This discussion assignment provides a forum for discussing relevant
topics for this week based on the course competencies covered. For this
assignment, make sure you post your initial response to the Discussion Area by the due date assigned.
To support your work, use your course textbook readings and the South
University Online Library. As in all assignments, cite your sources in
your work and provide references for the citations in APA format.
Start reviewing and responding to the postings of your classmates as
early in the week as possible. Respond to at least two of your
classmates’ initial postings. Participate in the discussion by asking a
question, providing a statement of clarification, providing a point of
view with a rationale, challenging an aspect of the discussion, or
indicating a relationship between two or more lines of reasoning in the
discussion. Cite sources in your responses to other classmates. Complete
your participation for this assignment by the end of the week.
For this assignment, you will complete a Aquifer case study based on
the course objectives and weekly content. Aquifer cases emphasize core
learning objectives for an evidence-based primary care curriculum.
Throughout your nurse practitioner program, you will use the Aquifer
case studies to promote the development of clinical reasoning through
the use of ongoing assessments and diagnostic skills and to develop
patient care plans that are grounded in the latest clinical guidelines
and evidence-based practice.
The Aquifer assignments are highly interactive and a dynamic way to
enhance your learning. Material from the Aquifer cases may be present in
the quizzes, the midterm exam, and the final exam.
Learn how to access and navigate Aquifer.
This week, complete the Aquifer case titled “Family Medicine 03: 65-year-old woman with insomnia”
Apply information from the Aquifer Case Study to answer the following discussion questions:
- Discuss the 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. - 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? - Please list 3 differential diagnoses for Mrs. Gomez and explain why
you chose them. What was your final diagnosis and how did you make the
determination? - What plan of care will Mrs. Gomez be given at this visit, include
drug therapy and treatments; what is the patient education and
follow-up?
Expert Solution Preview
Introduction:
Insomnia is a common sleep disorder that affects people of all ages. It is characterized by difficulty in falling or staying asleep. This discussion will explore the case of Mrs. Gomez, a 65-year-old woman with insomnia, using the Aquifer case study. The discussion will cover her history, physical examination, differential diagnoses, and plan of care, including drug therapy, treatments, patient education, and follow-up.
1. Discuss the 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’s chief complaint is difficulty sleeping. Her history would need to cover any medical conditions, current medications, and lifestyle factors that may be contributing to her difficulty in sleeping. Her medical history should be explored, including any history of psychiatric disorders such as anxiety, depression, or post-traumatic stress disorder. Her past medical history should be reviewed to determine if she has any chronic illnesses that may be contributing to her insomnia. Her social history should be carefully investigated to determine if she has any lifestyle factors that are negatively impacting her sleep, such as caffeine or alcohol intake, or excessive screen time before bedtime. Her family history should be assessed to determine if any family members have experienced sleep problems.
2. 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 physical exam for Mrs. Gomez should include an evaluation of her mental status and vital signs. Other assessments should include an examination of her cardiovascular and respiratory systems, as well as her neurological system. The diagnostic tools to be used for Mrs. Gomez should include a sleep study to evaluate any underlying sleep disorders. It would also be helpful to obtain a complete blood count, thyroid function tests, and a medication review to assess for any underlying medical causes of her insomnia.
3. Please list 3 differential diagnoses for Mrs. Gomez and explain why you chose them. What was your final diagnosis and how did you make the determination?
The three differential diagnoses for Mrs. Gomez’s insomnia could include obstructive sleep apnea, depression, and nocturnal reflux disease. Obstructive sleep apnea can lead to difficulty sleeping due to frequent disruptions in sleep from breathing difficulties, while depression can also impact sleep patterns. Nocturnal reflux disease can lead to difficulty sleeping due to acid reflux symptoms. Mrs. Gomez’s final diagnosis was obstructive sleep apnea, which was determined through a sleep study evaluation.
4. What plan of care will Mrs. Gomez be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?
Mrs. Gomez’s plan of care will include continuous positive airway pressure (CPAP) therapy to treat her obstructive sleep apnea. In addition to this therapy, her drug therapy may include the use of sedatives to help her sleep. Treatment may also include making lifestyle changes, such as avoiding caffeine and alcohol before bedtime. Patient education will be provided, including information about the use and care of her CPAP machine. A follow-up sleep study will be conducted to evaluate the efficacy of her therapy.
