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NR601 Week 3 Case Study

NR601 Week 3 Case Study

NR601 Week 3 Case Study

Total Points Possible: 70

Requirements:

Anxiety and depression are the most common psychiatric problems you will encounter in your primary care practice.

Review this case study

HPI: BT, 50-year-old Caucasian male presents to office with complaints of “no energy and staying in bed all day.” The mornings seem to be the worst times for these symptoms, which have been around for four months. Because he does not feel rested when he wakes up in the morning, it is challenging for him to get out of bed and begin the day. “Deep sadness & heartache over the loss of his wife,” according to BT. “I just don’t feel like going out or making arrangements,” she declares. Once a week, he tries to schedule plans with family or friends, but it can be very draining because everyone wants to know how he is coping with the loss. Reports that he is finding it difficult to focus and finish projects for work. He claims he hasn’t been eating consistently and has lost some weight. BT lost his wife ten months ago. His wife died unexpectedly, she had an MI. His oldest daughter has a 2-year-old daughter, she asked him to babysit a couple of times, which he thought would help with the loneliness, but the care of his granddaughter seems overwhelming at times. Rest, evening walks, & lifting weights 2 days a week help him feel better. At this time, he does not want to do any activities or exercise, it seems like too much effort to get up and go. He has not tried any medications, prescribed or otherwise. He reports drinking a lot of coffee, but that does not seem to help with his energy levels.  NR601 Week 3 Case Study
Current medications: Tylenol PM about once a week when he can’t sleep, does not help.

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PMH: no major illnesses. Immunizations up to date.  COVID Vaccinated.

SH: Widowed with a part-time job as a programmer. virtually always has one beer at night. Neither tobacco nor illegal drugs are used. accounts of an abusive, passive-aggressive marriage that took place 25 years ago and resulted in divorce. The judge granted his ex-wife sole custody of his children. Ten years have passed since he last saw his son. He resides in a different state. A few times per month, he visits his daughter. He would like to speak with his son, but he worries that because he moved out after the divorce, the bond cannot be mended.

FH: Parents are alive and well. Has a daughter 20 and a son 18.

ROS

CONSTITUTIONAL: reports weight loss of 4-5 pounds, no fever, chills, or weakness reported. Daily fatigue.

HEENT: Eyes: No visual loss, blurred vision, double vision or yellow sclera. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose or sore throat.

CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema.

RESPIRATORY: No shortness of breath, cough or sputum.

GASTROINTESTINAL: Reports decreased appetite for about 4 months. No nausea, vomiting or diarrhea. No abdominal pain or blood.

NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

GENITOURINARY: no burning on urination.

PSYCHIATRIC: No history of diagnosed depression or anxiety. Reports history feeling very sad and anxious about loss of wife. Sad about not speaking to his son. Did not seek treatment. He started to feel better about the loss of his wife after 6 months but the grief and depression has returned.

ENDOCRINOLOGIC: No reports of sweating, cold or heat intolerance. No polyuria or polydipsia

ALLERGIES: No history of asthma, hives, eczema or rhinitis.

Discussion Questions:

  1. Research screening tools for depression and anxiety. Choose one screening tool for depression and one screening tool for anxiety that you feel are appropriate to screen BT.
  2. Explain in detail why each screening tool was chosen. Include the purpose and time frame of each chosen tool.
  3. Score BT using both of your chosen screening tools based on the information provided (not all data may be provided, those areas can be scored as not present). Pay close attention to the listed symptom time frame for your chosen assessment tool.  In your response include what questions could be scored, and your chosen score.  Interpret the score according to the screening tool scoring instructions. Assume that any question topics not mentioned are not a concern at this time.
  4. Identify your next step for evaluation and treatment for BT. Remember to consider both physical and mental health differential diagnoses when answering this question. (2-3 sentences).
  5. What medication or treatment is appropriate for BT based on his screening score today? Provide the rationale. Any medications should include the medication class, mechanism of action of the medication and why this medication is appropriate for BT. Include initial prescribing information.
  6. If the medication works as expected, when should BT expect to start feeling better?
DISCUSSION CONTENT
Category Points % Description
Application of Course Knowledge   21   30 Initial discussion post includes the following:

1) two screening tools chosen- 1 for depression, one for anxiety

2)  Student explains rationale for both screening tool choices (2-3 sentences)

3) both screening tools are scored using provided case study information only AND scores are interpreted using tool scoring guidelines.

4) Next steps for treatment includes physical health diagnoses and suggested necessary diagnostics

5) Medication choice is listed. Rationale includes medication class, mechanism of action and initial prescribing information and education to include side effects and when BTshould notice efficacy.  NR601 Week 3 Case Study

Support from Evidence-Based Practice (EBP)  14  20  1. Discussion post is supported with appropriate, scholarly sources; AND

2. Sources are published within the last 5 years ; AND

3. Reference list is provided and in-text citations match; AND

4. Includes a minimum of one scholarly reference, textbook is not used

Interactive Dialogue  21  30  1. Student provides a substantive* response to at least one topic-related post of a peer; AND

2. Student provides a substantive response to any faculty questions asked regarding the initial student post.

3. Evidence from appropriate scholarly sources are included;

4. Submits a minimum of two posts on two different days.

(*) A substantive post adds new content or insights to the discussion thread and information from student’s original post is not reused in peer or faculty response

56 80% Total CONTENT Points= 56 points
DISCUSSION FORMAT
Category Points % Description
Organization  7 10  1) Discussion is presented in a logical format, AND

2) Responses are in sequence with the listed bullet points AND

3) The discussion response is understandable and easy to follow AND

4) All responses are relevant to the discussion  topic.

Grammar, Syntax, Spelling & Punctuation  7 10  Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*

14 20% Total FORMAT Points= 14 points
DISCUSSION TOTAL=____ out of  70 points 

 

Direct Quotes

Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category. NR601 Week 3 Case Study

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