Below is the entire case study that

Below is the entire case study that was posted on the discussion board. My professor asked a few questions based on this study. Please help me answer those questions and provide scholarly references from the last five years from US and use in-text citations as needed. The case study for Adult ADHD topic. CC: “It is disheartening, and I can’t forget the experience.” History of Present Illness (HPI): Jane is a female adult aged 40 living in California with his husband of fifteen years and his three boys aged ten, six, and three. She is under tremendous pressure and stress trying to balance schooling, parenting, and return to work. According to her husband, who visited the facilities where I worked, Jane has a history of poor concentration or attention. Medical practitioners identified the problem symptoms during her teenage life, which has progressed to adulthood and worsened for the past three months. Doctors who have examined her recommended that she get exceptional support and attention from her parents and teachers. However, her learning abilities were not severely affected because she used earplugs during her studies. Time management and focusing difficulties have affected her into adulthood, resulting in poor financial management and family or work imbalance. Jane is jovial and optimistic, although her mood may change abruptly. She always copes with the situation by putting “pressure” on herself, resulting in stress, depression, low self-esteem, self-guilt, and anxiety. However, her big worry is to manage and coordinate things both at home and place of work. She thinks giving one area more attention may result in neglecting the other, including her family. Jane is worried about perceived inefficiency or underachievement, especially in her place of work. Her procrastination, prioritization, and organization problem also influences the problem. Jane cannot focus on one task for more than one hour resulting in uncompleted tasks. Work, academics, and family responsibilities are very demanding on her, making her feel stressed. Jane is also worried about her home responsibilities, resulting in poor performance and a lack of focus in her workplace. Jane is sometimes overwhelmed by her worries and fear of inconsistency or underperformance based on work expectations and her corresponding capacity. She is easily affected by stressful situations or events at work, forcing her to retreat or withdraw from the public instead of calling for help. According to a report she gave to the primary physician, of late, she always feels stressed, which can be triggered by anything. Three years ago, Jane almost fell into acute depression when her father fell ill and was diagnosed with lung cancer, and her dog was sick to near death. According to her husband, Jane has used anti-depressants for the last five years as directed by her psychiatrist to manage her depression, though with no record of committing suicide or suicidal thoughts. Demographic data: 40-year-old, Black American female. Occupation: Nurse Medical/Surgical History: Seasonal allergies. Frequent hospital visits. No hospital admissions. COVID-19 (negative). No surgeries. Social History: Jane is a married woman and lives with her husband of fifteen years and her three boys, aged ten, six, and three. She is the only daughter in a family of three siblings. She agrees to have strong social support from her parents but denies her husband’s support. She is currently not smoking or drinking. She undertakes physical exercises, especially aerobics, once daily for one hour to improve her physical health. She works as fulltime as a nurse in a nearby hospital, though with consecutive underperformances. She reports a weak family relationship with her husband and confirms not abusing any marijuana or drug. Psychiatric History: psychiatrist confirms the adverse effect of easy distraction and short attention span. There are reported careless mistakes, losing things, or forgetfulness instances. A psychiatrist assessment report shows the inability to stick to tedious and time-consuming tasks with mild hyperactivity. Inattention and impulsivity are influenced by spontaneous aggressiveness, anger, and violence. Risk Factors: The stress factors include a cancerous father, a dog’s illness, increased family responsibilities, job resumption after an academic leave, anxiety, self-guilt, financial stress factors), workplace stress due to underperformance, high blood pressure, previous use of marijuana, acute depressive disorder, and a history of family mental health disorder (younger brother-bipolar) Physical Exam Findings: Vitals: BP 122/79mmHg. SPO2 98% RA. T: 98.2F. Pulse: 80 beats/minute. Height 5’1. Weight 110. Pain 0/10 General: inattentive type testing. Combined type testing. Hyperactivity-impulsive type testing. Anger, anxiety, stress, and depression evaluation. Skin: Skin moist, warm, and intact, normal skin color. Smooth skin texture. HEENT/Neck: Eyes: EOM intact, no papilledema. Head: atraumatic and normocephalic. Ears: TM intact and non-inflamed without deformities or drainage. Nose: no congestion. No throat exudate or erythema, or oropharynx. Mouth: no thrush, lesions, or vesicles, has moist mucous membranes and good definition. Neck: no LAD, neck supple, and thyroid WNL. Thyroid: firm. Tongue: smooth, pink, and moist. Cardiovascular: normal heat rate without swelling extremities or clubbing and cyanosis. Respiratory: Respiratory rate of 16 breaths/minute. Non-asthmatic. Chest expansion is symmetrical. Lungs clear. Abdomen: The abdomen is symmetrical and soft. No visible scars or lesions. Abdomen flat. No masses, pain, swelling, or rigidity. Neurologic: Intact I-XII cranial nerves. Perfect coordination. Strong muscles. No acute loss of sight, feeling, and memory. Psychiatric: Difficulty staying focused. Inattention and impulsivity are influenced by spontaneous aggressiveness and anger. PHQ-9 score of 17 (moderate depression), Generalized Anxiety Disorder 7 (GAD-7) score of 12 moderate anxiety. ASRS score 17. Recommended Diagnostic Tests: Adult Self-Report Scale (ASRS) screener QB test (computer-based and coupled with infrared cameras for tracking) Patient Health Questionnaire-9 (PHQ-9) Generalized Anxiety Disorder 7 (GAD-7) Mental Status Examination: Mood effects: Jovial and optimistic. Spontaneous aggressiveness, anger, and violent Perception: no report of hypnagogic or auditory hallucinations Insight: correct reasoning and understanding of thoughts and behavior changes. Observation and appearance: excellent communicator, clean, well dressed Attention: short attention span. Difficulty concentrating Thought pattern and process: Intelligent without delusions, understood, logical, and clear thoughts. Motor: steady posture with no unusual movements. Language: coherent speech, average articulation of words, and normal volume and rhythm. Memory: Ability to recall events. Judgment: Moderate judgment with instances of incorrect judgments Vision: Perfect vision. Other tests to rule out other medical illnesses: Yale-Brown Obsessive Compulsive Scale Schizophrenia Test and Early Psychosis Indicator (STEP) Hamilton Anxiety Scale (HAM-A) CBC, CMP, Thyroid panel and folate and vitamins Questions that need to be – Can you teach your peers about Yale-Brown Obsessive Compulsive Scale Schizophrenia Test and Early Psychosis Indicator (STEP) Hamilton Anxiety Scale (HAM-A) Also, which vitamins would you check and why? Reply SCIENCE HEALTH SCIENCE NURSING ADVANCED P NR603

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