Changes in Medication

Choose one of the following cases. From your perspective as their psychiatric nurse practitioner, answer the following questions in a two- to three-page double-spaced paper (not including the reference page) in APA format. Include at least three peer-reviewed, evidence-based references. Write a summary statement about the case presentation, including potential DSM-5 diagnoses. Is there a screening tool for this diagnosis? Would it be appropriate for this patient? If available online, include a link to the tool. What assessment questions would you ask them to identify their eating disorders, triggers, and current coping skills? What medication changes would you recommend, including doses and administration times? What precautions and interactions would you educate the patient about when prescribing your recommended medications or changes in medication? Explain any other health professional referrals that would be significant in your patient’s treatment plan. Cases Jill Paddington Jill Paddington, a nine-year-old female, has been brought to your office by her father for a psychiatric evaluation about her abnormal eating habits, anxiety, and confirmed autism spectrum disorder (which has been controlled with therapy and a consistent schedule). Her father, Dylan, fills you in. Dylan’s Transcript  (Links to an external site.) Before this appointment, her pediatrician ruled out organic causes and completed laboratory tests; additional blood serum iron, serum zinc, hemoglobin, stool, and urine tests showed unremarkable results. There has been no exposure to lead, so there is no test regarding lead concentration in her blood. Jill’s Lab Results Test Normal Levels Patient Test Result Serum ferritin ng/ml 10–55 9 Serum zinc ug/10 ml 66–194 50 Hemoglobin g/dl Above 11.5 11.5 Calcium mf/dl 7.6–10.8 8.3 Ryan Edwards Ryan Edwards is 30-year-old male reporting regurgitations without retching or gagging preceded by a sensation of pressure in his esophagus and abdomen. Ryan’s Transcript  (Links to an external site.) In his chart, you see that his doctor prescribed Fluoxetine 40 mg po daily and buspirone 15 mg po TID. Mike Hill Mike Hill is a 23-year-old male who sees you today with a history of fluctuating and significant weight loss. Today’s weight indicates a 30-pound loss since his last doctor visit two months ago. Mike’s Transcript  (Links to an external site.) According to his chart, his PCP diagnosed him with General Anxiety Disorder and noted “specific phobia of choking.” Mike has no other relevant past medical history or concurrent medical conditions or disorders. His diet doesn’t have any culturally associated practices, and food is available for consumption. Mike has no history of an eating disorder or trauma. Sleep is restful with Trazodone 25 mg po q hs and melatonin 3 mg po q hs. He tried Zoloft in high school and college but reported negative side effects of low libido and tiredness; he stopped taking it at age 19.