ARGEC: Case studies Depression: Programmatic Responses and Treatment
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Ms. G is a 75-year-old woman living alone who has become depressed since falling and injuring herself 6 weeks ago. She has lost interest in activities she used to enjoy like shopping and cooking. Her sons contact her weekly but live out of state. Treatment options for her depression could include counseling to help her cope with loneliness and loss of independence. The goal would be to improve her mood and engagement in meaningful activities. Barriers may include reluctance to seek help due to age and mobility issues after her fall.
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Extra Credit Case studies – Stump the Diagnostician1 point per c.docx
Extra Credit Case studies – Stump the Diagnostician
1 point per correct answer
Read the information on the following cases, and state the most appropriate diagnosis for each person. Explain the rationale for each of your diagnoses and suggest treatment(s). Some of these cases may not have disorders. In that case, indicate that the person does not have a disorder, and indicate why this is your opinion.
1. You see Susan (age 24) in the emergency room of a hospital where her parents have brought her for evaluation. They are worried because she is giving away all of her possessions and says she is planning to move to New York so she can "save the world." Her parents say that she has hardly been sleeping at all, but she seems very energetic. They say she has appeared to be "in a frenzy" lately but this is an improvement: months earlier she had been very unhappy and lethargic. When you interview Jill you notice that she speaks very rapidly. It is hard to get her to be quiet long enough for you to ask questions. She seems agitated, and has difficulty sitting still.
Diagnosis: ___________________________________________________________
Why: _______________________________________________________________
Suggested Tx: ________________________________________________________
2. Sulaiman has been referred to you for psychotherapy following a suicide attempt. When you interview him he is very teary. He speaks slowly and looks down at the ground as he speaks. He reports difficulty in falling asleep and staying asleep for the past month. Sulaiman states that he hasn't had much of an appetite and has lost 15 pounds. He reports that things he used to like just don't seem enjoyable anymore, and he thinks that life is not worth living. Sulaiman doesn't expect things to improve in the future, which is why he tried to kill himself.
Diagnosis: ___________________________________________________________
Why: _______________________________________________________________
Suggested Tx: ________________________________________________________
3. Shahida has been feeling very sad since her husband died 12 days ago. She has eaten very little, and has difficulty sleeping. She is weepy most of the time. Shahida is preoccupied with thoughts of her dead husband and does not want to do much other than thinking about him. She has declined all invitations by friends and spends most of her time alone.
Diagnosis: ___________________________________________________________
Why: _______________________________________________________________
Suggested Tx: ________________________________________________________
4. Patricia, age 38, is a worrier. She is restless, irritable and has difficulty concentrating. She worries that she worries so much and isn’t always sure what it is that she is worried about. She can’t let her husband or children leave the house without making them call her regularly to reassure her that they are ok. Her husband is growing wea ...
Page 1 of 2Ethics in Psychology © 2013 Argosy UniversityCour.docx
Page 1 of 2
Ethics in Psychology
© 2013 Argosy University
Course Case Study 2
Joe, a thirty-five-year-old, male mental health counselor, received a client referral, thirty-five-year-old Jill, from a community counseling clinic. He began providing counseling services to her. Jill's complaint was that she was unsatisfied with her current job as a bank teller and was experiencing mild anxiety and depression. Joe had been providing services to Jill for three weeks when she disclosed that she was confused about her sexuality because she experienced sexual attraction toward some women. Joe immediately responded to Jill with wide eyes and a shocked look. He told Jill that he was a traditional Catholic, who felt that this type of feeling was immoral and wrong. He informed her that she should avoid thinking about this and pray for forgiveness. He also told her that he felt uncomfortable talking about the issue any further. Jill continued to talk to Joe about dealing with her family issues.
