NURS 6670 Michael is a 18-year-old male who is presented to care at the urging of his parents.

 

Michael is a 18-year-old male who is presented to care at the urging of his parents.

Answer:

Michael is a 18-year-old male who is presented to care at the urging of his parents. He has never had any significant medical or psychiatric problems in the past, but during his first semester at college he has developed a very alarming pattern of excess sleep. He is missing classes and is in danger of losing a scholarship. Michael is sleeping normally at night but apparently is having these very long episodes of napping and sleeping during the day. When he is awake, he tends to be rather withdrawn. His parents have taken him to their family practitioner as they thought he might be using drugs. A full exam, laboratory assessment, and toxicology screen are all normal, and there are no apparent causes for this sleepiness

After taking a thorough history, the PMHNP makes a diagnosis of Kleine-Levin syndrome, a very rare disorder of excessive daytime sleepiness and recurrent episodes of hypersomnia. The PMHNP begins to educate Michael’s parents about this condition, ways to help manage it, and other related issues like safety and driving.

Michael, during your first semester of college, you started developing a pattern of sleeping very excessively during the day. Your parents brought you in when they became concerned about your behavior, as you had never had any significant medical or psychiatric problems before. With a thorough exam and numerous lab tests, there were no apparent reasons for why you were sleeping so during the day. After considering all other possible causes, we found that this is a rare disorder called Kleine-Levin syndrome .

Michael is a college student who has been persistently sleepy for the last few weeks. On initial evaluation, he appears withdrawn, but he is very friendly and cooperative. He takes a full history from you and your assessment reveals normal vital signs with no acute distress, and a good understanding of his problem and insight into it from both himself and his parents.

A fairly uncommon but potentially serious and usually treatable disorder, Kleine-Levin syndrome is characterized by excessive nocturnal sleepiness and recurrent episodes of compulsive eating during the day. The syndrome is characterized by the occurrence of a large number of episodes that recur over several years or even decades (although it can be worse in the early years) and clusters of symptoms, most commonly excessive daytime sleepiness and high-calorie food cravings. However, many people with this condition may experience intermittent episodes leading to diabetes, depression, substance abuse or other serious conditions. It should be suspected if: it begins before age 15; if there is a family history of a related disorder;   excessive sleep symptoms persist for more than one year; naps and night time sleep are disturbed; and they begin during puberty.

Question:

Michael is an 18-year-old male who is presented to care at the urging of his parents. He has never had any significant medical or psychiatric problems in the past, but during his first semester at college he has developed a very alarming pattern of excess sleep. He is missing classes and is in danger of losing a scholarship. He is sleeping normally at night but apparently is having these very long episodes of napping and sleeping during the day. When he is awake, he tends to be rather withdrawn. His parents have taken him to their family practitioner as they thought he might be using drugs. A full exam, laboratory assessment, and toxicology screen are all normal, and there is no apparent cause for this sleepiness. While very rare, the PMHNP considers Kleine-Levin syndrome and further assesses for coincident onset of:

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