solved

Question
Answered step-by-step
Asked by DrGalaxyHorse22

Chief Complaint: 
“You all are all morons! I want to go home. There’s nothing wrong with me and I shouldn’t be here. Do 
you see that there are alien doctors at the hospital, and they are helping to take over if we don’t do 
something to stop them?” 
History of Present Illness:
37-year-old female brought into the state psychiatric hospital by the police. The patient attacked a 
police officer under the bridge where she is apparently living. The police were investigating a report of 
theft of food from a nearby grocery store. The report included information about the thief did not 
appear to be making any sense talking about needing food to store for when aliens invade the planet. 
The police report that when they went to investigate the reported theft, the patient talked of the city 
water supply being poisoned by aliens, seeing aliens under the bridge that look just like her and that 
alien men had been raping her. 
PMH:
Depression 5 years ago secondary to the death of her son; reports being on anti-depressants for a few 
months; denies history of any other mental health concerns 
Complications secondary to arthroscopic knee surgery resulting in long term IV Vancomycin
Lymphoma diagnosed 7 years ago treated with six cycles of chemo with excellent response, in remission
+PPD for six years, treated for 12 months
Family Hx:
Mother diagnosed with schizophrenia at age 36
Maternal grandfather – placed in an ‘insane asylum for hysteria’
Social Hx:
Divorced with a daughter, son is deceased
Heterosexual
Homeless – living under the bridge, stating her family disowned her ‘years ago’ 
Employment history – primary work experience as a nurse aid, reports she has ‘difficulty keeping a job’
Legal history – no history arrests or legal charges
ROS:

 

 

General – denies loss of appetite or recent weight loss
Neuro – reports occasional headache due to ‘surgery performed on her by aliens’
Otherwise ROS is negative
SIGECAPS:
Reports sleep interrupted by aliens entering her space under the bridge, interest is focused on thoughts 
of alien invasion and her need to stop it, expresses no guilt, reports feels ‘hyper’ most of the time as she 
has to be on the lookout at all times, reports concentrates solely on alien invasion, denies changes in 
appetite, reports is constantly on the move, denies suicidal/homicidal ideations 
Medications:
OTC Ibuprofen 400mg PRN HA
Allergies:
Mycins – upset stomach
Bactrim – rash
Physical Examination:
General – thin Hispanic female who appears older than stated age; disheveled in appearance; 
BP 143/84, P 82, RR 16, Ht 64 in, Wt 109 lbs, BMI 19
Integument – warm, dry; good turgor; no rashes, ecchymoses or petechiae noted
HEENT – Head is normocephalic and atraumatic, PERRLA, EOMs intact, TMs gray and shiny bilateral, 
nares patent without discharge noted, no tonsillar enlargement 
Neck – supple without adenopathy, no thyromegaly
Lungs – CTA
Breasts – deferred
Heart – RRR without murmur/gallop
Abdomen – soft, non-distended, active bowel sounds, non-tender, no organomegaly
Genitalia/Rectum – deferred
Musculoskeletal – no gross abnormalities noted 
Neurologic – lethargic, DTRs 2+ and equal bilateral, negative Babinski

 

 

Diagnostics – Na 140 meq/L, K 4.0 meq/L, Cl 102 meq/L, HCO3 22 meq/L, Bun 14 mg/dL, Cr 0.8 mg/dL, 
non-fasting Glu 134 mg/dL, Ca 9.9 mg/dL, PO4 3.2 mg/dL, Total Protein 7.0 g/dL, Mg 2.7 mg/dL, AST 21 
IU/L, ALT 15 IU/L, Alb 4.5 g/dL, TSH 2.33, Hgb 14.6 g/dL, HCT 42 %, RBC 4.2 million/mm3, WBC 
6000/mm3, Plt 264,000/mm3
Urine pregnancy test – negative; urine drug screen – negative; urine dipstick – specific gravity 1/017, pH 
5.8, other parameters negative
Assessment:
Diagnoses are not needed for this assignment.
Plan:
The assignment directs identification of priority social determinants of health and development of a plan 
that ‘address challenges with or support strengths identified in’ the three priority SDH that you 
identified in this patient.
Diagnostics – Na 140 meq/L, K 4.0 meq/L, Cl 102 meq/L, HCO3 22 meq/L, Bun 14 mg/dL, Cr 0.8 mg/dL, 
non-fasting Glu 134 mg/dL, Ca 9.9 mg/dL, PO4 3.2 mg/dL, Total Protein 7.0 g/dL, Mg 2.7 mg/dL, AST 21 
IU/L, ALT 15 IU/L, Alb 4.5 g/dL, TSH 2.33, Hgb 14.6 g/dL, HCT 42 %, RBC 4.2 million/mm3, WBC 
6000/mm3, Plt 264,000/mm3
Urine pregnancy test – negative; urine drug screen – negative; urine dipstick – specific gravity 1/017, pH 
5.8, other parameters negative
Assessment:
Diagnoses are not needed for this assignment.
Plan:
The assignment directs identification of priority social determinants of health and development of a plan 
that ‘address challenges with or support strengths identified in’ the three priority SDH that you 
identified in this patient.

 

 

In paragraph form, construct a discussion that identifies those priority SDHs using data from the objective and subjective data sets where appropriate to support your discussion.
Include in your discussion some strategies you might utilize to address challenges with or support strengths identified in those three priority SDH.

 

SCIENCE
HEALTH SCIENCE
NURSING
NU 671

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."