Joe had recently read about a new technique and immediately became excited about trying it. He explained to her that he had read an article in a magazine about a new technique called rebirthing. The new technique was being used in Europe to help people change their views about their relationships with their family. Joe said, "It is supposed to be really effective in almost wiping out your memory of your family; it is like hypnosis." "I would really like to try it on you today, what do you think?" Jill declined his offer and continued to talk about her family. Joe thought to himself that even though Jill said no, he was still going to try to hypnotize her as they talked because he thought she could benefit from the technique. Jill disclosed that she was raised in a traditional Asian American home with many cultural influences and culture-specific rules and behavior. Jill was struggling with balancing her individualism and her cultural heritage. Joe explained to her that because he was living and working in a rural community, mostly consisting of people of East European descent, he could not relate to Jill’s culture and the issues with which she was struggling. He apologized and explained that he was not required to study these cultural issues because of his geographical location.
Jill moved on to talk about her depression. She began talking about feeling lonely and how it contributed to her depression. During a counseling session several months later, she revealed that she was attracted to Joe and would like a closer, intimate relationship with him. Joe, aware that he was also attracted to Jill, talked about his feelings toward her but explained that engaging in a relationship outside the established counseling relationship was unethical. He informed her that because of the mutual feelings of attraction, the counseling relationship would be ineffective and that he would refer her to another counselor for continued services. Jill agreed, and they terminated the couns.
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Extra Credit Case studies – Stump the Diagnostician1 point per c.docx
Extra Credit Case studies – Stump the Diagnostician
1 point per correct answer
Read the information on the following cases, and state the most appropriate diagnosis for each person. Explain the rationale for each of your diagnoses and suggest treatment(s). Some of these cases may not have disorders. In that case, indicate that the person does not have a disorder, and indicate why this is your opinion.
1. You see Susan (age 24) in the emergency room of a hospital where her parents have brought her for evaluation. They are worried because she is giving away all of her possessions and says she is planning to move to New York so she can "save the world." Her parents say that she has hardly been sleeping at all, but she seems very energetic. They say she has appeared to be "in a frenzy" lately but this is an improvement: months earlier she had been very unhappy and lethargic. When you interview Jill you notice that she speaks very rapidly. It is hard to get her to be quiet long enough for you to ask questions. She seems agitated, and has difficulty sitting still.
Diagnosis: ___________________________________________________________
Why: _______________________________________________________________
Suggested Tx: ________________________________________________________
2. Sulaiman has been referred to you for psychotherapy following a suicide attempt. When you interview him he is very teary. He speaks slowly and looks down at the ground as he speaks. He reports difficulty in falling asleep and staying asleep for the past month. Sulaiman states that he hasn't had much of an appetite and has lost 15 pounds. He reports that things he used to like just don't seem enjoyable anymore, and he thinks that life is not worth living. Sulaiman doesn't expect things to improve in the future, which is why he tried to kill himself.
Diagnosis: ___________________________________________________________
Why: _______________________________________________________________
Suggested Tx: ________________________________________________________
3. Shahida has been feeling very sad since her husband died 12 days ago. She has eaten very little, and has difficulty sleeping. She is weepy most of the time. Shahida is preoccupied with thoughts of her dead husband and does not want to do much other than thinking about him. She has declined all invitations by friends and spends most of her time alone.
Diagnosis: ___________________________________________________________
Why: _______________________________________________________________
Suggested Tx: ________________________________________________________
4. Patricia, age 38, is a worrier. She is restless, irritable and has difficulty concentrating. She worries that she worries so much and isn’t always sure what it is that she is worried about. She can’t let her husband or children leave the house without making them call her regularly to reassure her that they are ok. Her husband is growing wea ...
Page 1 of 2Ethics in Psychology © 2013 Argosy UniversityCour.docx
Page 1 of 2
Ethics in Psychology
© 2013 Argosy University
Course Case Study 2
Joe, a thirty-five-year-old, male mental health counselor, received a client referral, thirty-five-year-old Jill, from a community counseling clinic. He began providing counseling services to her. Jill's complaint was that she was unsatisfied with her current job as a bank teller and was experiencing mild anxiety and depression. Joe had been providing services to Jill for three weeks when she disclosed that she was confused about her sexuality because she experienced sexual attraction toward some women. Joe immediately responded to Jill with wide eyes and a shocked look. He told Jill that he was a traditional Catholic, who felt that this type of feeling was immoral and wrong. He informed her that she should avoid thinking about this and pray for forgiveness. He also told her that he felt uncomfortable talking about the issue any further. Jill continued to talk to Joe about dealing with her family issues.
