You are still seeing Alejandro Escobar-Vega, a 34-year-old Hispanic…

Question Answered step-by-step You are still seeing Alejandro Escobar-Vega, a 34-year-old Hispanic… You are still seeing Alejandro Escobar-Vega, a 34-year-old Hispanic man. He attended your group therapy sessions last year, and you saw him for individual therapy. He attended your group therapy sessions last year, and you saw him for individual therapy. You diagnosed him with DSM-5 296.32 Major Depressive Disorder, recurrent, moderate; and placed him on Trazodone 50 mg my mouth at bedtime as needed for sleep and Lorazepam 0.5 mg by mouth 3 times daily for anxiety and agitation, initially. Subsequently, he began taking 100 mg Quetiapine (Seroquel) and 100 mg Lamotrigine (Lamictal).He was admitted to the hospital for attempted suicide for the third time last week when he ingested a hundred 100 mg Quetiapine (Seroquel) and a hundred 100 mg Lamotrigine (Lamictal) pills. He spent last week in the intensive care unit and is now in a medical unit where he is undergoing medical stabilization. Given the number of pills he ingested, it is likely he was not regularly taking his medications and was stockpiling them.During your session, he says, “I just didn’t want to live any longer. I am a failure. I am not good for Daniella or my family. I can’t even kill myself, right. Why am I here? I am sleeping terrible. I lay awake at night, and my mind is going and going and going. I can’t get my mind to shut off. I keep thinking about all the ways I have failed my family, thinking what a terrible father I am, what a terrible husband, Dad, and son I am. I don’t even have the energy or desire to get out of bed in the morning. I feel worse in the morning … I feel completely worthless.”Alejandro’s physical exam and lab results have all been normal, including a normal thyroid function and normal vitamin D levels. There is no evidence of recent head trauma, cancer, stroke, and so on. Alejandro’s mental status exam results include that he is unkempt, unshaven, and the front of his shirt is stained with food. He is cooperative and follows direction but is severely depressed and has poor eye contact. He shows some anger but generally his voice is monotone. He answers questions appropriately but has some short-term memory issues. He cannot recall the exact sequence of events or exactly what happened when he took the overdose.You know from past interaction that his mother was diagnosed with an anxiety disorder and his cousin Luis died from suicide 18 months ago. He has a wife, Daniella (Dani) and a 16-year-old son, Dario.From your perspective as Alejandro’s psychiatric nurse practitioner, answer the following questions. Include at least two peer-reviewed, evidence-based references.What screening tools would you use during this interview?Would you keep the same diagnosis? Are there any symptoms that would make you consider a different diagnosis? On what evidence and symptoms do you base your diagnosis?What medication changes would you prescribe for Alejandro and why? Please note the medication(s), initial dose, and dosing schedule.Include the American Psychiatric Association Standards of Care conclusions for each medication.How will you educate and inform Alejandro about how this medication will work?How will you discuss with Alejandro the side effects and risks of taking this medication? Health Science Science Nursing NURS 663 Share QuestionEmailCopy link Comments (0)