Paper Sample on Diagnosing L.P. with Chronic Fatigue Syndrome (CFS): A Case Study

Introduction

L.P. is likely to be diagnosed with chronic fatigue syndrome (CFS). One reason is that L.P is showing various types of contradicting symptoms that none indicates the specific condition she is suffering from at the time (Jain et al., 2017). Likewise, L.P states to have been experiencing extreme long-term exhaustion, something she says has persisted for more than nine months. This condition cannot be attributed to an existing medical disorder or even drugs side effects drugs. The fatigue also appears to aggravate with more mental activity since she points out the frequent feeling of ‘going blank' while at work. As a result, she had consistent worries about the performance at work and the inability to improve after rest due to difficulties to catch sleep.

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Specific Pharmacotherapeutic Treatment Goals

L.P.’s pharmacotherapeutic goals will focus on relieving the symptoms because CFS has no specific medicine. A majority of the individuals showing chronic fatigue syndrome symptoms are also reported to have some extent of depression. That means trying to ease the patient from depression-related symptoms will, therefore, help the patients to cope effectively with the issues associated with CFS. At the onset, administering antidepressants like Prozac in a lower dosage to L.P. will be an effective treatment (Jain et al., 2017). Giving her this can alleviate symptoms, including anxiety, and then improve her sleep routine, which, in turn, would reduce her levels of fatigue and irritability. With less anxiety and improved quality of sleep, her concertation will improve, thus realize better work performance. By alleviating her CFS with Prozac, then the CNP can treat the underlying condition effectively until she recuperates control over her life activities and to get to live normally.

Labs for L. P.

Before recommending medications, the CNP must indeed order some laboratory tests for L.P. to eliminate various diseases that could have similar symptoms to CFS. This examination should consist of checking her blood for indications of other conditions that might be the source of fatigue, including diabetes, anemia, and underactive thyroid (Jain et al., 2017). Once the results are obtained, the CNP can state if L.P has CFS. Negative results for the conditions will increase the likelihood of chronic fatigue disorder in the patient.

Apart from the labs, the CNP needs to order additional assessments for L.P to confirm the diagnosis, such as evaluate her sleep regime. This study is necessary if she reported sleep disorders to confirm if such conditions could be the primary cause of the underlying chronic fatigue. Therefore, the results will indicate if disorders like restless legs syndrome, insomnia, and sleep apnea are disturbing her sleep (Richman et al. 2019). L.P also will need lung and heart impairment assessment because such weakening could be the cause of the feeling of impairedness. The patient’s heart and lung function can be assessed using exercise stress tests.

The CNP can as well as refer L.P for psychotherapy, where it would be evaluated if she has mental health conditions. Such issues can be responsible for heart symptoms like fatigue. A psychotherapist can evaluate mental disorders, including schizophrenia, bipolar disorder, anxiety, and depression. From the laboratory, mental, and physical tests, then the CNP can attribute L. P’s symptoms to chronic fatigue syndrome and rule out any other thoughts and then find appropriate ways to treat the patient successfully.

Drug Therapy

CFS has no cure; however, there are some treatments L.P. can consider to relieve the symptoms. One of the most efficient drug therapy from the start, include administering antidepressants like Prozac in low doses. Antidepressants function by increasing neurotransmitters levels in the brain while also reducing the rate of transmitters break down (Richman et al. 2019). This effect will alleviate symptoms like anxiety, thus improve her sleep and leave the patient with lower levels of fatigue and less irritability. Prozac is effective because it serves as selective serotonin reuptake inhibitors thus can regulate serotonin levels of the patient. Sedating in Prozac is also commonly recommended because the drug is helpful for hyperventilation problems. The reason to start using small doses is that CFSs react negatively to higher levels. Again, its listed side-effects cannot distress the patient.

Parameters for Monitoring the Success of the Therapy

Prescription medicines used in treating sleep difficulties and symptoms of CFS must be monitored. As a patient using antidepressants, the first parameter will entail evaluating her sensitivity to the medication (Richman et al. 2019). This aspect is particularly true because the therapy acts on her central nervous system for its therapeutic benefits that are often achieved at low doses. If L.P. is tolerating the amount, then it will be a sign of success, and if not, then a portion of the recommended quantities will be administered. After the first management using lower medicating, then one or even more gradual rises can be considered as tolerated and required by L.P.

Specific Patient Monitoring for Therapy

Throughout and especially at the start of the treatment, vigilant monitoring will be vital. At six weeks, the patient should be asked if there is any identified improvement. Spending an adequate amount of time with L.P. and asking her direct questions will enable the CNP to identify the acceptable side-effects profiles for the patient. Richman et al. (2019) said that if adverse effects exist, titrating to ideal doses will be essential to avoid further problems. For the antidepressant prescribed, providing alternative treatment choices will be necessary. In actuality, some patients may take longer, like about three months to get better.

CNP’s Response

If L. P. returns to CNP after six weeks with the complaint of feeling anxious, the response will take the reminding of the patient. Many treatment options are available if initial attempts of treatment are insufficient. Because it is good, the patient knows about Klonopin medication, and then her request to switch can be guaranteed. Patients suffering from CFS can be prescribed Klonopin to alleviate insomnia as well as other neurological bound symptoms. However, she must plan carefully since antidepressants, especially short-acting prescriptions, have withdrawal associated symptoms, including dizziness, sweating, nausea, chills, or loss of appetite, etc.

Conclusion

CFS is debilitating to treat easily, and so management plans for the patients must aim at reducing and stabilizing the symptoms (Freire et al. 2016). Because L.P. presents moderate symptoms, non-drug approaches, including exercise, controlled light exposure, and cognitive-behavioral therapy, may be healthy activities. Limiting continuous activity when possible, is a rational therapeutic approach that minimizes risks of deterioration.
One of the outcomes of this condition is that L.P., as a CFS, will have a good prognosis (Bell MD, 2016). Particularly, she is still young, and so if she adheres to the line of therapy, then the antidepressant treatment would be effective, leading to full recovery.

References

Richman, S., Morris, M. C., Broderick, G., Craddock, T. J., Klimas, N. G., & Fletcher, M. A. (2019). Pharmaceutical interventions in chronic fatigue syndrome: a literature-based commentary. Clinical therapeutics, 41(5), 798-805.

Jain, V., Arunkumar, A., Kingdon, C., Lacerda, E., & Nacul, L. (2017). Prevalence of and risk factors for severe cognitive and sleep symptoms in ME/CFS and MS. BMC Neurology, 17(1), 117.

Freire, R. M., Landeiro, M. J., Martins, M. M., Martins, T., & Peres, H. H. (2016). Taking a look to promoting health and complications' prevention: differences by context. Revista Latino-Americana De Enfermagem, 24, e2749. https://doi.org/10.1590/1518-8345.0860.2749

Bell MD, D. S. (2016, August 9). Prognosis of ME / CFS. Retrieved from https://www.omf.ngo/2016/08/01/prognosis-of-mecfs/