Respond at least 2 times each to all colleagues who presented this week (should be 2-3 presenters each week). The goal is for the discussion forum to function as robust clinical conferences on the patients. Provide a response to 1 of the 3 discussion prompts that your colleagues provided in their video presentations. You may also provide additional information, alternative points of view, research to support treatment, or patient education strategies you might use with the relevant patient.
I need two responses for this student please
Week 9 Grand Rounds
Patrice Campbell-Marques
College of Nursing-PMHNP, Walden University
PRAC 6675: PMHNP Across the Lifespan II
Prof. Demesia Brown
July 24, 2022
NRNP/PRAC 6675 Comprehensive Psychiatric Evaluation Template
CC (chief complaint): “I’m feeling awful, I need help”.
HPI: J.H is a 70 year old white female who presents for an initial psychiatric evaluation status post hospitalization after a recent suicidal attempt by overdosing on ambien 5mg pills. She denies any history of psychiatric diagnoses or psychiatric consults, however, she has needed to use a sleep aid since her husband died over a year ago. Since then she has experienced increasing thoughts of death and dying, loss of interests in hobbies, difficulty sleeping, increased fatigue and depressed mood on most days. She reports feeling increased isolation and loneliness since the pandemic and experiencing the deaths of a few friends and her husband have left her with “very little will to continue living”. She also discloses feelings of shame and guilt about her actions to hurt herself. She has no close family or support, only a stepson and they do not have a good relationship. She is experiencing difficulty falling asleep and staying asleep, along with poor energy, low mood and diminished appetite. She is currently taking fluoxetine 20mg daily as prescribed by her primary care physician and denies the presence of any auditory or visual hallucinations, suicidal/ homicidal ideations or plans, or side effects to any medications.
Past Psychiatric History: Denies.
Substance Use – Current and History: Does not drink any alcohol, smoke cigarettes or use illicit drugs.
Family Psychiatric/Substance Use History: No known family history.
Social History: J.H is a widow and was raised in Connecticut in a strict Jewish household with both parents and an older brother who is now deceased. She reports growing up in a loving environment. She is a retired educator has a masters degree in education and leadership. She has no biological children and no close family members or relatives. There is no reported legal problems and she denies any financial difficulties.
Medical History: Hypertension
Surgical History: Breast Augmentation in 2000
Current Medications: fluoxetine 20mg daily, Amlodipine 5mg QD, Daily multivitamin.
· Allergies: NKDA
· Reproductive Hx: She is menopausal
ROS:
· GENERAL: diminished appetite, difficulty sleeping, denies any fever or noticeable weight loss.
· HEENT: No issues with vision or with hearing.
· SKIN: There is no re
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