Charlie Leonard is a 68-year-old widowed white male who has been increasingly more withdrawn and lonely. His wife died five months ago, very suddenly after a cardiac arrest. They had been married for 42 years. He is a long time member of his church but he has missed services and Bible study classes for the past five Sundays. He used to love to watch baseball on TV and take walks around the block, but he states he doesn’t have the interest or the energy to do so any more. His appetite is poor and he has lost 10 pounds in the past month. Often, Charlie has difficulty sleeping during the night because he often takes a few naps during the day.
He is referred to you, a psychiatric nurse practitioner, by his primary care nurse practitioner, who had started Charlie on Wellbutrin (bupropion) 100 mg po daily over a month ago.
Answer the following questions from your perspective as his psychiatric nurse practitioner in APA format.
Identify one screening tool you could use when evaluating Charlie.
Articulate one DSM-5 diagnosis and at least one differential diagnosis for Charlie.
What interviewing techniques would be best used with Charlie? If he were 25 years old or 35 years old, would the techniques vary? If so, describe how they would vary.
Identify a pharmacologic evidence-based intervention that could be used to treat these symptoms. Would you continue his Wellbutrin (bupropion) or would you change it? Why or why not?
Identify whether cognitive behavioral therapy would be helpful for Charlie. Provide evidence to support your decision. If you think it would not be helpful, provide evidence for another psychotherapeutic intervention that would be.
Identify what lab work you would order for Charlie. Provide evidence to support your rationale.
Is Charlie in need of hospital stabilization? If so, what steps would you take to seek hospitalization? Would you involve his family? Why or why not?
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