ASSIGNMENT Respond to at least two of your colleagues in one of the following ways: If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include add

Expert Solution Preview

Introduction:

In this case study, a 75-year-old woman presents with insomnia and depression following the death of her spouse. As a medical professional, it is important to ask relevant questions, assess the patient’s situation thoroughly, and provide appropriate treatment. In response to my colleagues:

1. List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.

a. What is your current sleep pattern?
b. Have you experienced any recent weight loss or gain, changes in appetite or energy levels?
c. How has your daily routine changed since your spouse’s death?

These questions can help to determine the severity of the patient’s insomnia and assess any potential underlying causes. Additionally, it can provide insight into how the patient is coping and adapting to changes in their life.

2. 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.

I would need to speak to the patient’s family members to get a better understanding of her life since the passing of her spouse. Questions I might ask include:

a. How has the patient’s mood been since the passing of her spouse?
b. Has the patient expressed any suicidal ideations?
c. How has the patient’s sleep been since the passing of her spouse?

By speaking to family members, I can get a better understanding of the patient’s home life and assess any potential support systems that may be available for her.

3. Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.

A physical exam and blood work may be appropriate to assess the patient’s current health and rule out any underlying medical conditions. Additionally, a sleep study may be necessary to further assess the patient’s insomnia.

4. List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.

Differential diagnoses may include depression, anxiety, or grief. Depression may be the most likely diagnosis as the patient is experiencing related symptoms following the loss of her spouse.

5. 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.

Two pharmacologic agents that may be appropriate for antidepressant therapy are Sertraline and Escitalopram. Sertraline may be preferred due to its shorter half-life and lower risk for drug interactions.

6. 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?

Alterations in dosing may be necessary for elderly patients due to their increased risk for side effects. Additionally, it is important to consider the potential for drug interactions with medications the patient is already taking.

7. 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.

Follow-up appointments may be necessary to assess the effectiveness of medication and monitor potential side effects. Therapeutic changes may need to be made if the patient experiences no improvement or adverse reactions to medication.