Case 1: Volume 2, Case #16: The woman who liked late-night
TV
The patient is a 70 year-old- female, who complains of being sad. She had been doing
well until her hearing began to diminish in both ears. She often cries for no clear reasons despite
the promising improvement on her hearing.
Questions for the Patient
1. Do you have trouble falling or staying asleep?
2. Have you lost interest in hobbies or activities?
3. Do you feel sad, irritable, or hopeless?
Rationale for Asking the Questions: These questions will help evaluate the presenting
symptoms and severity of the patient’s condition.
People in the patient’s life to speak to or get feedback from
The people in the patient’s life to ask questions include her son and the home aide. The
Son: 1) Do you have history of depression in your family? 2) Have you noticed any unusual
behaviors or movements in the patient? Home Aide: 1) How can you describe the client’s mood
and behavior during your visits? 2) What type of changes have you noticed in the client now
versus when you first started working with her? These questions will give more information and
guide the diagnosis.
Physical Exams and Diagnostic Tests
Actigraphy test to assess sleep-wake patterns over time. Actigraphs are small, wrist-worn
devices (about the size of a wristwatch) that measure movement and are useful in assessing
insomnia, circadian rhythm disorders, movement disorders and an assortment of rare events
(Sadock, & Sadock, 2011).
Polysomnogram test measure activity during sleep. This will help determine if the
patient present any unusual behavior during sleep (Sadock, & Sadock, 2011)..
Mental Health Exam: insomnia may be a symptom of depression, anxiety, or
another mental health disorder, a mental status exam, mental health history, and basic
psychological evaluations may be part of your initial assessment.
DDx
1. Restless legs syndrome. Difficulty sleeping may occur due to discomfort or
irresistible movements of the legs. Diagnosis for this condition is usually based on
clinical history.
This study source was downloaded by 100000852681095 from CourseHero.com on 12-15-2022 20:43:58 GMT -06:00
https://www.coursehero.com/file/41147808/Deb-Wk7Discussiondocx/
TV
The patient is a 70 year-old- female, who complains of being sad. She had been doing
well until her hearing began to diminish in both ears. She often cries for no clear reasons despite
the promising improvement on her hearing.
Questions for the Patient
1. Do you have trouble falling or staying asleep?
2. Have you lost interest in hobbies or activities?
3. Do you feel sad, irritable, or hopeless?
Rationale for Asking the Questions: These questions will help evaluate the presenting
symptoms and severity of the patient’s condition.
People in the patient’s life to speak to or get feedback from
The people in the patient’s life to ask questions include her son and the home aide. The
Son: 1) Do you have history of depression in your family? 2) Have you noticed any unusual
behaviors or movements in the patient? Home Aide: 1) How can you describe the client’s mood
and behavior during your visits? 2) What type of changes have you noticed in the client now
versus when you first started working with her? These questions will give more information and
guide the diagnosis.
Physical Exams and Diagnostic Tests
Actigraphy test to assess sleep-wake patterns over time. Actigraphs are small, wrist-worn
devices (about the size of a wristwatch) that measure movement and are useful in assessing
insomnia, circadian rhythm disorders, movement disorders and an assortment of rare events
(Sadock, & Sadock, 2011).
Polysomnogram test measure activity during sleep. This will help determine if the
patient present any unusual behavior during sleep (Sadock, & Sadock, 2011)..
Mental Health Exam: insomnia may be a symptom of depression, anxiety, or
another mental health disorder, a mental status exam, mental health history, and basic
psychological evaluations may be part of your initial assessment.
DDx
1. Restless legs syndrome. Difficulty sleeping may occur due to discomfort or
irresistible movements of the legs. Diagnosis for this condition is usually based on
clinical history.
This study source was downloaded by 100000852681095 from CourseHero.com on 12-15-2022 20:43:58 GMT -06:00
https://www.coursehero.com/file/41147808/Deb-Wk7Discussiondocx/
