Using the theory of unpleasant symptoms as a guide, what would you look for in an assessment tool for patient symptoms?

Three references please 

1. Because the patient’s reported hallucinations are not persecutory, as a clinician, what medications would you start with?

2. What treatments (pharmacological and non-pharmacological) are most effective for patients with extensive trauma history?

3. What symptoms could be co-occurring in relation to PTSD vs schizophrenia for this patient?  

 Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.Scenario:

Kel is a 42-year-old certified public accountant (CPA) who dreams each year that she will board a cruise ship the day after Tax Day and go somewhere, anywhere, except Portsmouth, Virginia. Each year the dream, like the ocean, ebbs and flows, but this year she is not even going to think about such a “ridiculous idea.” In fact, she does not even have the energy to dream; getting out of bed and preparing to go to work is simply too labor intensive. 

Each evening Kel retires to bed with a lack of energy to complete her normal tasks such as readying her clothes for work and making a lunch. She lacks the energy to shop in the evening; consequently, she eats mostly crackers and canned soup. She is not hungry, and her scale reflects this. She has lost 15 pounds over the last 2 months. She does not attend to her makeup or clothes; she finds both too taxing. The clothes she selects are drab and not ironed. At work she makes no effort to talk with her co-workers and does not initiate new contacts with clients. The normal work of filing taxes and writing reports, which she used to enjoy, are overwhelming, and she feels too disorganized to complete them. Telephone calls and e-mail messages from friends are ignored. Attendance at work is spotty.

Sue, her sister, becomes alarmed with Kel’s unanswered telephone calls and e-mails. Worried, she decides to visit her sister at home. She finds the apartment unclean and in disarray. Kel is unkempt, disheveled, and looks sad. Her voice is monotone and flat. Kel tells Sue that she feels “sad and hopeless. Nothing is ever going to change. I am a bad person and I can’t even do my work right. Although I sleep for many hours, I am still tired all the time.” Sue is alarmed at the changes in her sister and arranges for Kel to visit a health care worker at the medical clinic.

Questions:

Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers. 

1. Describe the presenting problems.
2. Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes.
3. Formulate and prioritize a treatment plan. 
4. Identify and discuss appropriate screening instruments for a patient who has suicidal ideation.

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
• All replies must be constructive and use literature where possible.
• Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
• Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

see below

Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. 

A 38 year female old med student goes to her physician with complaints of arthralgia and a new rash on her face bilaterally. The rash get worse when in the sun. When she is fatigued, she complains of a sharp pain in her chest when taking a deep breath. She has experienced this before, but this present episode has been the worst she has ever felt. An exam was completed and tests ordered. The following results are:

Physical:

Temperarture, respiratory rate, and BP normal, Heart rate regular and normal

Facial rash macular over the bridge of her nose and cheeks. Discoid scaling also noted on her extensor surfaces of her arms.

Joint pain and stiffness and pain in hands on active and passive motion

Pleural friction rub auscultated with deep respiration

Other systems examined normal.

Labs:

Serum electrolytes – normal

Hemoglibin and Hematocrit – low

Platelet count – slightly low

White blood cells – normal

BUN and Creatinine – elevated

Urine – Positive for Protein

CXR – Small pleural effusion noted

Antinuclear antibody (ANA) – positive

Anti-DNA antibodies – positive

Diagnosis: Systemic Lupus Erythematosus (SLE)

Questions:

1. What is the common descriptive term for this patient’s facial rash and why?

1. What does sunlight do to people with this disease that they are taught t avoid it?

1. Which lab results indicate renal dysfunction. Is this dysfunction related to SLE? Why or why not?

1. State the other signs and symptoms of SLE that are manifested in this patients physical exam and labs? Give the rationale for each.

1. What is the pathophysiology behind SLE causing widespread tissue damage?

1. What is discoid lupus and is it different from SLE?

1. What type of teaching and management plan will be need to be devised by the APN for this patient?