Week 12 Assignment 1: O'Neil inhuman Case Study, Exams of Nursing

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Week 12

Assignment 1:

O'Neil inhuman

Case Study

Informed

Consent

Week 12

Assignment 1:

O'Neil inhuman

Case Study

Informed Consent

- Pulse: 68 bpm - Respiration: 14 bpm - SP0 2 : 97% Physical Exam - Height: 5'3" - Lymphatic: no lymphadenopathy - Psychiatric General : Oriented and alert to time and place. Casually dressed and obese. Speech : increased speech rate (Hyperverbal) Mood : Seems anxious and depressed Thought content: Has passive suicidal thoughts, has paranoia, focuses on shame, writing assessment Findings Sarah seems to be having bipolar II disease with psychotic characteristics. For the last month, Sarah says she's been sad every day, and for the past two weeks, she's felt sad "every minute of every day." Because of her faith and family, she admits to having suicidal thoughts, but she says she will not act on them. As a result of some delusional thinking, she believes she's being targeted for dismissal by her colleagues. About six weeks ago, Sarah says she went days without sleeping and behaved in a way that was clearly out of character for her. An extra-marital affair was discussed at the pub, she nearly departed with a stranger, and she became blackout drunk. Sarah has also recently gained weight and is dissatisfied with the way she looks, she tells us. For a mother with schizophrenia, a father with alcoholism, and a sister with depression, the family history is significant. Differential Diagnosis: Generalized Anxiety Disorder DSM- 5 300.02 (F41.1) Generalized anxiety disorder is characterized by excessive, irrational anxiety and stress in the face of ordinary daily situations. An alternative term for it is GAD. GAD sufferers constantly

worry about their health, family, finances, employment, and education (Kim, 2020). His feelings of despair are exacerbated by her emotional and behavioral reactions. Worry and sleeping issues are also among her complaints. Even though her partner is supportive, she finds it impossible to focus on anything, even her relationship. Bipolar II disorder 296.89 (F31.81) Bipolar II disorder patients commonly appear during a major depressive episode, while hypomanic episodes are rarely the cause of disability (Jain, 2021). Impairment is caused by significant episodes of depression or recurrent trends of irregular mood fluctuations and inconsistent interpersonal or vocational functioning. Treatment Plan Diagnostics: Drug toxicology, thyroid function test, CBC , blood alcohol concentration chg., complete metabolic panel, and acetaminophen Pharmacological Treatment:

1. quetiapine fumarate 50 mg/day PO divided q12hr. As a single drug or in conjunction with other mood stabilizers, quetiapine has been found to be useful in the treatment of bipolar disorder, including manic, mixed, and depressed episodes. Continuous monitoring of metabolic side effects is necessary to detect dyslipidemia and hyperglycemia (Savva, 2019).
2. Prozac 20 mg PO Day. A depressive disorder can be treated with fluoxetine. The patient's mood, sleep, appetite, and activity level may improve as a result of taking this medicine. Fear, anxiety, undesirable thoughts, and panic attacks may be reduced (Taylor et al, 2021).
3. Ramelteon 8 mg add. The patient's insomnia is alleviated by using this drug (insomnia). As a result, she will be able to get a good night's sleep sooner (Townsend & Morgan, 2017).