Molly is a 66-year-old, biracial woman living in an inner-city suburb with her husband and two children. She comes today accompanied by her husband and daughter who have been concerned about increasingly odd behaviors. Molly has had previous diagnoses of schizophrenia, anxiety, and obsessive-compulsive disorder. She says she first started hearing voices around the age of 8 years old. She has spent a great deal of her life in and out of psychiatric hospitals, and this is where she said she started smoking cigarettes. Molly said that she has smoked over a pack a day for most of her life and had switched to using nicotine patches and gum in her middle 50s.
Nicotine gum is a type of chewing gum that delivers nicotine to the body. It is used as an aid in nicotine replacement therapy (NRT), a process for smoking cessation. The nicotine is delivered to the bloodstream via absorption by the tissues of the mouth. The pieces are usually available in individual packages and come in various flavors. Individuals are directed to chew the gum until it softens and the gum is then “parked,” or tucked, in between the cheek and gums. It’s chewed again until taste returns, and is then re-parked in a new location. These steps are repeated until the gum is depleted of nicotine (about 30 minutes) or the craving dissipates.
Using NRT supported Molly to stop smoking; however, she said that to this day she still feels anxious about chewing the gum and has often expressed the desire to cease altogether.
Molly disclosed that she was chewing a significantly high amount of gum and was often going to bed chewing it and had woken up choking on the gum often in the night. Molly also explained that she believed she had grown a brain tumor from chewing the gum over the past few years, and she was expecting to be diagnosed with cancer at her PCP appointment next week. Molly became very anxious when speaking about this. She explained that she thought nicotine gum could give her cancer.
Molly’s husband has been worried about her dose of antipsychotic medication not being sufficient or that she has not been taking it. He has found her wandering the neighborhood explaining to different neighbors that she will be “dead soon.” Recent stressors are the death of a close friend from COVID-19 and finding out that both her son and daughter have plans to move out next month. She has a family history of alcohol use disorder (father) and depression (mother). Son has had treatment for opioid use disorder (OUD) but has been in recovery for 1 year. She has a grandson who she can’t see because there is a restraining order against her son and the rest of her family.
Primary Care of the Psychiatric Mental Health Client II
Geriatric Case Study Assignment Question
After viewing the patient interactive information, address the following:
- What important information is missing from the case study?
- Discuss normal developmental achievements and potential vulnerabilities of the elderly.
- What precipitating factors could be contributing to the current symptoms?
- What is the differential diagnosis? Dementia,
- Describe the etiology of the primary diagnosis.
- How should physiologic complications be monitored and assessed?
- What are the usual nonpharmacologic therapies that would help?
- What medications could help and why?
- Identify safety risks and how they should be dealt with in the treatment plan.
Include current supportive evidence in your responses. National guidelines should also be considered with treatment plans.
Do you need help with this assignment or any other? We got you! Place your order and leave the rest to our experts.