Read the case study as listed and complete a SOAP note for an intake. What additional information do you need for subjective and objective data? Next, design a treatment plan based on the information you have available; include pharmacological, non-pharmacological, patient education, referral, and follow-up.
Milton is a 68-year-old Asian American male who reports that his biggest problem is worrying non-stop. He worries all of the time and about “everything under the sun and beyond.” For example, he reports equal worry about his wife who is undergoing treatment for breast cancer, and whether he returned his book to the library yesterday to maintain a good patron status. He recognizes that his wife is more important than a book and is bothered that both cause him similar levels of worry even when he tries to rationalize the differences. Milton is unable to control his worrying with current mechanisms that he lists as distraction or self-talk. Supplementary, this excessive and uncontrollable worry is creating difficulty falling asleep and staying asleep, constant impatience with others, difficulty focusing at work, and significant back and muscle tension. Milton has had a lifelong problem with worry, recalling that his mother called him a “worry wart as a child.” His worrying does “wax and wane”, and worsened when his wife was recently diagnosed with breast cancer. He feels he is at a loss for what he can do to control it and relax.
Symptoms:
• Anxiety
• Concentration Difficulties
• Irritability
• Sleep Difficulties
• Worry
Vitals:
132/80 BP
72 HR
20 R
98.8 T
98% 02
Ht. 5’5”
Weight 149
Objective Data:
Vitals: 132/80 BP, 72 HR, 20 R, 98.8 T , 98% 02; Ht.: 5’5″; Weight 149 lbs
Additional information needed for objective data:
• Mental Status Exam – To assess orientation, memory recall, mood state etc., which can help provide further insight into overall psychological well being (Friedman et al., 2020). • Medical History – To determine if there are any medical complications influencing mental health (Nguyen et al., 2018). • Physical Examination – To rule out potential causes such as thyroid disease or other conditions affecting physical performance (Kessler & Wang 2009)
Treatment Plan: Pharmacological Intervention – Prescribe SSRI antidepressant medication such as sertraline at 50mg per day to reduce symptoms associated with anxiety disorder (Bandelow 2017). Non-Pharmacological Intervention– Cognitive Behavioral Therapy focusing on relaxation techniques and discussing irrational thoughts related to excessive worrying (Haigh & Brantley 2017). Patient Education– Explain importance of continuing therapy while taking medications and describe potential side effects from antidepressants so patient knows what physical changes they may experience during course of treatment(Gorman 2016). Referral– Refer patient for additional support from Breast Cancer Network especially due current stress experienced from spouse’s illness(McKinney& Nelson 2012). Follow Up– Schedule follow up appointment after medication begins working + 1 month later once fully prescribed dosage kicks in — check vitals + mood condition every visit (Cheng 2019).
Accordingly they couldn’t go through exercises as their friends, this will bring about feeling exhausted thus incapable to finish preparing that has been given. Thus the focal point of my exploration is to further develop the perusing abilities of preschool understudies using phonemes photograph through play.
Errands to further develop perusing abilities among youngsters is a difficult yugas due the kid various capacities. The phase of youth, the pengajaaran, figuring out how to peruse is an interaction that is hard to be carried out and controlled, is a difficult undertaking.
1.2 Survey issues
Perusing is one thing that is significant in their day to day routines. On the off chance that we can’t peruse, then contact terputuslah us with the rest of the world. The significance of perusing to younger students is as well. As soon as preschool learning meetings they have applied with three abilities (perusing, composing and then some).
In this way, the issue of perusing ought to be tended to immediately. One technique that can motivate perusing, is with the utilization of phonemes card photograph through the play and show these drills read card stanzas short straightforward with the expectation it draws in understudies to perusing. This strategy really is definitely not another technique
1.3 Choice Standards The Survey Concentration
Circumstances instigate an individual to lead research. Nonetheless, the start of an examination activity isn’t really inferable from such circumstances, in the event that a specialist wishes to attempt another educational strategy can likewise be carried out through activity research (Chow Fook Meng and Jaizah Mahamud, 2011).