Pursuing A Profession: A Case Study

When I answered the questions on career cruising I found that my results were inaccurate as to the career I am interested in. The first career was mechanical engineer. Environmental engineer is the second on list. The career that I am actually interested in Software development and Computer science I did not get the results I was looking for in my career assessment. I will still look for a career in information technology when I enter the workforce but for now I will look into the jobs the field has to offer. I want to become a software developer and work for good software company, I hope it works out that way in the end. I disagree with the survey results because I do not want to become a engineer in those fields, I feel like being an engineer will be to heavy of a weight on my shoulders. Environmental engineer would not fit me because I am not a environmental type of person.

The patient was admitted to the hospital by her daughter after discovering that she had abandoned her medication and was significantly experiencing adverse effects from the withdrawal. The patients’ medical history included renal dysfunction, anemia, malnourishment, back pain, and a family history of mental health. The patient has a psychiatric history of being previously placed in the same clinical structure eight months ago due to related issues including the failure to take her medication and increased levels of mental health conditions that led

This is a complex medication visit. This is a young woman who I have treated for (lipastimea) and depression last seen a year ago. She returns now complaining of increasing depression over the past several months culminating an emergency room visit.

Pt has x5 hx of IP hospitalizations, most recent was April 2015 due to SI. Pt currently receive intensive in home therapy x2 week through integrated helath services. She also receives outpatient psychiatry thorugh Dr. Burk Seigle. Pt is currently prescrived Vyvanse 50 mg daily, Abilify 5mg daily, Clonidine .01mg daily. Pt has not been compliant with Vyvanse or Clonidine due to pt mother does not want medication to be come addicted to medication. Per report from mother she is trying to wean pt off her medication to help stabilize

This week she reported she wasn’t feeling well. Client reported no changes in her medications.

We did talk about this at length. I definitely encouraged her to consider moving forward with counseling. This is something she initially said she was not interested in, but by the end of the visit seemed open to it. I also talked with her about medication options, as she was very interested in that. We review different choices and I elected to place her on Celexa 10 mg one p.o. daily #30 with no refills. She was advised if in two weeks really not noticing much of a difference and definitely no side effects that she could increase to two a day for 20 mg. We talked about the typical use and side effects. We talked about the blackbox warning and she is aware of what to watching for. Any acute worsening of her symptoms, she will seek care immediately or call 911. She seemed comfortable with this. We talked about the importance of healthy lifestyle choices including ensuring she is getting enough sleep, which as of right now is a problem for her. She struggles somewhat with waking up and not being able to stay asleep or sometimes falling asleep as well. We talked about regular exercise and maintaining a good diet. I will follow up with her in approximately three weeks. She will follow up sooner if her symptoms necessitate

A 79-year-old female present with her daughter for ongoing fatigue also noted to have lost 5 pounds over past 6 months. No night sweats or fevers. Pertinent past medical history includes severe, generalized osteoarthritis, hypertension, type 2 diabetes mellitus and depression. She is taking the following medications: acetaminophen 650mg every eight hours, Lyrica 75 mg twice daily; alendronate 70 mg once weekly, valsartan 320 mg once daily, fluoxetine 40mg once daily and insulin glargine 20 units once daily. Your exam reveals slight pale conjunctivae, a 2/6 systolic ejection murmur and generalized arthritic joints in her extremities. A point of care test results in a hemoglobin of 10.2 g/dL. Complete blood cell count is done; results

" When I missed my dose, I did not have any withdrawals. I felt fine, Charlene.....I am just tired of having to come there everyday and its affecting my work schedule. I tried to call you and I know you were busy as you just returned from vacation.....I have a lot going on. I do not need doctor to tell me that I cannot go down because I am still using." This writer explained to the patient as to why the doctor made the comment due to past consultation over the summer. The patient is aware of the clinic's concern, but does not feel to continue due to the risk

SW was paged at son Dean's request by Pt's nurse April Tucker, RN. Pt was in be and Pt's granddaughter and son Dean were present in the room. Pt appeared brighter today and reported she was feeling o.k. Pt reported Dr. Reda, Neurologist came in yesterday and ordered more tests. Pt. Reported she is still going to get better, and no one can tell her different. Pt reported she is not going to begin her medications again because she took the medications Dr. Reda ordered and she became weaker and is now in the hospital. I asked Pt. If she felt it was a coincidence that her physical decline occured when she began taking the medication, and Pt. Reported "I was not coincidence, it made me not be able to walk."

In this patient, the drugs that he is on can lead to many severe side effects. Firstly he is on a number of medications that can cause CNS depression, hypotension, bradycardia, and sedation potentially leading to falls.

MENTAL UPDATE: Client report no mental issues this week but she was diagnosed by the onsite psychiatrist on 3/2/2016, with Axis 1: Minimal cognitive impairment; 331.83 (primary) rule out and Anxiety about health -300.09 vs. illness anxiety d/o vs. pt. seeking secondary gain. No medication was prescribed.

The patient is a 34 year old female who presented to the ED with increase depressive symptoms and SI since medication changed last week. Denies suicidal plan and reports having back pain for 2 months due to passing of kidney stones as well as upper jaw pain from tooth being pulled last week. Patient denies HI or symptoms of psychosis.

On 7/13/17 Emily had a routine visit with Dr. Hegab. He talked with staff and Emily about how she has been doing with anxiety since starting Celexa. Staff talked with Dr. Hegab about observations made since her last visit. The doctor discussed the option of starting a new medication (Namenda) for possible early signs of dementia. He explained that dementia symptoms may precede the actual diagnosis by several years and that starting this medication may be beneficial in the long term. He advised Emily to continue taking Celexa as prescribed and to return in six months. Her next routine appointment was scheduled for January. Staff consulted Emily's sister on starting a medication for possible dementia signs in Emily. Emily's sister stated that

This year I have been granted with the great opportunity to participate in New Visions Medical Professions. New Visions is a rigorous program in which one has to go through an application process and an interview. You have to make yourself stand out enough in order to be chosen out of all the applicants and finally placed in the class of 14 students.

It has been 10 years passed since last time I entered in college as a freshman, and now, at the end of 2017, I decide to go back to college for pursuing a new major and reaching a new objective of career path. All of these will start from Fullerton College.