and well-being.

 

Case study: An elderly widow who just lost her spouse. 

 

Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications: 

· Metformin 500mg BID 

· Januvia 100mg daily 

· Losartan 100mg daily 

· HCTZ 25mg daily 

· Sertraline 100mg daily 

Current weight: 88 kg

Current height: 64 inches

Temp: 98.6 degrees F

BP: 132/86 

 

 

Discussion Instructions: For this Discussion use the above case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs.

 

Post a response to each of the following:

 

· List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.

· Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.

· Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.

· List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.

· List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.

· For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on ethical prescribing or decision-making. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals based on ethical prescribing guidelines or decision-making?

· Include any “check points” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen.

· Use at least 5 references.

· Review the Grading Rubric

 

 

**THIS DISCUSSION IS DIVIDE IN TWO PARTS

 

 

1.

 

MAIN DISCUSSION POST BY

WEDNESDAY

1/12/2022

 

BEFORE 8:00 PM EST

 

 

2.

 

TWO REPLIES BY FRIDAY

01/14/2022

 

BEFORE 8:00 PM EST

 

 

Discussion: Treatment for a Patient

with

 

a Common Condition

 

 

Insomnia is one of the most common medical conditions you will encounter as a PNP. Insomnia is a

common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD

(Abbott, 2016). Various studies have demonstrated the bidirecti

onal relationship between insomnia and

mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90%

of adults with depression experience sleep problems (Abbott, 2016). Due to the interconnected

psychopathology, i

t is important that you, as the PNP, understand the importance of the effects some

psychopharmacologic treatments may have on a patient’s mental health illness and their sleep patterns.

Therefore, it is important that you understand and reflect on the evid

ence

based research in developing

treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate

psychopharmacologic treatments for optimal health and well

being.

 

 

Case

 

study

: An elderly widow who just lost her spouse.

 

 

 

Subjective: A patient presents to your primary care office today with chief complaint of insomnia.

 

Patient is

75 YO with PMH of DM, HTN, and MDD.

 

Her husband of 41 years passed away 10 months a

go.

 

Since then, she

states her depression has gotten worse as well as her sleep habits.

 

The patient has no previous history of

depression prior to her husband’s death.

 

She is awake, alert, and oriented x3.

 

Patient normally sees PCP once

or twice a year.

 

Pa

tient denies any suicidal ideations.

 

Patient arrived at the office today by private

vehicle.

 

Patient currently takes the following medications:

 

 

·

 

Metformin 500mg BID

 

 

·

 

Januvia 100mg daily

 

 

·

 

Losartan 100mg daily

 

 

·

 

HCTZ 25mg d

aily

 

 

·

 

Sertraline 100mg daily

 

 

 

Current weight: 88 kg

 

Current height: 64 inches

 

Temp: 98.6 degrees F

 

BP: 132/86

 

 

 

 

Discussio

n Instructions

:

 

For this Discussion

 

u

se the above

case study excerpt presented. Reflect on

the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat

the patient’s hea

lth needs.

 

 

 

Post

 

a response to each of the following:

 

 

·

 

List three questions you might ask the patient if she were in your office. Provide a rationale for

why you might ask these questions.

 

 

·

 

Identify people in the patient’s life you would need to speak to or get feedback from to further

assess the patient’s sit

uation. Include specific questions you might ask these people and why.

 

 

·

 

Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and

how the results would be used.

 

 

**THIS DISCUSSION IS DIVIDE IN TWO PARTS –

 

1. MAIN DISCUSSION POST BY WEDNESDAY 1/12/2022 BEFORE 8:00 PM EST

2. TWO REPLIES BY FRIDAY 01/14/2022 BEFORE 8:00 PM EST

 

Discussion: Treatment for a Patient with a Common Condition

 

Insomnia is one of the most common medical conditions you will encounter as a PNP. Insomnia is a

common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD

(Abbott, 2016). Various studies have demonstrated the bidirectional relationship between insomnia and

mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90%

of adults with depression experience sleep problems (Abbott, 2016). Due to the interconnected

psychopathology, it is important that you, as the PNP, understand the importance of the effects some

psychopharmacologic treatments may have on a patient’s mental health illness and their sleep patterns.

Therefore, it is important that you understand and reflect on the evidence-based research in developing

treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate

psychopharmacologic treatments for optimal health and well-being.

 

Case study: An elderly widow who just lost her spouse.

 

Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is

75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she

states her depression has gotten worse as well as her sleep habits. The patient has no previous history of

depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once

or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private

vehicle. Patient currently takes the following medications:

 Metformin 500mg BID

 Januvia 100mg daily

 Losartan 100mg daily

 HCTZ 25mg daily

 Sertraline 100mg daily

Current weight: 88 kg

Current height: 64 inches

Temp: 98.6 degrees F

BP: 132/86

 

 

Discussion Instructions: For this Discussion use the above case study excerpt presented. Reflect on

the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat

the patient’s health needs.

 

Post a response to each of the following:

 

 List three questions you might ask the patient if she were in your office. Provide a rationale for

why you might ask these questions.

 Identify people in the patient’s life you would need to speak to or get feedback from to further

assess the patient’s situation. Include specific questions you might ask these people and why.

 Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and

how the results would be used.