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¶ … Night TV Watcher
Questions to Ask the Patient
Would you be interested in recording your late night TV shows and watching them in the day if it means you can get to sleep earlier and be more wakeful during the daytime? If not
Would you be interested in asking your morning nurse to arrive later and if she is unable to do so would you be interested in making other arrangements for a nurse who can better accommodate your schedule? If not
Would you be interested in conducting a type of therapy that utilizes your enjoyment of receiving faxes during the day -- something like dignity therapy or spirituality therapy, which can have positive impacts on mood and outlook (Azizi, Azizi, Abedi et al., 2016)?
People to speak with for feedback to further assess the patient's situation would be her son who is devoted to her as well as her morning health assistant who visits her. Identifying and seeking feedback from her friends might also be helpful for determining the state of her social wellbeing. Questions to ask would include: 1) Does the patient signify any desire to talk to others? 2) Does the patient question her existence or why she is alive? 3) Does the patient have a desire to contact...
Differential diagnoses would include: central nervous system diseases such as Parkinson's, MS, dementia, or endocrine disorders such as hyper- or hypothyroidism. I would also test for OSA by sleep electrophysiology, as this could be linked to depression caused by opioids (Wang, Rowsell, Wong et al., 2016). The most likely differential diagnosis is OSA.
Two pharmacological agents that would be appropriate for the patient's sleep/wake therapy based on pharmacokinetics and pharmacodynamics would be: modafinil and armodafinil as both are non-amphetamine drugs that could be used for the patient during the day to help her feel less tired. I would recommend modafinil as it uses both R. and S. enantiomers (Loland, Mereu, Okunola, 2012). Dosage would be 200mg once a day in the morning.
Therapeutic changes that might I might make based on the data would be based on cardiovascular test results to see if the modafinil is impacting the…
References
Azizi, M., Azizi, A., Abedi, A., Kajbaf, M. et al. (2016). The Effect of Spiritual Therapy
on Hope of Life in Female Students Who Referred to Isfahan University Counseling Center. Psychology7(1): 126-131.
Loland, C., Mereu, M., Okunola, O. (2012). R-modafinil a unique dopamine uptake inhibitor. Biological Psychiatry, 72(5): 405-413.
Wang, D., Rowsell, L., Wong, K. et al. (2016). Identifying obstructive sleep apnea patients vulnerable to opioid induced respiratory depression. American Journal of Respiratory Critical Care Medicine, 193(20): 3-21.
Article Review on “Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults with Sleep Disturbances” Introduction The article by Black et al. (2015) evaluating sleep patterns, assesses these issues and explores treatment techniques for the three prevalent sleep disorders among the elderly. It also discusses the consequences of geriatric HCPs in clinical practice who are caretakers of the older population living within communities. The authors argue that treating
Depression, Diabetes and Obesity This is a case study on a 58-year-old male, Mr. H.Y. who worked at a supermarket and is now retired. He has a supportive wife who works full time and children who are all independent .He has a history of smoking, but quit 10 years ago and drinks alcohol twice a week. He is obese and a known case of diabetes for one year. He has gained
Not all physical activity could tackle depression. Researchers at Glasgow University interviewed hundreds of men and women about the types of exercise they engaged in (Templeton 2002). They discovered that housework, unlike vigorous exercise, not only failed to improve the morale of depressed people but also worsened their condition. They found that physical activity performed as paid work had no effect on well-being. There was no improvement in the mood,
Golant and Golant (2007) gave an example of an 8-year-old boy's externalizing behavior after his parents went through a separation and his father's departed: As the self-proclaimed new "man of the family," he began acting out as if he were an irate parent, bossing around his little brother, yelling at him and hitting him. He seemed to regress emotionally. & #8230;When his mother & #8230; tried to comfort him, he would
Depression: Not just a Bad Mood MDD: Not Just Another Bad Mood The term "Prozac Nation" says a lot. This catch-phrase had begun to describe the current state in the U.S. when cases of clinical depression began blooming and treatment turned to medication as a first response. According to the National Institute of Mental Health, over fourteen million of the adult U.S. population suffers from Major Depressive Disorder. Major Depressive Disorder,
Health care workers are not immune to psychosocial problems and often may face distinctive obstacles in dealing with them. Self-care among physicians, nurses, and other health care workers is not included as a part of their training but it is an issue that often comes up in the course of their daily routines or in their professional practice. The stresses of professional practice, shift work, and personal life can be