Respond to two peers with the following: Read another studentàtherapy  note and pretend that you are the NP who will see this patient next. Is  there anything that wasn clear in the note that you would like to ask  your NP colleague? Realize that none of us ever have enough time with  our patients, but what is one thing you would have liked to ask this  patient? Also, assume the patient isn tolerating the medication when  you see them in follow up. Identify an alternative medication that would  be appropriate and why you would choose it.

Post 1 

D- Met with R for 45 minutes via virtual session.  Today she is  reporting that she is starting at new college  and it is going well.   She reports that she is anxious about the first day of class and also  about the new classmates, so she is coming/ going in the dark. She is  also worried about having to much work hours during the week and also  now the college responsabilities . She states she was anxious about  finding her way to do all activities at school , and continue been a  good employee and  after a few days she is feeling more at ease. She is  happy  to return to community college now that she has found this  employment that is a permanent job.  

A- Monica has made  improvement in her anxiety symptoms and seems quite proud of her  progress and accomplishments with the new school. We discussed her past  patterns of putting pressure on herself and over thinking. She has  already overcome one obstacle by finding her own way to do all her  activities and can use the same skills for the other stressors that  cause her anxiety at this new job. 

P- HW: Breathing and  mindfulness techniques when feeling anxious. Speaking up politely if  feeling overwhelmed at new school. Talk with mother and sister about  going back to college. Next session in 1 week.

Post 2

D: Met  with 23 year old patient C in office. Patient is alert and oriented.  Speech is clear and relevant. Thoughts are linear. Patient reports that  she has a court date next month and she is somewhat nervous about court  date. Patient had difficulty articulating her concerns, other than fear  of wearing an orange jump suit. Therapist explained that she is not in  custody and will likely wear her own clothing as she has at her other  hearings. Patient reports she called her attorney and didn’t get a  response. Patient reports that she seeks “justice” and accountability  from others who are involved in the trial. Patient then related this  lake of not telling the truth and accountability to her parents, for not  listening to her in her adolescence. Patient was given medications at  the time that caused her to gain weight. Patient reports parents still  lie about that issue and never take accountability for their mistakes.  Patient feels that parents are not supportive and they don’t care. She  looks for parents to acknowledge that they were wrong but, she reports,  they are too prideful.

A: Patient C has made some improvement from the last week’s session.  Patient is less anxious about her upcoming court date this week, than  she was last week. One of patient’s fear is that she will be put in  jail. Patient is unable to speak with her attorney properly, so she  understands the details about her upcoming appointment. Patient has not  made any improvements regarding her relationship with her parents.  Patient continues to hold grudge against her parents and refuse to  listen to their side of the argument. This therapy was mandated by the  court for the patient due to a misdemeanor. Patient attends all her  sessions and verbalizes stressors and people that makes her feel sad and  angry. Currently, patient is not progressing towards the goal of  handling stressful situations in a calm manner and working on  relationships.

P: The treatment plan for the patient is to get back on track with  her life, such as: finding a job and continuing school. Patient also  needs to learn how to articulate better and how to deal with obstacles  in a calm manner. Lastly, the plan is also for patient to reconcile with  parents, have faith in them, and gaining their support.