Write what the 3 differential diagnoses are 150-to-200-word count. Taking into account the patient case study below.
1.Post Traumatic distress syndrome
2. Acute Stress Disorder
3.Panic attacks
Part 2
Write a reflection note responding to the information provide below (the patient is a patient primary diagnosis of PTSD post discovering her son being dead due to and over dose of drugs)
Reflection notes: What would you do differently in a similar patient evaluation? Reflect on one social determinant of health according to the HealthyPeople 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.
NB 50 y/o Caucasian F
Chief Complaint: “Panic attacks are getting worst.”
The patient is on a follow-up visit. Her psychiatric history is MDD, GAD, PTSD, and ADD. The patient reported I am having difficulty adjusting to the death of my 23 y/o son. If I had gotten up early and checked on him, he may have been alive”. The patient reported that she found her son died from an overdose of an unspecified street drug one year ago. The patient reported, “I had a nervous breakdown on my way to this appointment seems this is the town he was born and grew up. NB reported her anxiety has been very high currently. The PT rated her anxiety 10/10 on a scale of 0-10, with 10 being the worst anxiety, and her depression 8/10 on a scale of 0-10, with 10 being the worst depression. She denies any SI/HI but wishes to turn things around, stating ‘I blame myself for his death”. Currently, the patient reports difficulty initiating sleep, low mood, poor motivation, lack of pleasure in the things she once used to enjoy, and poor appetite.
Plan: Encourage and promote sleep hygiene, such as the use of cellphones or tablets 2 hours before going to bed, cutting down on caffeinated drinks, continuing supportive therapy, starting Desyrel 50 mg po at bedtime for insomnia, Vistaril 50mg po at bedtime PRN for anxiety and insomnia, continue bupropion 300 mg po daily, lorazepam 0.5 mg po BID PRN and Vyvanse 70 mg po Q am. F/U visit in 6 weeks.
