NURS6635: Week 9 Assignmen

CASE STUDY

HPI: A. is a 47-year-old Moroccan male presented to the psychiatric center for complaints of
chronic back and panic attack. He has had back pain for two years. The pain is due to the nature
of his job as a cab driver. He has been taking oxycodone 30 mg every 4 hours as needed for 2
years. Pt reports that his doctor discontinued his oxycodone and prescribed Meloxicam 7.5mg
daily instead. He reports that the medication is not effective, so he started doubling on the dose.
Pt reports since the discontinuation of his oxycodone, he has begun to have panic attacks. He
reported that few months ago he once forgot to refill his prescription and had the “worst pain
ever” of his life. Therefore, the thought of not having his pain med makes him panic. He
describes the panic attack symptoms as shortness of breath (SOB), chest tightness, and sweating.
So, he came to the practice and would like to have his medication to be reordered. He has not
been able to work his usual hours. He is afraid that he will not be able to provide for his family
since he is the sole bread winner. Meloxicam dosage was increases from 7.5mg daily to 15mg
daily. Side effects from the medications were discussed including black box warning. Alternative
treatments were explored and discussed. The client verbalized understanding and consented to
the medications. He was asked to return in one month

Based on the above case study, I have provided you with these 3 differential
diagnoses. I want you to write on them just as you did my previous assignment.
Differential Diagnoses:

1. Panic Disorder: (Primary dx:) Explain each and state why
2. Opioid Use Disorder (OUD): 
3. Opioid Withdrawal: 

Please elaborate each according to DSM-5 criteria and why the other two dx were ruled out. In
other words, compare the DSM-5 diagnostic criteria for each differential diagnosis and explain
what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the
critical-thinking process that led you to the primary diagnosis you selected. Include pertinent
positives and pertinent negatives for the specific patient case.
Diagnostic results and Lab tests: What diagnostic test and Lab work will you order for this
patient (This information is not provided but you must provide)