NR511 week 6 discussion 2

Week 6: Discussion Part Two

Now, assume that you sent your patient for labs and she returns the following day, as instructed, to review the results.

CBC with differential

WBC 8.6 x10E3/uL

RBC 4.44 x 10E6/uL

Hemoglobin 14.0 g/dL

Hematocrit 41.2%

MCV 93fL

MCH 31.5 pg

MCHC 34.0 g/dL

RDW 13%

Platelet 241 x 10E3/uL

Neutrophils % 67%

Lymphocytes % 22%

Monocytes % 8%

Eosinophils % 3%

Basophils % 0%

Absolute Neutrophils 5.7 x 10E3/uL

Absolute Lymphocytes 1.9 x 10E3/uL

Absolute Monocytes 0.7 x 10E3/uL

Eosinophils Absolute 0.3 x 10E3/uL

Basophile Absolute 0.0 x 10E3/uL

Immature Grans % 0%

Absolute Immature Grans 0.0 x 10E3/uL

TSH with Reflex to FT4

TSH 6.770 uIU/mL

FT4 0.62 ng/dL

PHQ-9 Depression Score=10 (previous was 5 at last visit 6 months ago)

• What is your primary diagnosis for this patient as the cause for the CC of fatigue?

• Identify the corresponding ICD-10 code.

• Provide a treatment plan for this patient's primary diagnosiswhich includes:

? Medication*

? Any additional testing necessary for this particular diagnosis*

? Patient education*

? Referral and follow-up to the treatment plan

? Provide an active problem list for this patient based on the information given in the case.

Are there any changes that you would make to the patient's overall plan at this time? Must provide an evidence-based medicine (EBM) argument to support any treatments or testing decisions.

Provide an appropriate follow-up plan (include any additional testing that you feel is necessary and include an EBM argument).

*If part of the plan does not warrant an action, you must explain why. ALL medication and testing decisions (or decisions not to treat with medication or additional testing) MUST be supported with an EBM argument.