The Case of a Graduate Student Jane is a 22-year-old graduat

The Case of a Graduate Student Jane is a 22-year-old graduate… The Case of a Graduate Student    Jane is a 22-year-old graduate student who presents to primary care with complaints of a persistent dull stomach ache over the last 2 months with mild nausea but no vomiting. The comprehensive work-up, including specialist consultation, points to all findings as essentially within the normal range.  During the course of the work up, Jane makes occasional references to her concern of being poisoned and has asked if there are any common household poisons which have no odor or taste.  You answer her s but any time you probe for more information as to the nature of her s she appears fearful and suddenly distracted with her thoughts.      Jane does not have any psychiatric history and patient’s family history is unknown. She has functioned well in school and work up until recently. This last semester her grades have dropped and she quit her part-time job.  There are no acute medical concerns, no chronic conditions and the patient is not on any medications, herbal or dietary supplements.  The patient is in your office today and growing increasingly more upset and mildly agitated after you have explained the lack of support for any medical reason for her symptoms.  She makes a tearful request that you please do a blood test to make sure there is no poison in her body.  A brief cursory mental status overview provides the primary care with the following information:? Alert, fully oriented and easily engaged for most topics though avoidant of the discussion relative to poison.? Patient’s stated mood is “nervous”.? Speech is somewhat halting or delayed in response, as if the patient is carefully considering her response. Normal tone, low volume.? Thought process/content presents as organized without cognitive distortion of reality however it is unclear if the delay in speech is related to a delay in processing. The content, though absent of any overt evidence of psychosis, is ably paranoid given the patients fixation on poison.  With this presentation and assurance that there is no medical cause for the patient’s complaints, as the primary care provider please address the following s:s:1) Using the DSM V diagnostic criteria, what is/are the diagnostic possibility (or possibilities) appropriate for this case study? What would substantiate the diagnosis?  (Please refer to the diagnostic criteria and exclusionary criteria in the DSM V to answer this ).2) What are the differentials to consider and what allows you to rule out these conditions?  This is an important section as it justifies your clinical impression by walking me through your diagnostic decision making.3) What psychosocial and environmental problems are important to consider in this case in terms of treatment and prognosis of the identified mental disorders (assess the problems on your own, you don’t need to cite references for this section)?  Is this patient at risk in anyway?  If so, in what areas is she at risk and why?  How would you assess this patient’s potential for self-harm or suicide?4) What medication(s) are appropriate considerations?  Are there short term and long-term considerations?  Research what current medications or psychotherapeutic treatments are gaining advantage in managing this disorder.  Please provide yourpsychopharmacologic plan with specific drugs, dosages and any monitoring needs or patient educational needs relative to this plan.  Provide some case-specific or individualized interventions/approach considerations for the APN.      Health Science Science Nursing

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