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.
Determine the patients support system. It may be a close friend(s), sibling(s), child(ren), grandchild(ren), or a community group such as church.
Specific questions would include asking them what symptoms they see the patient displaying. Is she more withdrawn? Is she properly caring for herself?
Are her socioeconomic needs met? Possibly see if anyone has been staying with her and/or helping since her the passing of her spouse. HIPPA must be addressed, and the patient must consent to these interactions.
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.
Considering this patients problem is an acute issue and sleep is essential. The medications prescribed should have an almost immediate effect, she should have a follow up in a week or so. At this point her sleep will be reevaluated and treatment may change or be continued. Ensure she know possible adverse effects and educated to report them immediately.
