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What is the best initial step in the management of patient


Problem: A 66-year-old female presents for a follow-up. She resides with her son and daughter-in-law. Given her continued cognitive decline, she has a caregiver to assist with medication management and monitoring of blood pressure. Her past medical history includes ischemic stroke, vascular dementia, diabetes mellitus, and hypertension. Her medications include aspirin, metformin, insulin glargine, metoprolol, lisinopril, donepezil, and a multivitamin. The clinician reviews her home blood pressure readings, which have been under control. Her blood pressure at the current visit is 140/80 mmHg, and random blood sugar is 180 mg/dl. She has a 30-pack-year smoking history. Her son states she has become more irritable and prefers to stay at home. Which of the following is the best initial step in the management of this patient? Need Assignment Help?  A. Screen for depression B. Provide caregivers with support and education C. Motivational interviewing and encourage socialization D. Start antidepressant medication

 

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