A 78-year-old female comes to your office escorted by a neighbor who
is a patient of yours. The neighbor, who has lived next door to the
older woman for years, relates that a week ago the elderly woman’s
sister died and that she had been her caregiver for many years. The
neighbor relates that although she would occasionally see the older
woman, she did not visit the home. At the funeral last week, she noticed
that the woman appeared fatigued, confused, sad, and gaunt in
appearance. Later the neighbor approached the woman, inquired about her
health, and determined that the woman had a very difficult time the past
couple of months, caring alone for her sister until the end when
hospice care was initiated. The neighbor convinced the woman to seek
medical care and today is the first appointment with a provider that
this 78-year-old female has had in 3 years. The older woman states that
she is very fatigued and sad over the loss of her sister. Neither her
sister nor the patient has been married. A distant niece came to the
funeral but lives about 30 miles away. The woman states that she is not
taking any prescription medication and relates no medical problems that
she is aware of being diagnosed.
Vital signs: T 97.6°F, HR 98, RR 22, BP 95/60, BMI 21
Chief Complaint: Fatigue and sadness over the death of her older sister.
Discuss the following:
1) What additional subjective information will you be asking the patient?
2) What additional objective findings would you be examining the patient for?
3) What are the differential diagnoses that you are considering?
4) What laboratory tests will help you rule out some of the differential diagnoses?
5) What screening tools will you select to use on this patient?
6) What is your plan of care?
7) What additional patient teaching may be needed?
8) Will you be looking for a consult?
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited
in current APA style with support from at least 2 academic sources. Your
initial post is worth 8 points.
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