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Josh is a 27-year-old male who recently moved back in with his parents after his fiancée was killed by a drunk driver 3 months ago. His fiancée, a beautiful young woman he’d been dating for the past 4 years, was walking across a busy intersection to meet him for lunch one day. He still vividly remembers the horrific scene as the drunk driver ran the red light, plowing down his fiancée right before his eyes. He raced to her side, embracing her crumpled, bloody body as she died in his arms in the middle of the crosswalk. No matter how hard he tries to forget, he frequently finds himself reliving the entire incident as if it was happening all over.

Since the accident, Josh has been plagued with nightmares about the accident almost every night. He had to quit his job because his office was located in the building right next to the little café where he was meeting his fiancée for lunch the day she died. The few times he attempted to return to work were unbearable for him. He has since avoided that entire area of town.

Normally an outgoing, fun-loving guy, Josh has become increasingly withdrawn, “jumpy”, and irritable since his fiancé’s death. He’s stopped working out, playing his guitar, or playing basketball with his friends – all activities he once really enjoyed. His parents worry about how detached and emotionally flat he’s become.

Josh has no known history of SUD. He is slightly overweight, but otherwise seems to be in good health based on the labs he had done last year for his annual physical exam. 

 

Based on the case study above, please answer the following questions- and include each question above your answer: 

What diagnosis would you give Josh and explain your rationale? Any rule out diagnoses you would consider?
What concerns you the most about Josh’s behavior at this point?
Although his PE was unremarkable, it is a year old. Would you order any lab work on Josh? If so, what and why?
What medication(s) would you consider for Josh? Explain rationale for selecting the medications you would use and what symptoms they would be used to treat.
For the medications you would prescribe, what are some general contraindications and side effects?
Based on the medications you prescribed, when might you expect to see an improvement in various symptoms?
What, if any medications would you not use, and why not?

 

Please include and cite references both in the answers and at the end in the References section.

SCIENCE
HEALTH SCIENCE
NURSING
NUR 642

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