NUR601 week 3 discussion part 1 and 2

Week 3: Geriatric Assessment Tools

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Review the course library page list of available screening
tools.

Choose two that are appropriate for primary care and discuss
the following:

· explain the
purpose of the tool

· scoring
guidelines

· how you
apply the assessment in practice

*If you would like to present a screening tool that is not
listed, contact your instructor for approval.

part 2

Week 3: Psychiatric Disorders and Screening

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Anxiety and depression are the most common psychiatric
problems you will encounter in your primary care practice.

Review this case study

HPI: KB, 55-year-old Caucasian female who presents to office
with complaints of fatigue. The fatigue has been present for 6 months and seems
worse in the morning, improving slightly through the day. KB reports a lack of
energy and “loss of joy”. States” I really don’t feel like going
anywhere or doing anything” Reports she often has difficulty staying on
task and completing projects for work. She reports not feeling hungry and does
not feel rested when she wakes up in the morning. KB is a widow for 2 years,
social events that are couples only can make her symptoms worse. She tries to
do at least one social activity a week but it can be really exhausting. Her
husband died in their car while she was driving him to the hospital and sometimes
driving in that car makes all the memories come back. She recently got a puppy,
which she thought would help with the loneliness but the care of the puppy
seems overwhelming at times. Rest and exercise, specifically yoga and
meditation seem to make her feel better. At this time she does not want to do
either. She has not tried any medications, prescribed or otherwise. She reports
drinking a lot of coffee, but that does not seem to help.

Current medications: Excedrin PM about once a week when she
can’t sleep, seems to help a bit. NKDA.

PMH: no major illnesses. Immunizations up to date.

SH: widowed, employed full time as a manager. Drinks wine, 1
glass every night. No tobacco, no illicit drugs. Previously married while
living in France, reports an abusive relationship. The French government gave
custody of her son to the ex-husband. She returned to US without her son 10
years ago. She sees her son two times a year, they skype and text “all the
time” but she misses him.

FH: Parents are alive and well. Has one son, age 21, he is
healthy but lives in France with his father.

ROS

CONSTITUTIONAL: reports weight loss of 2-3 pounds, no fever,
chills, or weakness reported

HEENT: Eyes: No visual loss, blurred vision, double vision
or yellow sclera. Ears, Nose, Throat: No hearing loss, sneezing, congestion,
runny nose or sore throat.

CARDIOVASCULAR: No chest pain, chest pressure or chest
discomfort. No palpitations or edema.

RESPIRATORY: No shortness of breath, cough or sputum.

GASTROINTESTINAL: Reports decreased appetite for about 3
months. No nausea, vomiting or diarrhea. No abdominal pain or blood.

NEUROLOGICAL: No headache, dizziness, syncope, paralysis,
ataxia, numbness or tingling in the extremities. No change in bowel or bladder
control.

GENITOURINARY: no burning on urination. Last menstrual
period 4 years ago.

PSYCHIATRIC: See above. No history of diagnosed depression
or anxiety. Reports experiencing great anxiety during her first marriage due to
verbal and concern for physical abuse, reports feeling very sad and anxious
when divorcing and leaving her son in France years ago. Did not seek treatment
at that time. She started to feel better after about 4 months.

ENDOCRINOLOGIC: No reports of sweating, cold or heat
intolerance. No polyuria or polydipsia

ALLERGIES: No history of asthma, hives, eczema or rhinitis.

Discussion Questions:

1. Research screening tools for depression and anxiety.

· Choose one
screening tool for depression and one screening tool for anxiety that you feel are
appropriate to screen KB.

· Explain why
you chose that particular tool for KB. If you can, attempt to score KB based on
the information provided (not all data may be provided). Include what questions
could be scored, and your calculated score for the questions you scored.
Interpret the score based on the screening tool interpretation ranges.

2. Identify your next step for evaluation and treatment for
KB.

· What
medication, if any, would you recommend for treatment? Provide the EBP rationale.
This rationale should include the medication class, mechanism of action of the
medication and why this medication is appropriate for KB. Include initial
prescribing information.

· If the
medication works as expected, when should KB expect to start feeling better?

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