Author Question: A soldier serving in the Middle East was in a convoy when an improvised explosive device (IED) ... (Read 28 times)

savannahhooper · **on:** Jul 19, 2018

A soldier serving in the Middle East was in a convoy when an improvised explosive device (IED) killed three fellow soldiers in the vehicle in front of hers.

Five weeks later, she began to report intrusive thoughts of missiles screaming toward her and exploding, and loud sounds began to trigger an involuntary re-experiencing of the IED explosion. Three months later, she reported continuing sleep impairment, nightmares, social withdrawal, disrupted relationships, and flashbacks. This soldier's presentation most suggests: a. acute stress disorder.
b. pathological grief reaction.
c. posttraumatic stress disorder.
d. panic disorder with agoraphobia.

Question 2

A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer's disease or multiple infarcts.

Which diagnostic procedure should the nurse expect to prepare the patient for first? a. PET
b. Skull x-rays
c. Computed tomography (CT) scan
d. Single-photon emission computed tomography (SPECT)

akpaschal · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

C
DSM-IV-TR criteria for posttraumatic stress disorder is most consistent with the soldier's presentation. The symptoms noted are not part of the clinical manifestations of pathological grief, panic disorder, or agoraphobia. Acute stress disorder has many symptoms in common with posttraumatic stress disorder, but the criteria for this disorder specify that the symptoms begin soon after the traumatic event and do not extend beyond 4 weeks after the event.

Answer to Question 2

C
A CT scan shows the presence or absence of structural changes, including cortical atrophy, ventricular enlargement, and areas of infarct, information that would be helpful to the health care provider. PET and SPECT show brain activity rather than structure and may be completed later.