Problem:
Mrs. Jones is an 85-year-old female, widowed patient who lives alone in her own one-story home. She has strong family support in her children, and a strong tie to her Christian faith. She tries to keep busy but recognizes how difficult getting older is, with the loss of many family members and friends she once had. Other than this loneliness and grief, she feels well. She denies depressive symptoms, states anxiety and panic symptoms are well managed with her current medication regimen. Her chief complaint today is insomnia. She states despite her current medication regimen, she still cannot initiate or maintain sleep. Mrs. Jones states, "I've just never been a good sleeper!" Her current medications include: Mirtazapine 7.5 mg PO QHS - insomnia Doxepin 10 mg PO QHS - insomnia Gabapentin 100 mg PO TID - mild idiopathic neuropathy Zolpidem 5 mg PO QHS Xanax 0.5 mg PO BID Venlafaxine 225 mg PO daily Answer the following prompts using 2-3 scholarly references: What patient education do you provide to Mrs. Jones about her current medication regimen? Is there any further evaluation or testing you would order? Are there any changes to her medication regimen you would make? If so, what would your changes be?