North Virginia Community College Anxiety Case Study Analysis

NURS 752Please use the template in the document that said case study example. Please analyze
the attachment that said anxiety case study. Please APA 7 FORMAT ONLY
ANXIETY CASE STUDY
CC:
“I’m really stressed and feel like I’m losing it. I’m so tense that I am having trouble sleeping and
fell like I’m a time bomb about to explode.”
HPI:
JA is a 24-year-old female who presents to the primary clinic with complaints of nausea,
restlessness, fatigue, poor sleep, and headaches. She states that since starting her graduate
school program approximately 6 months ago, she has been on edge and worries about
everything. She worries about her school performance, paying for her tuition, her father’s
health, and even her younger brother, who is a freshman undergraduate at Colorado State
University. She states her mother reassures her that everything is “OK” with her dad and
brother but she worries about them anyway. She was offered a summer internship program with
a pharmaceutical company and is considering not taking it as she feels overwhelmed and is not
sure she can manage moving to the east coast for the summer. She reports having a couple of
“episodes” while at home studying, where her heart races, she feels shaky, and had difficulty
concentrating on her work. This prompted her to seek treatment at an urgent care clinic last
month and she was provided a prescription for quetiapine. “They said it would help me sleep
and feel less anxious.” She also describes being easily startled when someone taps her on the
shoulder. This happened in class and she was embarrassed by her response. JA states she has
taken a friend’s medication for anxiety a couple of times and that it “calms her immediately.”
She also reports seeing a therapist for several sessions a couple of months ago with little
improvement, so she stopped.
PMH:
Knee surgery (age 16, ACL tear while playing soccer)
Mild traumatic brain injury (TBI) (age 16 from motor vehicle accident. Treated with
levetiracetam for 1 year)
Mild depression (age 21, resolved with counseling)
FH:
Father has CAD and had MI 3 months ago at age 52. Mother with depression, treated with
venlafaxine. Paternal grandfather with alcoholism and a maternal aunt who died at age 60 of
suicide.
SH:
JA is a graduate student in biomedical engineering at the University of Colorado. She lives
alone in a condominium and works part-time as a research assistant in the College of Medicine.
Nonsmoker. ETOH 2-3 drinks daily.
Allergies/Intolerances/Adverse Drug Events:
NURS 752
NKDA
Medication History:
Levetiracetam 500 mg bid x 12 months for seizure prophylaxis 8 years ago
Quetiapine 25 mg po twice daily as needed – received 30 days supply from urgent care physician
last week
Ibuprofen 400 mg po prn
Review of Systems:
Frequent tension headaches relieved by ibuprofen; muscle ache in shoulders; nausea and
intermittent loose stools
PE:
•
•
General: Anxious-appearing 24-year-old woman in no acute distress
Vital signs
o BP 130/76 mm Hg, P 88, RR 18, T 37.3oC
o Weight 169 lb.
o Height 65 in.
o Denies pain
Mental Status Examination:
A 24-year-old cooperative, casually dressed, well-groomed female. Appears dysphoric and
moderately anxious. Speech is normal in rate and volume. Mood is “irritable” and “sometimes
down,” affect congruent to mood. No apparent delusions or hallucinations. Denies suicidal or
homicidal ideation. She appears to have good attention and concentration.
Labs:
All WNL
Urine pregnancy test (-)
Urine drug screen (+) benzodiazepine
ECG: QTc 442 ms