Joe had recently read about a new technique and immediately became excited about trying it. He explained to her that he had read an article in a magazine about a new technique called rebirthing. The new technique was being used in Europe to help people change their views about their relationships with their family. Joe said, "It is supposed to be really effective in almost wiping out your memory of your family; it is like hypnosis." "I would really like to try it on you today, what do you think?" Jill declined his offer and continued to talk about her family. Joe thought to himself that even though Jill said no, he was still going to try to hypnotize her as they talked because he thought she could benefit from the technique. Jill disclosed that she was raised in a traditional Asian American home with many cultural influences and culture-specific rules and behavior. Jill was struggling with balancing her individualism and her cultural heritage. Joe explained to her that because he was living and working in a rural community, mostly consisting of people of East European descent, he could not relate to Jill’s culture and the issues with which she was struggling. He apologized and explained that he was not required to study these cultural issues because of his geographical location.
Jill moved on to talk about her depression. She began talking about feeling lonely and how it contributed to her depression. During a counseling session several months later, she revealed that she was attracted to Joe and would like a closer, intimate relationship with him. Joe, aware that he was also attracted to Jill, talked about his feelings toward her but explained that engaging in a relationship outside the established counseling relationship was unethical. He informed her that because of the mutual feelings of attraction, the counseling relationship would be ineffective and that he would refer her to another counselor for continued services. Jill agreed, and they terminated the couns.
For this assignment, you will refer to the section Course Case St.docx
For this assignment, you will refer to the section "
Course Case Study
"(below). Reread the case study, looking specifically at issues related to cultural competence. Examine the ACA's and APA's ethical guidelines related to the issue of cultural competence and respond to the following:
Describe the ethical issues related to cultural competence.
Examine the influence of your own personal values as related to the diversity issues presented in this case. Reflect on how you felt as you read the case study, how your values came into play, and how you would handle your values in a situation such as this.
Make recommendations based on your readings and the
APA
or
ACA
ethics codes.
Be sure to apply specific ethical principles.
Paper should be atleast 2 pages long not including title and reference page. Use APA format.
Course Case Study
Joe, a thirty-five-year-old, male mental health counselor, received a client referral, thirty-five-year-old Jill,
from a community counseling clinic. He began providing counseling services to her. Jill's complaint was that
she was unsatisfied with her current job as a bank teller and was experiencing mild anxiety and depression.
Joe had been providing services to Jill for three weeks when she disclosed that she was confused about
her sexuality because she experienced sexual attraction toward some women. Joe immediately responded
to Jill with wide eyes and a shocked look. He told Jill that he was a traditional Catholic, who felt that this
type of feeling was immoral and wrong. He informed her that she should avoid thinking about this and pray
for forgiveness. He also told her that he felt uncomfortable talking about the issue any further. Jill continued
to talk to Joe about dealing with her family issues.
Joe had recently read about a new technique and immediately became excited about trying it. He explained
to her that he had read an article in a magazine about a new technique called rebirthing. The new technique
was being used in Europe to help people change their views about their relationships with their family. Joe
said, "It is supposed to be really effective in almost wiping out your memory of your family; it is like
hypnosis." "I would really like to try it on you today, what do you think?" Jill declined his offer and continued
to talk about her family. Joe thought to himself that even though Jill said no, he was still going to try to
hypnotize her as they talked because he thought she could benefit from the technique.
Jill disclosed that she was raised in a traditional Asian American home with many cultural influences and
culture-specific rules and behavior. Jill was struggling with balancing her individualism and her cultural
heritage. Joe explained to her that because he was living and working in a rural community, mostly
consisting of people of East European descent, he could not relate to Jill’s culture and the issues with which
she was .
· Referral information Client reported that she has been struggli.docx
· Referral information: Client reported that she has been struggling with her mental health and symptoms have been worsening since last year. Being recommended by CMH to agency. Client said she wants to "Getting to what I used to be, being able to get to a functioning level, take care of my child and work". Specifically need therapy, case management.
