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Author Question: A 22-year-old male patient who has dropped out of college has increasingly disorganized behavior and ... (Read 26 times)

luvbio

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A 22-year-old male patient who has dropped out of college has increasingly disorganized behavior and delusional thinking. His parents report that he lives at home and has no desire to find a job or help around the house.
 
  The primary care NP has ruled out organic causes and has referred the patient to a psychiatrist for treatment. To prepare for the referral visit, the NP should: a. begin therapy with a low-potency antipsychotic.
  b. begin therapy with a high-potency antipsychotic.
  c. obtain a complete blood count (CBC), serum lipids, and hemoglobin A1c.
  d. order liver function tests (LFTs), a CBC, an electrocardiogram (ECG), and a urinalysis.

Question 2

A patient who has diabetes reports intense discomfort when needing to void. A urinalysis is normal. To treat this, the primary care NP should consider prescribing:
 
  a. flavoxate (Urispas).
  b. bethanechol (Urecholine).
  c. phenazopyridine (Pyridium).
  d. oxybutynin chloride (Ditropan XL).



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parshano

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Answer to Question 1

D
Before antipsychotic drugs are initiated, baseline laboratory tests, including LFTs, CBC, ECG, and urinalysis, should be performed. Serum lipids and hemoglobin A1c may be ordered if the patient has risk factors for diabetes or metabolic syndrome.

Answer to Question 2

D
This patient is describing urge incontinence, or overactive bladder, which occurs when the detrusor muscle is hyperactive, causing an intense urge to void before the bladder is full. Urge incontinence is associated with many conditions, including diabetes. Oxybutynin chloride, which is an anticholinergic, acts to decrease detrusor overactivity and is indicated for treatment of urge incontinence. Flavoxate is used to treat dysuria associated with UTI. Bethanechol is indicated for urinary retention. Phenazopyridine is used to treat dysuria.





 

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