T. J. Summerton comes to your office with his two daughters for a second opinion. His older daughter, Vaida, says that their dad's moods are all over the place and that his memory is getting worse. His younger daughter, Eleanor, says that their dad never had any mood problems until their mom died, and then his moods kept getting worse. Vaida says that their dad recently went into a nursing home because he stopped taking care of himself. Since he has been in the nursing home, he has seen the psychiatric nurse practitioner, who sees all the residents at the home. Eleanor says that they are here to see you today because they want a second opinion about the medications and treatment T.J. is getting.
Review the records from the nursing home (below) and revise T.J.'s treatment plan.
T. J. Summerton, male
Resident, Hall C, Room 134
Medical history: high cholesterol, GERD,
high blood pressure, memory loss, depression
Surgeries: Left knee replacement
Allergies: iodine, shellfish
A & O x 2-3
Brief examination
Depression: 7/10; lays in bed, doesn't attend the nursing home
events, says "I want to go to heaven."
Anxiety: 5/10 "I just get nervous with the stuff going on around
here."
SI: "I would never do it because of my faith, but I don't want
to be around much longer."
Psychosis: denies
Sleep: "Even with my sleep medications, I wake up all
night."
Appetite: Poor; NH staff, patient has lost 5 lbs. in 2
months.
Current weight: 177 lbs. Height: 5'9"
14 February 1941
Medication
Dosage
Instructions
Reason
Prescribing Doctor
Metoprolol
50 mg
Daily
Blood pressure
Dr. Ampadu
Synthroid
100 mcg
Daily in the morning
thyroid
Dr. Ampadu
Lipitor
20 mg
Daily at night
cholesterol
Dr. Ampadu
Flomax
4 mg
Daily
prostate
Bill Jones, PA
Ambien
10 mg
Daily at night
Sleep
Jessica Balkus, PMHNP
Sertraline
150 mg
Daily
depression
Jessica Balkus, PMHNP
Nexium
40 mg
Daily
GERD
Dr. Ampadu
Aricept
5 mg
Daily
Memory
Jessica Balkus, PMHNP
Allergies: Shellfish,
iodine
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