Differential diagnosis for the patient

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For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs.
Case: An elderly widow who just lost her spouse.
Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patients normally see PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications:
• Metformin 500mg BID
• Januvia 100mg daily
• Losartan 100mg daily
• HCTZ 25mg daily
• Sertraline 100mg daily
Current weight: 88 kg
Current height: 64 inches
Temp: 98.6 degrees F
BP: 132/86
Post a response to each of the following:
• List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.
• 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.
• Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.
• List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.
• 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.
• 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?
• 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.
2 Pages only.
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Schizophrenia Spectrum and Other Psychotic Disorders.

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• Select psychopharmacologic treatments you might recommend for treatment of patients with Schizophrenia Spectrum and Other Psychotic Disorders.
Create a study guide for the assigned psychotropic medication agents. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! IT SHOULD NOT BE IN A FORMAT OF AN APA paper. Your guide should be informed by the FDA-approved and Evidenced-Based, Clinical Practice Guidelines Research but also supported by at least three other scholarly resources.
Areas of importance you should address, but are not limited to, are:
• Title page
• Description of the Psychopharmacological medication agent including brand and generic names and appropriate FDA indication uses
• Any supporting, valid and reliable research for non-FDA uses
• Drug classification
• The medication mechanism of action
• The medication pharmacokinetics
• The medication pharmacodynamics
• Mechanism of Action
• Appropriate dosing, administration route, and any considerations for dosing alterations
• Considerations of use and dosing in specific specialty populations to consider children, adolescents, elderly, pregnancy, suicidal behaviors, etc.
• Definition of Half-life, why half-life is important, and the half-life for your assigned medication
• Side effects/adverse reaction potentials
• Contraindications for use including significant drug to drug interactions
• Overdose Considerations
• Diagnostics and labs monitoring
• Comorbidities considerations
• Legal and ethical considerations
• Pertinent patient education considerations
• Reference Page
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How a personality trait like shyness could be influenced by both genetic and environmental influences.

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Using the research on temperaments, explain how a personality trait like shyness could be influenced by both genetic and environmental influences.
 
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Family health organization

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Imagine that you work for a family health organization. You have been asked to create a newsletter to hand out to expecting parents. The newsletter should consist of 600-750 words that will inform parents of issues related to prenatal development and infancy. In the newsletter, include the following:
List critical periods of prenatal development.
List teratogens that could impact prenatal development.
List and describe ways to have a healthy pregnancy and to reduce prenatal risks.
Describe infant risks and how to minimize those risks (e.g., SIDS, injury).
Address attachment issues during infancy.
Provide tips for fostering healthy development in the three areas of infant development.
Use two to four scholarly resources to support your information.
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