The FASD Respect Act Essay Discussion PaperTreatment for a Patient with a Common Condition Discussion Questions you would ask the patient

Inquire about her surrounding environment. Environmental factors such as excessive light, extreme temperatures and noise often interfere with the sleeping habits (Krystal et al., 2019). Ask about the patients support system; family, friends, social and church groups. Has her financial status changed after her husband’s death? Clinical studies have shown that insomnia is prevalent in people with greater social and financial stressors. Is the patient responsible for taking your own medications or do you require assistance when taking your medications? Polypharmacy is commonly seen in the elderly population due to the need to treat different diseases that develop with age (Bates, 2019). Adherence to medications may be affected thus resulting to worsening symptoms. Treatment for a Patient with a Common Condition Discussion

The people I would consult about the patient’s life include; family members, care giver, friends and church members. Ask if there are any social or financial stressors which are major causes of insomnia. Ask how long they have noted her mental health deterioration as about any behavioral or mood changes they have noticed.

Physical and diagnostic tests

A sleep diary is an assessment tool that is recorded by the patient for at least two successive  weeks. It is necessary when a patient reports an irregular sleeping pattern and is used to characterize the specific sleeping problem, describe maladaptive behaviors and provide an indicatory of treatment outcome (Krystal et al., 2019). Thyroid function tests to rule out hyperthyroidism as it presents with sleep disturbances. An airway examination and neck circumference is required to rule obstructive sleep apnea. The Davidson trauma scale is administered to help assess patients for PTSD and determine if they meet the DSM IV criteria. The Hamilton depression rating scale is used to assess the severity of depressive symptoms in order to determine whether dose adjustment is necessary. Treatment for a Patient with a Common Condition Discussion

Differential diagnosis

Post-traumatic stress disorder (F43.1): a mental disorder that is often triggered by a terrifying event such as trauma or loss of a loved one. The onset of symptoms is usually after one month of occurrence but in other cases it may occur years late after the incident (Bryant, 2019). People with underlying mental disorders such as anxiety, depression and others are at increased risk of getting PTSD.

Pharmacological agents

• PO Eszopiclone 1mg 24hourly (nocte): it is a sedative that acts on GABA that results in relaxation that helps one to fall and stay asleep (Rösner et al., 2018). However, this drug should be used with caution.
• PO fluraxepam 15mg 24hourly (nocte): it is a benzodiazepine that induces sleep through their positive allosteric modulation of GABA type A receptor(Flurazepam, 2017).

The most preferable drug Eszopiclone because it is not associated with toxicity with the patients current medications. Fluraxepam is not used in the elderly due to its long-acting metabolites that increase the rates of falls.

Contraindications

Not to be used in patients with gait problems and at risk of accidental falls.

Follow up after 2 weeks to monitor the progress of symptoms. Treatment for a Patient with a Common Condition Discussion