Due 09/17/22 at 730 AM EST

Student Notes

Patient is a 68yo F with PPHx. of Schizoaffective disorder and stimulant (cocaine) use disorder and PMHx. of HTN, CKD, anemia, Afib who presents to crisis under PC after ingesting unknown number of pills and endorsing suicidal thoughts. Patient is hostile, uncooperative, restless and irritable during interview; history limited due to irritability. Patient endorses having taken an unknown number of pills, cannot recall the name of the pills with the intention to "hurt [herself]". Patient states she has had suicidal ideations chronically, from "years ago". Patient denies past suicidal attempts and history of self-injurious behavior. She also denies symptoms of depression such as anhedonia, low energy, sleep disturbances and difficulty concentrating. Patient denies homicidal ideation. Patient endorses persecutory delusions and auditory hallucinations although she is unable to further elaborate on their content. Patient endorses crack cocaine use with last use being 2 days ago, she cannot tell the amount consumed. She denies use of other illicit drugs including alcohol. UTOX positive for cocaine and metabolites. Patient endorses medication non-adherence and is currently homeless. Cocaine use disorder (ICD10-CM F14.10, Discharge, Medical) *Probable Unspecified mood [affective] disorder (ICD10-CM F39, Discharge, Medical) *Probable Acute psychosis (ICD10-CM F23, Discharge, Medical) Plan: -Admit to Inpatient, Involuntary -Meds: -Psychotropic: ETOs only -Medical: Seroquel 50mg BID, Remeron 15mg, QHS, QHS -Labs: -Safety: No 1:1 sitter acutely indicated at this time. Continue current level of inpatient staff observation. Discussed with team and will continue to monitor and treat as indicated.