COURSE:
NR546 – Advanced Pharmacology: Psychopharmacology
Case Study
| Subjective | Objective |
| The client AA, is a 32-year-old, white female being seen for a psychiatric evaluation at an outpatient clinic.
Client’s Chief Complaints: “I just feel down and not myself.” History of Present Illness AA reports increasing depressive symptoms describes feeling overwhelmed by a persistent sense of sadness, which has been present for the past six months. AA reports a loss of interest in activities she once enjoyed, such as spending time with friends and engaging in hobbies. She notes difficulty concentrating at work and experiencing fatigue. Additionally, AA mentions changes in her appetite, with a notable decrease in food intake leading to unintentional weight loss over the past few months. Her husband has also shared that he has noticed she is “not herself.” AA also reports difficulty falling and staying asleep due to anxiety and restlessness, difficulty making decisions, and self-isolation. She has found it difficult to go to work some days due to the stress and worry she is experiencing. She denies any thoughts of self-harm or suicide but admits to feelings of hopelessness about her future. Past psychiatric history: Denies any history of previous psychiatric diagnoses or treatment for depression. However, she acknowledges a family history of depression, with her mother and maternal aunt both having been diagnosed and treated for the condition; this is the client’s first contact with a mental health provider. Past Medical History: none |
Physical Examination:
Height: 5’6″, weight: 135 lb. General: Well-nourished female appears stated age Mental status exam: Appearance: Appropriate dress for age and situation, well nourished, poor eye contact, slumped posture Alertness and Orientation: Alert, fully oriented to person‚ place‚ time‚ and situation, Behavior: Cooperative Speech: Soft, flat Mood: Depressed Affect: Constricted, congruent with stated mood Thought Process: Logical‚ linear Thought content: Self-defeating thoughts endorses thoughts suggestive of low self-worth. Denies thoughts of suicide‚ self-harm‚ or passive death wish Perceptions: Denies experiencing any perceptual disturbances, such as auditory or visual hallucinations. No evidence of psychosis, not responding to internal stimuli. Memory: Recent and remote WNL Judgement/Insight: Insight is fair, Judgement is fair Attention and observed intellectual functioning: Attention intact for the purpose of assessment. Able to follow questioning. Fund of knowledge: Good general fund of knowledge and vocabulary Musculoskeletal: Normal gait |
Family History
Father is alive and well.
Mother is alive, has depression and being treated as well as maternal aunt
One brother age 28, with anxiety and one sister age 30 with depression
Social History
Lives with husband and dog
Married for 4 years
Does have a few close friends
Denies alcohol use states “makes me feel worse.”
Denies marijuana or illicit drug use
Graduated college and works full-time as a 3rd grade teacher.
Trauma history:
Denies history of trauma but admits that mother had untreated depression for many years when she was younger and would lay in bed most of the day.
Review of Systems
Appetite diminished, weight loss 10 lbs
Sleeps 5-6 hours at night, difficulty falling asleep with frequent night waking.
No headache
No palpitations, tremors
Allergies: NKDA
Preparing the Discussion
Follow these guidelines when completing each component of the discussion. Contact your course faculty if you have questions.
General Directions
Review the provided case study to complete this week’s discussion.
Include the following sections:
- Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
- Select one drug to treat the diagnosis(es) or symptoms.
- List medication class and mechanism of action for the chosen medication.
- Write the prescription in prescription format.
- Provide an evidence-based rationale for the selected medication using at least one scholarly reference. Textbooks may be used for additional references but are not the primary reference.
- List any side effects or adverse effects associated with the medication.
- Include any required diagnostic testing. State the time frame for this testing (testing is before medication initiation or q 3 months, etc.). Includes normal results range for any listed laboratory tests.
- Provide a minimum of three appropriate medication-related teaching points for the client and/or family.
Solution
Given no apparent or stated history of mania or hypomania, this client’s symptoms are most consistent with major depressive disorder and generalized anxiety disorder (American Psychological Association, 2013). This client’s symptoms are consistent with decreased positive affect, or dopamine/norepinephrine dysfunction. Given this client’s diminished appetite and………………..purchase this case study at $15 only