· History of presenting problem(s):
· She reported that she sleeps all day, has difficulties getting out of bed, has low energy, low motivation and has been unable to attend work, has been hopelessness, worthlessness, isolating and not able to tend to her activities of daily living. Stated that she has been endorsing symptoms of depression for "quite a while" and the past several months things have been worsening.
· She reported that she currently doesn't have any thoughts of hurting self however has a history of suicidal thoughts including attempts. Stated that she has had suicidality all throughout the Fall of 2019. She also has history of suicide attempts prior to the most recent attempt stating that in the past she "has many overdoses mostly on pills that were prescribed and Tylenol". She reported a history of self-harming thoughts and behaviors. Stated that in the summer and fall of 2019 she has cut self and prior to that she hasn't cut herself since her early 20s.
· Client works at a Senior day program in Ypsilanti and has housing at this time however is at risk of losing employment and housing due to her worsening symptoms and inability to care for herself.
· Bio-psycho-social-spiritual history:
· Biological domain: Client is a 35years old female-single with two children. White. She reported that she was previously on the following: Paxil, Celexa, Lexapro however all have been discontinued and uncertain why.
· Psychological domain: Denied any auditory of visual hallucinations or paranoia. She reported that she currently doesn't have any thoughts of hurting self however has a history of suicidal thoughts including attempts. Stated that she has had suicidality all throughout the Fall of 2019 with an attempt in august.
· Social domain: Born and raised in Dexter by both parents. Her parents are still together and alive. She has three siblings (two brothers and a sister) and client is the middle child. She stated that her siblings and her "get along but aren't super close". She reported a history of sexual assault.
She shares custody of her 4years old son with her ex. Her son has been staying mostly with his father due to her worsening depression. She stated that she hopes to get better soon so he can return to her home. She stated that when she spends time with her 4 years old son she feels "drained" after her son leaves. She worked at the senior center after earned a Bachelors in Social Work at EMU. Is at risk of losing her employ.
· Referral information Client reported that she has been struggli.docx
· Referral information: Client reported that she has been struggling with her mental health and symptoms have been worsening since last year. Being recommended by CMH to agency. Client said she wants to "Getting to what I used to be, being able to get to a functioning level, take care of my child and work". Specifically need therapy, case management.
· History of presenting problem(s):
· She reported that she sleeps all day, has difficulties getting out of bed, has low energy, low motivation and has been unable to attend work, has been hopelessness, worthlessness, isolating and not able to tend to her activities of daily living. Stated that she has been endorsing symptoms of depression for "quite a while" and the past several months things have been worsening.
· She reported that she currently doesn't have any thoughts of hurting self however has a history of suicidal thoughts including attempts. Stated that she has had suicidality all throughout the Fall of 2019. She also has history of suicide attempts prior to the most recent attempt stating that in the past she "has many overdoses mostly on pills that were prescribed and Tylenol". She reported a history of self-harming thoughts and behaviors. Stated that in the summer and fall of 2019 she has cut self and prior to that she hasn't cut herself since her early 20s.
· Client works at a Senior day program in Ypsilanti and has housing at this time however is at risk of losing employment and housing due to her worsening symptoms and inability to care for herself.
· Bio-psycho-social-spiritual history:
· Biological domain: Client is a 35years old female-single with two children. White. She reported that she was previously on the following: Paxil, Celexa, Lexapro however all have been discontinued and uncertain why.
· Psychological domain: Denied any auditory of visual hallucinations or paranoia. She reported that she currently doesn't have any thoughts of hurting self however has a history of suicidal thoughts including attempts. Stated that she has had suicidality all throughout the Fall of 2019 with an attempt in august.
· Social domain: Born and raised in Dexter by both parents. Her parents are still together and alive. She has three siblings (two brothers and a sister) and client is the middle child. She stated that her siblings and her "get along but aren't super close". She reported a history of sexual assault.
She shares custody of her 4years old son with her ex. Her son has been staying mostly with his father due to her worsening depression. She stated that she hopes to get better soon so he can return to her home. She stated that when she spends time with her 4 years old son she feels "drained" after her son leaves. She worked at the senior center after earned a Bachelors in Social Work at EMU. Is at risk of losing her employ ...
