A 70-year-old woman has scheduled an initial evaluation with you. Her medical diagnoses include hypertension, hyperglycemia, mild obesity,
A 70-year-old woman has scheduled an initial evaluation with you. Her medical diagnoses include hypertension, hyperglycemia, mild obesity,
A 70-year-old woman has scheduled an initial evaluation with you. Her medical diagnoses include hypertension, hyperglycemia, mild obesity, and hyperlipidemia. Her psychiatric diagnoses include anxiety and depression. Her current medications are atorvastatin 20 mg daily for seven years, Ozempic 1 mg injection weekly for three years, lisinopril 10 mg daily for 10 years, and Abilify 5 mg daily for six years.
Labs: Fasting Blood Glucose – 115, HbgA1C – 6.9, Total Cholesterol – 200, LDL – 100, HDL – 37. Her height is 5’2” and her weight is 176 pounds. Her blood pressure was 146/83 upon arrival at the office.
During your interview, she explains she became depressed following the death of her husband seven years ago. She became anxious about performing everyday tasks without him present. After starting Abilify, she gained 25 pounds and required an increased dose of atorvastatin and Ozempic. She has been unable to lose the weight she gained and tries to closely monitor her dietary intake due to her persistently elevated glucose but reports still craving carbohydrates. Her depression has improved slightly but she is still anxious to go out alone, so she no longer goes for daily walks to exercise.
Questions:
What advice or modifications to his treatment regimen would you recommend for your new patient? (Discuss a minimum of two). Please support your answer with research-based evidence.
If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?
Please include the subjective and objective information in this post.
If your LAST name begins with the letters A through N please address the following:
A 70-year-old woman has scheduled an initial evaluation with you.
Her medical diagnoses include hypertension, hyperglycemia, mild obesity, and hyperlipidemia.
If your LAST name begins with the letters O through Z please address the following:
Your patient is a 36-year-old woman with bipolar disorder and anxiety. She has been stable on a combination of fluoxetine and olanzapine for two years. She is morbidly obese at 340 pounds at 5’5” in height, has type II diabetes, hypertension, and hyperlipidemia. She has concerns about her weight and has tried numerous ‘fad diets’ to no avail. She explains she has lost, at most, 15 pounds and has been able to keep it off for three months.
She has three children, one of which is severely disabled, and a husband who has a terminal diagnosis. She expresses worry that her weight will impact her ability to care for her disabled child when her husband dies. She reports she eats out frequently due to her children’s busy schedules. She is a stay-at-home mother but gets little exercise and performs no regular physical activity.
She reports feelings of shame that she can no longer orgasm on the rare occasions her husband has the energy and desire to be intimate.
Questions:
What would be your approach to managing this patient’s weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence.
What would be our approach to the sexual side effects she is experiencing?
If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?
Please include the subjective and objective information in this post.
All responses must by supported by correct APA 7th edition formatted citations and references.