Evaluation tool in adolescents
Family nurse practitioner treating pediatrics in the outpatient setting. please answer the questions using below case study.
Describe the evaluation tool and explain why this tool is essential in the care of the adolescent patient population.
Apply the findings of the scholarly research articles to the use of this evaluation tool and describe its validity and reliability. Apply this evaluation tool to a patient situation and summarize your opinion of the results. Describe a plan of care for the patient, depending upon the results.
Name: Angela Cortez
Age: 17 years
Sex: F
Height: 5' 4"
Weight: 168 pounds (BMI 28.8)
Temperature: 98.6 F (oral)
Pulse: 70 bpm - regular
Blood pressure: 110/74 mmHg
Respiratory rate: 14 bpm
SpO2: 99% on room air
Expert key findings: Decreased energy / interest in pleasurable activities (anhedonia)
Fatigue Related
Irritability Related
25+ lb weight gain Related
Crying more than usual Related
Recent decline in school grades Related
Mild to moderate obesity/elevated BMI Related
Acanthosis nigricans Unknown
Acne Unknown
Striae Unknown
Family history of obesity, DM, and HTN Unknown
Problem statement:
Angela Cortez is a 17-year-old female who presents with a history of fatigue and lack of energy for the past two months; associated with irritability and weight gain. Her symptoms have led to a decline in her school performance and lack of participation in her usual activities. She has been crying on a near daily basis over the past month. On physical exam, she has an elevated BMI, is tearful, and is noted to have acne, striae, and acanthosis. She denies any active suicidal thoughts.
DDX: cushing syndrome vs hypothyroidism vs ADD/ADHD vs depressive disorder vs EBV vs anemia vs pregnancy vs DMII.
Test : all result are negative
HgA1c
HCG urine
TSH
CBC
Mononucleosis spot
FT4
Urine drug screen
Blood glucose
Urine cortisol
Diagnosis: depression
Angela will be referred to a psychiatrist for initiation of both psychotherapy and pharmacotherapy in treatment of adolescent depression. She will be started on fluoxetine, a selective serotonin reuptake