Read the section Course Case Study and analyze the behavior of t.docx
Read the section "Course Case Study" and analyze the behavior of the counselor, as a professional, that you consider unethical or unprofessional. Write a brief summary of the questionable behavior. Substantiate the summary with reasons for your analysis.
Next, identify how the counselor may have been in violation of the ACA Code of Ethics. Give the number and definitions of specific violations and compare these violations to the APA ethical standards.
In relation to these specific violations, describe the similarities or differences in the ACA and APA ethical codes.
Finally, select an ethical decision-making model from those in your readings and apply the model to a minimum of one ethical dilemma you identified in the course scenario.
Your paper should be at least 4 pages long, not counting the title page and the reference page.
8-1A Formula ViewThompson Lumber (Dec Making Under Uncertainty)PAYOFFSOutcomesMaximaxMaximinAlternativesHigh demandModerate demandLow demandMax payoffChoiceMin payoffChoiceLarge plant$200,000$100,000-$120,000$200,000Best-$120,0000Small plant$90,000$50,000-$20,000$90,0000-$20,0000No plant$0$0$0$00$0BestPAYOFFSOutcomesHurwiczEqually likelyAlternativesGood marketFair marketPoor marketRealism payoffChoiceAverage payoffChoiceLarge plant$200,000$100,000-$120,000$24,0000$60,000BestSmall plant$90,000$50,000-$20,000$29,500Best$40,0000No plant$0$0$0$00$00a =0.45REGRETOutcomesMinimaxAlternativesHigh demandModerate demandLow demandMax regretChoiceLarge plant$0$0$120,000$120,0000Small plant$110,000$50,000$20,000$110,000BestNo plant$200,000$100,000$0$200,0000
Identifies maximum payoff
IF function is used to identify the best alternative.
Identifies minimum payoff
AVERAGE function is used to calculate equally likely payoffs.
= a * maximum payoff + (1-a) * minimum payoff
Identifies maximum regret
Formula to calculate regret value
8-1BThompson Lumber (Dec Making Under Uncertainty)PAYOFFSOutcomesMaximaxMaximinAlternativesHigh demandModerate demandLow demandMax payoffChoiceMin payoffChoiceLarge plant$200,000$100,000-$120,000$200,000Best-$120,0000Small plant$90,000$50,000-$20,000$90,0000-$20,0000No plant$0$0$0$00$0BestPAYOFFSOutcomesHurwiczEqually likelyAlternativesHigh demandModerate demandLow demandRealism payoffChoiceAverage payoffChoiceLarge plant$200,000$100,000-$120,000$24,0000$60,000BestSmall plant$90,000$50,000-$20,000$29,500Best$40,0000No plant$0$0$0$00$00a =0.45REGRETOutcomesMinimaxAlternativesHigh demandModerate demandLow demandMax regretChoiceLarge plant$0$0$120,000$120,0000Small plant$110,000$50,000$20,000$110,000BestNo plant$200,000$100,000$0$200,0000
Best alternative for maximin criterion
Coefficient of realism
Regret table computed from payoff table
Best alternative for minimax regret criterion
Page 1 of 2
Ethics in Psychology
© 2013 Argosy University
Course Case Study
Joe, a thirty-five-year-old, male mental health counselor, received a client referral, thirty-five-year-old Jill,
from a communit ...
NSG6001 Advanced Practice Nursing I Page 1 of 5 © 2007 S.docx
NSG6001 Advanced Practice Nursing I
Page 1 of 5
© 2007 South University
Week 1: Cardiology Clinical Case
HPI
A 52-year-old Irish American male is discharged from the hospital. He was hospitalized for four
days after a stent placement, following admission from the emergency room with angina
symptoms. This patient presented to the emergency room with four hours of crushing chest pain.
He was short of breath with exertion and diaphoretic. The patient thought he was having a heart
attack and was afraid to come to the hospital. The symptoms lasted for four days before the
patient sought help. The patient had been suffering from similar symptoms for the past six months
but thought that he just out of shape. It was worse upon admission to the hospital. Prior to this,
the symptoms disappeared with rest.
