Case Study- Female Patient
The case study examined a 68-year-old female patient with a history of asthma, chronic obstructive pulmonary disease (COPD), arthritis, tobacco use, bipolar disorder, and schizophrenia. COPD can have a significant negative impact on the patient’s physical and mental well-being (Duffy & Criner, 2019). During the interview, the patient expressed concern about her daughter being held hostage and someone injecting her chest; however, she was able to maintain appropriate eye contact and engage in conversation. The patient demonstrated disorganized thought content, impaired insight, and judgment related to her current condition, which was likely exacerbated by her increasing delusions and paranoia. The patient denied drinking but admitted to smoking a pack of cigarettes daily. Her family members and friend stated that she had not been taking her medication as prescribed, and they were worried about her worsening delusions and paranoia. Engaging patients and the healthcare team is essential to ensure successful medication adherence, and interventions such as face-to-face counseling, electronic reminders, and minimizing adverse effects can help (Bombard et al., 2018).
The patient reported having left leg pain and increased fatigue, which was assessed and treated. She was prescribed olanzapine 20 mg at bedtime and referred to physical therapy to manage her generalized pain and increase mobility, as well as a tobacco cessation group. Based on the information provided, the patient’s diagnosis is likely a combination of a mental health disorder, such as bipolar disorder and/or schizophrenia, and a physical health disorder, like COPD. Additionally, she will continue to take Divalproex 125 mg and chlorpromazine 75 mg at bedtime and receive psychotherapy to manage her psychosis. The diagnosis is appropriate for this patient since she exhibited symptoms that are consistent with her medical history, including disorganized thought content, impaired insight, and judgment. Also, her family and friends reported that she had not been taking her medication as prescribed. The healthcare team developed a plan that included both physical and psychological interventions, as well as medication to help manage her symptoms. This plan is tailored to her specific needs and is likely to improve her overall health and well-being.
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., … & Pomey, M. P. (2018). Engaging patients to improve quality of care: a systematic review. Implementation Science, 13(1), 1-22.
Duffy, S. P., & Criner, G. J. (2019). Chronic obstructive pulmonary disease: evaluation and management. Medical Clinics, 103(3), 453-461.