T. J. Summerton comes to your office with his two daughters for a second opinion. His older daughter, Vaida, says that their dad’s moods are all over the place and that his memory is getting worse. His younger daughter, Eleanor, says that their dad never had any mood problems until their mom died, and then his moods kept getting worse. Vaida says that their dad recently went into a nursing home because he stopped taking care of himself. Since he has been in the nursing home, he has seen the psychiatric nurse practitioner, who sees all the residents at the home. Eleanor says that they are here to see you today because they want a second opinion about the medications and treatment T.J. is getting.
Review the records from the nursing home (below) and revise T. J.’s treatment plan.
T. J. Summerton, male
Resident, Hall C, Room 134
Medical history: high cholesterol, GERD, high blood pressure, memory loss, depression
Surgeries: Left knee replacement
Allergies: iodine, shellfish
A & O x 2–3
Brief examination
Depression: 7/10; lays in bed, doesn’t attend the nursing home events, says “I want to go to heaven.”
Anxiety: 5/10 “I just get nervous with the stuff going on around here.”
SI: “I would never do it because of my faith, but I don’t want to be around much longer.”
Psychosis: denies
Sleep: “Even with my sleep medications, I wake up all night.”
Appetite: Poor; NH staff, patient has lost 5 lbs. in 2 months.
Current weight: 177 lbs. Height: 5’9”