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Assignment : Cognitive Behavioral Therapy

Assignment : Cognitive Behavioral Therapy
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Assignment : Cognitive Behavioral Therapy

Notice that nothing in the scenario tells us that the PMHNP has assessed this.

Fluvoxamine immediate release is FDA-approved for the treatment of OCD in children aged 8 years and older. Fluvoxamine’s sigma-1 antagonist properties may cause sedation and as such, it should be dosed in the evening/bedtime.

At this point, it would be appropriate to consider increasing the bedtime dose, especially since the child is responding to the medication and there are no negative side effects.

Atypical antipsychotics are typically not used in the treatment of OCD. There is also nothing to tell us that an atypical antipsychotic would be necessary (e.g., no psychotic symptoms). Additionally, the child seems to be responding to the medication, so there is no rationale as to why an atypical antipsychotic would be added to the current regimen.

Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. The PMHNP should augment medication therapy with CBT. If further assessment determines that Tyrel has social anxiety disorder, CBT is effective in treating this condition as well.

A 56-year-old male was brought to the emergency room with a chief complaint was right flank pain.

History of present Illness:

One day prior to admission, the patient developed a change in the color of his urine from pale yellow to red in color. There was no associated fever, painful urination, or penile discharge. He decided to consult with his primary physician the following day.

One hour prior to admission, the patient developed severe right flank pain associated with nausea. Upon admission, the patient was noted by the ER physician to be in severe pain, with a pain scale of 9 from a visual analog pain scale from 1 to 10. On physical exam, patient had the following findings:

Vital Signs BP: 140/90 mm Hg
Heart rate: 110 bpm
Respiration rate: 15 breaths per minute patient
Temperature: 98.6 deg C
All exam findings for the head, neck, heart, lungs, and abdomen were normal.
On examination of the back, patient had tenderness on the right flank upon palpation.
On examination of the genitalia, there was no penile discharge.
Note of a 1 x 1 cm tophus on right big toe.
The following diagnostic exams were ordered

CBC with WBC differential count
Urinalysis
Serum uric acid
KUB x-ray
MRI Scan abdominopelvic area
Past Medical History:

Diagnosed with gout one year prior to admission
On medication with allopurinol
No heart and lung disease
No diabetes or hypertension
Click here to review the results of the diagnostic exam.

Questions and topics for discussion:

After considering his signs, symptoms, findings, and diagnostic exams, what would be the clinical diagnosis in this patient? (1 pt)
What is causing the hematuria to occur? (1 pt)
Why are his vitals (BP, HR, breathing) elevated? (1 pt)
What is causing the severe right flank pain? (1 pt)
How are the elevated levels of serum uric acid and positive uric acid crystals in the urinalysis related to your diagnosis? (1 pts)
What pain medication would you provide to this patient? Why would you choose this medication? (2 pts)
What treatment would you recommend for removing the cause of his pain? Explain your answer. (3 pts)

Assignment : Cognitive Behavioral Therapy
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print