Reference no: EM133639580
Case Scenario:
40 year old single Caucasian female who presents with complaints of difficulty sleeping, depression, and suicidal thoughts. Reports she has been having difficulty sleeping for the past 6 months. She's been having problems getting to sleep, states that she's been having a lot of thoughts and bad dreams which wakes her up and keeps her awake. The theme of the dream is her being chased. She feels very tired when she wakes up in the morning. She has been having issues at work, states she has a hard time concentrating. Reports that she doesn't have a lot of energy and her mood is sad. Report that lately nothing has made her happy. 6 months ago, her fiancé got into a car accident and 3 weeks later died at the hospital. He was her best friend. The day of the accident they had a small argument and not long after the fight the accident happened. Reports she has been having intrusive thoughts about the crash and her fiancé, and flashbacks a couple times a day, which is getting worse.
She reports having thought of harming herself and wishing that she was dead. She has been having those thoughts once a day. She states that she thought about of overdosing a couple of times with Aspirin, she had this thought last week. She reports that these thoughts are getting worse. Additionally, she mentioned that she's been having thoughts of driving her car off the road, which has also been getting worse. Being around her mom and dad is her protective factor. She recently moved back in with them because she was afraid that she would harm herself. She doesn't think that she can keep herself safe if she's alone. She has a past history of depression when she was about 11 years in middle school when her grandfather passed away by suicide.
She spoke to a counselor at that time, which she states was beneficial. Reports family history of substance abuse, her mothers brother was depressed and died of an overdose. Denies any drugs use. She drinks about once a week, drinks a 6 packs of beer and sometimes drink to intoxication. States she drinks to calm her thoughts. Reports that her drinking has gotten worse. Has not had any physical or any blood works in 2 years. She currently works as a county clerk office.
Discussion:
As a Psychiatric-Mental Health Nurse Practitioner (PMHNP) build a plan of care and be the provider for the client throughout it. What is the proposed treatment plan (expand on treatment modalities and plan)? What medication would you begin, what dosage and why?
Use 1 APA reference cited within the text to support application to practice. Research should be current within the last 5 years.