His symptoms were relieved in the emergency department with medication and he was
transferred to the cardiac floor for catheterization.
The patient’s symptoms were highly debilitating upon his admission to the emergency
department.
Prior to his admission to the hospital for this event, the patient was not very active because of his
angina symptoms. The pain that he had was substernal and crushing and radiated to his neck
and jaw. His symptoms resolve with rest only. He has not sought any therapeutic maneuvers.
He is currently asymptomatic and is here for a follow-up visit from his hospitalization to discuss
his risk factors. The patient is still concerned that he may have other episodes of angina, even
after the stent placement.
PMH
The patient has not sought care for his problems in the past. He had been treated for
hypertension and high cholesterol in the past but stopped medication on his own. Besides that,
he has had no other significant illnesses.
He was hospitalized for a cholecysectomy ten years ago.
NSG6001 Advanced Practice Nursing I
Page 2 of 5
© 2007 South University
This patient had a baseline EKG at his doctor’s office when he was first prescribed his blood
pressure medication. Otherwise he’s had no other investigations for heart disease besides his
cholesterol levels checks.
Results of Laboratory Investigations Following Hospitalization
Total cholesterol - 210
LDL- 200
HDL- 25
Triglycerides – 250
Fasting blood sugar – 140
HgbA1c – 7.5
CXR – hyperinflation of the lungs – no infiltrate
EKG – no change from baseline.
Risk Factors:
• High blood pressure
• Hypercholesterolemia
• Type 2 diabetes
• Android obesity
• Cigarette smoker
• Positive family history
Past surgical history of Cholecysectomy, almost 10 years age without any complications.
ROS
Review of systems is otherwise negative
DISCHARGE MEDICATIONS
Tenormin XL 50 mg QD
Lipitor 10 mg QD
Glucophage – 500mg BID
Baby ASA QD
Patient is now compliant with the prescribed regimen, but wasn’t in the past. The medicines were
prescribed by the physician who disc.
Directions Offer a reflective essay integrating your experience
Directions
Offer a reflective essay integrating your experience in this course along with a shift in understanding about the basic principles of exercise prescription (pre-participation, FITT-VP and cognitive and behavioral strategies) and patients with chronic disease and special populations. (CO1, CO3)
This assignment is worth 75 pts.
Use the information below to help guide your efforts in writing this essay.
Reflective Essay Guide:
This reflective essay is a paper that should reflect your personality, your experiences, and your influences that shaped your perspective of Clinical Exercise Prescription. Ultimately, this essay will help me, the course instructor, get to know more about your experience in the class. Unlike other essays that you’ve written before in this class, this essay does not necessarily relay on research completely. Instead, this essay needs to focus on you. However, if you want to make a point directed at the course, please reference the appropriate source. An important aspect that separates a good essay from a bad one is organization; thus, start by building an outline.
Format
The format of this reflective essay greatly differs from normal argumentative or research essays. This reflective essay is more of a well-structured story or a diary entry. An essay in APA format is only applicable when it comes with an external text that you are reflecting upon. This reflection essay length should have a main body between 800 and 1000 words with at least 3 external sources.
It is important to avoid the academic style of writing. Stick to your feelings and original ideas. This essay is about you, not about the text. Use the following as a quick short-hand guide to format your essay with:
APA
· Times New Roman 12 pt font double spaced;
· 1” margins;
· Include a page header on the top of every page;
· Insert page number on the right;
· Essay should be divided into four parts: Title Page, Abstract, Main Body, and References.
It is important to avoid the academic style of writing. Stick to your feelings and original ideas.
PCN-501 Relapse Prevention Plan
Read the Jed case study and create a relapse prevention plan for Jed. Keep in mind that you would typically create a relapse prevention plan in collaboration with the client to ensure the greatest chance for success; however, in this instance, you will create one for Jed based on what you can glean from the case study.
Client Name: __________________________ Age/Date of Birth: _____________________
Date of Plan: __________________________ Next Date of Review:* __________________
*This can be 30, 60, or 90 days.
