Treatment plan for this patient's primary diagnosis

Requirements:

1. What is your primary (one) diagnosis for this patient at this time? (support the decision for your diagnosis with pertinent positives and negatives from the case)
2. Identify the corresponding ICD-10 code.
3. Provide a treatment plan for this patient's primary diagnosis which includes:
   o Medication*
   o Any additional testing necessary for this particular diagnosis*
   o Patient education
   o Referral
4. Provide an active problem list for this patient based on the information given in the case.
5. Are there any changes that you would also make to this patient’s overall treatment plan at this time? Must provide an EBM argument for each treatment or testing decision.
6. Provide an appropriate F/U plan.
   *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 evidence-based medicine (EBM) argument. Over-the-counter (OTC) and RXs must be written in full as if handing a script to the patient in the office.

Case Study
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)

**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.
DISCUSSION CONTENT
Category Points % Description
Application of Course Knowledge 15 30% 1. Student chooses one appropriate diagnosis for the patient; AND

2. Diagnosis is supported with strong pertinent positive and negative subjective and objective data from parts 1 & 2; AND
3. The ICD code for the diagnosis is correct; AND
4. Treatment plan for primary diagnosis includes medication, additional testing, patient education, and referral; AND
5. Prescription and OTC medications are written appropriately as a RX and all components are correct; AND
6. Treatment decisions (medication, additional testing, referrals) are supported with appropriate EBM arguments; AND
7. An accurate problem list is presented based on case information; AND
8. Student discusses changes (or not) to the overall treatment plan for the patient for pertinent issues; AND
9. An appropriate F/U plan is provided
   (9 critical elements)
   Support from Evidence-Based Practice (EBP) 15 30% 1. Discussion post is supported with appropriate, scholarly sources AND
10. Sources are published within the last 5 years (unless the most current CPG is used) AND
11. A reference list is provided with in-text citations that match AND
12. All treatment and testing decisions are fully supported with an appropriate EBM argument
    (4 critical elements)
    Interactive Dialogue 10 20% 1. Student provides a substantive* response to at least one topic-related post of a peer AND
13. Includes evidence from appropriate scholarly sources AND
14. Provides a reference list which match in-text citations AND
15. Student responds to all direct faculty questions
    (4 critical elements)
    Total CONTENT Points= 40 pts
    DISCUSSION FORMAT
    Category Points % Description
    Organization 5 10% 1. Case study response is presented in a logical format, AND
16. Responses are in sequence with the numbered questions AND
17. The case study response is understandable and easy to follow AND
18. All responses are relevant to the case topic
    

Sample Solution