(Q) Finds sensitive in nature

CASE:The patient, Mrs. Maria Perez, is a 53-year-old Puerto Rican female who has presented for consultation regarding a personal issue she finds sensitive innature.The client reports a history of alcohol use disorder dating back to her late teens and involvement with Alcoholics Anonymous over the past 25 years, withincreased difficulty maintaining sobriety since the opening of a nearby casino. She describes a high associated with gambling and an increased frequency ofdrinking and cigarette smoking while gambling, as well as concerns about the health effects of the smoking. Despite attempts at abstinence, the clientreports feeling the need for alcohol during gambling activities. She has also experienced weight gain from excessive drinking. The client expresses concernabout having borrowed a substantial sum from her retirement account to pay off gambling debts without her husband’s knowledgeThe patient is a 53-year-old Puerto Rican female who is conscious and oriented to her surroundings. She is dressed appropriately for the weather and theseason. Her speech is clear and coherent, with a clear goal. Her eye contact during the clinical interview is somewhat limited, but her mannerisms, gestures,and tics are not notable. She reports feeling “sad” and her affect is consistent with her reported mood. There is no evidence of hallucinations or delusionalthinking, and her insight and judgment appear to be intact. However, she has an impaired ability to control her impulses. There are no reported suicidal orhomicidal ideations at this time.Diagnosis: Gambling Disorder, Alcohol Use Disorder.
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making whenprescribing medication for this patient.Decision #1After a thorough history and physical from the patient, the diagnosis is gambling disorder and alcohol use disorder. Select what the PMHNP should do:• Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal regionevery 4 weeks• Antabuse (Disulfiram) 250 mg orally daily• Campral (Acamprosate) 666 mg orally three times/dayMy decision: Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal regionevery 4 weeks (BASE ANSWER ON THIS DECISION)RESULTS OF DECISION POINT ONEClient returns to clinic in four weeks. Mrs. Perez says she feels “wonderful” as she has not “touched a drop” of alcohol since receiving the injection. Clientreports that she has not been going to the casino, as frequently, but when she does go she “drops a bundle” (meaning, spends a lot of money gambling).Client She is also still smoking, which has her concerned. She is also reporting some problems with anxiety, which also has her concerned• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primaryliterature.• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specificresources, including the primary literature.• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including theprimary literature).• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.Decision #2Select what the PMHNP should do next:• Add on Valium (diazepam) 5 mg orally TID/PRN/anxiety• Refer to a counselor to address gambling issues• Add on Chantix (varenicline) 1 mg orally BIDMy decision: Refer to a counselor to address gambling issues (BASE ANSWER ON THIS DECISION)RESULTS OF DECISION POINT TWOMrs. Perez returns in 4 weeks and reports that the anxiety that she had been experiencing is gone. She reports that she has met with the counselor, but shedid not really like her. She also started going to a local meeting of Gamblers Anonymous. She states that last week, for the first time, she spoke during themeeting. She reports feeling supported in this group.• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primaryliterature.• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specificresources, including the primary literature.• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including theprimary literature).• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.Decision #2Select what the PMHNP should do next:• Add on Valium (diazepam) 5 mg orally TID/PRN/anxiety• Refer to a counselor to address gambling issues• Add on Chantix (varenicline) 1 mg orally BIDMy decision: Refer to a counselor to address gambling issues (BASE ANSWER ON THIS DECISION)RESULTS OF DECISION POINT TWOMrs. Perez returns in 4 weeks and reports that the anxiety that she had been experiencing is gone. She reports that she has met with the counselor, but shedid not really like her. She also started going to a local meeting of Gamblers Anonymous. She states that last week, for the first time, she spoke during themeeting. She reports feeling supported in this group.• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primaryliterature.• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specificresources, including the primary literature.• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including theprimary literature).• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.Decision #3Select what the PMHNP should do next:• Explore the issue that Mrs. Perez is having with her counselor, and encourage her to continue attending the Gamblers Anonymous meetings• Encourage Mrs. Perez to continue seeing her current counselor as well as continuing the Gamblers Anonymous group• Discontinue Vivitrol. Encourage Mrs. Perez to continue seeing her counselor and to continue participating in the Gamblers Anonymous groupMy decision: Explore the issue that Mrs. Perez is having with her counselor, and encourage her to continue attending the Gamblers Anonymous meetings(BASE ANSWER ON THIS DECISION)

regards to the osmosis of pieces into lumps. Mill operator recognizes pieces and lumps of data, the differentiation being that a piece is comprised of various pieces of data. It is fascinating regards to the osmosis of pieces into lumps. Mill operator recognizes pieces and lumps of data, the differentiation being that a piece is comprised of various pieces of data. It is fascinating to take note of that while there is a limited ability to recall lumps of data, how much pieces in every one of those lumps can change broadly (Miller, 1956). Anyway it’s anything but a straightforward instance of having the memorable option huge pieces right away, somewhat that as each piece turns out to be more natural, it very well may be acclimatized into a lump, which is then recollected itself. Recoding is the interaction by which individual pieces are ‘recoded’ and allocated to lumps. Consequently the ends that can be drawn from Miller’s unique work is that, while there is an acknowledged breaking point to the quantity of pi>
GET ANSWER

Share on Facebook

Tweet

Follow us

• WE OFFER THE BEST CUSTOM PAPER WRITING SERVICES. WE HAVE DONE THIS QUESTION BEFORE, WE CAN ALSO DO IT FOR YOU.
• Assignment status: Already Solved By Our Experts
• (USA, AUS, UK & CA PhD. Writers)
• CLICK HERE TO GET A PROFESSIONAL WRITER TO WORK ON THIS PAPER AND OTHER SIMILAR PAPERS, GET A NON PLAGIARIZED PAPER FROM OUR EXPERTS

QUALITY: 100% ORIGINAL PAPER – NO PLAGIARISM – CUSTOM PAPER

Why Choose Us?

How It Works

• Click on the “Place Your Order” tab at the top menu or “Order Now” icon at the bottom and a new page will appear with an order form to be filled.
• Fill in your paper’s requirements in the “PAPER DETAILS” section.
• Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
• Click “CREATE ACCOUNT & SIGN IN” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
• From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

About AcademicWritersBay.com

AcademicWritersBay.com is an easy-to-use and reliable service that is ready to assist you with your papers 24/7/ 365days a year. 99% of our customers are happy with their papers. Our team is efficient and will always tackle your essay needs comprehensively assuring you of excellent results. Feel free to ask them anything concerning your essay demands or Order.

AcademicWritersBay.com is a private company that offers academic support and assistance to students at all levels. Our mission is to provide proficient and high quality academic services to our highly esteemed clients. AcademicWritersBay.com is equipped with competent and proficient writers to tackle all types of your academic needs, and provide you with excellent results. Most of our writers are holders of master’s degrees or PhDs, which is an surety of excellent results to our clients. We provide assistance to students all over the world.
We provide high quality term papers, research papers, essays, proposals, theses and many others. At AcademicWritersBay.com, you can be sure of excellent grades in your assignments and final exams.