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Case: An primeval widow who fair lost her spouse.
Subjective: A resigned presents to your original regard service today with leading remonstrance of insomnia. Resigned is 75 YO with PMH of DM, HTN, and MDD. Her wife of 41 years passed far 10 months since. Since then, she states her lowering has gotten worse as well-mannered-mannered as her slumber conduct. The resigned has no restraintmer narrative of lowering precedent to her wife’s departure. She is recover, prompt, and oriented x3. Resigned normally sees PCP unintermittently or twice a year. Resigned denies any suicidal ideations. Resigned arrived at the service today by privy conveyance. Resigned currently takes the aftercited 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
List three questions you coercionce request the resigned if she were in your service. Afford a rationale restraint why you coercionce request these questions.
Authenticate crowd in the resigned’s vitality you would demand to accost to or secure feedback from to prefer assess the resigned’s footing. Include local questions you coercionce request these crowd and why.
Clear-up what, if any, corporeal exams, and symptom tests would be misspend restraint the resigned and how the results would be authenticationd.
List a differential personality restraint the resigned. Authenticate the individual that you contemplate is most slight and clear-up why.
List two pharmacologic delegates and their dosing that would be misspend restraint the resigned’s antidepressant therapy naturalized on pharmacokinetics and pharmacodynamics. From a agency of controlce perspective, afford a rationale restraint why you coercionce adopt individual delegate balance the other.
Restraint the offal therapy you choice, authenticate any contraindications to authentication or alterations in dosing that may demand to be considered naturalized on the client’s ethnicity. Discuss why the contraindication/alteration you authenticate exists. That is, what would be problematic with the authentication of this offal in individuals of other ethnicities?
Include any “check points” (i.e., follow-up postulates at Week 4, 8, 12, etc.), and betray any curative changes that you coercionce constitute naturalized on feasible outcomes that may supervene fond your texture options chosen.