Mental Health Final Treatment Plan/Analysis Chamberlain University After further review of this patient being seen in the emergency department for a traumatic incident, I agree with the fo llowing subject information, objective information, and treatment plan. Patient: C.U. Patient Demographics: Ag...
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After further review of this patient being seen in the emergency department for a traumatic
incident, I agree with the following subject information, objective information, and treatment plan.
Patient: C.U.
Patient Demographics:
Age: 79 y.o
Sex: female
Race: African American
Subject:
CC: distressed, delusional, confused, extreme fear and anxiety
History: 79-year-old female has been living at her independent living facility since 2010. She is fully
functional and independent. She provided care for five years for her husband who recently passed away
six months ago. Her only relative is a daughter who talks with her about once a month. Two days ago, her
home was broken into, and she was raped and robbed. The housekeeper found her laying on the floor. She
was down for two days and was taken to a local hospital. Here, she is distressed, delusional, and is
reported to be very emotionally distraught. There are no signs of broken bones or rhabdomyolysis
SHx:
Marital Status: widowed
Children: one daughter
Occupation: retired school secretary
Living Quarters: independent living facility
Tobacco use: Denies
Alcohol use: Denies
Illicit drug use: Denies
PMHx: Chronic conditions are pernicious anemia, osteoarthritis, and urinary incontinence
PSHx: hysterectomy
Allergies: penicillin
Current Medications:
Multivitamin one-a-day for women
Cyanocobalamin (vitamin B12) 1000mcg
Capsaicin topical cream 0.075%
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