Lorazepam is an antianxiety medication in the class of benzodiazepines. This medication can help alleviate anxiousness prior to the surgery.
Clonidine would not be useful in this circumstance, especially because her blood pressure is already low. This patient does not exhibit signs of depression, and her anxiety seems to be related only to her upcoming surgery; therefore, an antidepressant medication like fluoxetine is unnecessary. Carbamazepine is a mood stabilizer and would not be useful in this situation.

The fourth layer of the scalp contains an area of loose connective tissue. Deep lacerations that penetrate this layer have an increased risk of infection and possible meningitis. Pus and blood spread easily throughout this area of loose connective tissue, and infection can pass into the cranial cavity along the emissary veins into the meninges.

Commonly seen in Japan and Korea, the syndrome of taijin kyofusho is a form of social phobia. It is characterized by a fear of social evaluation. The patient often reports that they believe they are making other people uncomfortable. For example, a patient might state, "My gaze upsets people, so they avoid me." This fear also has some traits of body dysmorphic disorder (in that the patient may believe they possess an offensive body odor) and it can accelerate to a delusional intensity.

Social interactions on a professional level are appropriate as long as the nurse practitioner maintains healthy boundaries.
Treating close friends or family members creates an ethical dilemma and should be avoided at all times. Depending on state licensure and scope of practice, the provider could be compromising certain regulations and statutes by treating family members; this is never advised and is a poor practice habit.
Although the client does have the right to see who they choose, the nurse-client relationship is a two-way relationship. The provider has a responsibility to ensure that the relationship is a good fit and that it meets certain standards of care required by each state.

The COWS scale is used to assess the severity of opioid withdrawal symptoms and guide the initiation of detoxification. Symptoms such as severe muscle aches will score more heavily on the scale than more mild symptoms in other categories and can contribute to a higher score, indicating more severe withdrawal symptoms.
While sweating, yawning, and nausea can also indicate opioid withdrawal, as described for this patient, they would not contribute to a high score on the COWS scale. The PMHNP should use the COWS in conjunction with other assessments to determine the best course of action for the patient's opioid withdrawal management.