Biopsychosocial Summary:
Provide a brief description of the client's presenting symptoms.
<Add the client's presenting symptoms here.>
Part 1: Harmful/Destructive Behaviors Chart
Complete the chart below by including a minimum of three behaviors as well as associated rewards and consequences related to relapse and abstinence behaviors.
Harmful/des ...
Discussion #1Discuss Mrs. Gomez’s history that would be pertin.docx
Discussion #1
Discuss Mrs. Gomez’s history that would be pertinent to her difficulty sleeping. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.
Mrs. Gomez is a sixty-five-year-old female with the chief complaint of “can’t seem to sleep”. She reports to the healthcare provider that for the past six months, sleep has only occurred in 2-3-hour increments, each night. According to her daughter, she no longer attends church or reads, which was once her favorite hobbies. The patient admits to feeling guilty for the change in her behavior and mood and for no longer helping her daughter with housework. Mrs. Gomez states “I don’t have the energy to do anything”. Lack of concentration has also become a problem for the patient, and she attributes this problem to the reason she no longer reads. Her appetite has changed in that she mostly eats unhealthy foods now, while watching television. Sylvia, her daughter states that it seems that her mother is moving in “slow motion”. Lastly, the patient admits to feeling sad but states that she would never be able to harm herself due to religious reasons.
Mrs. Gomez’s husband of thirty-years passed away last year, and she has since relocated to her daughter’s home. She denies a history of smoking but admits to having alcoholic beverages recreationally. Past medical history includes hypertension, hypercholesterolemia, and diabetes. Home medications include Glyburide 10mg per day, Metformin 1000mg BID, Methyldopa 250mg BID, Lisinopril 10mg per day, Atorvastatin 80mg per day, Aspirin 81 mg daily, and Calcium citrate with Vitamin D 600mg/400 IU BID. The patient also admits to using Diphenhydramine and zapote tea.
Describe the physical exam and diagnostic tools to be used for Mrs. Gomez. Are there any additional you would have liked to be included that were not?
The SIG E CAPS mnemonic was used to assess Mrs. Gomez for depression and the results are expressed above. Also, the Geriatric Depression Scale aided the health care providers in making a diagnosis, and the Mini-Cog examination helped rule out other conditions. A CBC, CMP and TSH were collected on Mrs. Gomez to evaluate for electrolyte abnormalities, anemia or other illnesses that could be causing her mood changes. TSH evaluation should always be considered due to the link between hypothyroidism and depression, as well as, other cognitive impairments (Tayde et al., 2017). On assessment, the patient’s vital signs are within normal range, and the physical examination is unremarkable. With a ten-pound increase in weight from last year and the report of fatigue and sadness, as a practitioner, focus should also be placed on the patient’s skin and hair. Is the patient’s skin dry or does her hair appear to be brittle? Is there edema noted in the hands or eyelids (Buttaro et al., 2017).
Please list 3 differential diagnoses for Mrs. Gomez and explain why you chose them. What was your ...
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- 1. DEPRESSION: TREATMENT AND PROGRAMS: CASE STUDIES AND DISCUSSION QUESTIONS
- 2. Case Study Ms. G is a 75-year old female living alone in her apartment in New York City. Her husband died suddenly two years ago of a heart attack. Their two children are alive and living out-of- state. Both of her sons maintain weekly phone contact with Ms. G and visit usually once a year. Ms. G has been doing well until about 6 weeks ago when she fell in her apartment and sustained bruises but, did not require a hospital visit. Since then, she has been preoccupied with her failing eyesight and decreased ambulation. She does not go shopping as often, stating she doesn’t enjoy going out anymore and feels “very sad and teary.” Ms. G states that her shopping needs are less, since she is not as hungry as she used to be and she states, “I’m getting too old to cook for one person only”.
- 3. Case Study Discussion Questions What type(s) of treatment/interventions would be beneficial for the depression Ms. G may be experiencing? Describe why you think this type of treatment/intervention may be an appropriate choice. What would be the goals of the intervention that you selected? What are some of the barriers to treatment you should consider for Ms. G?