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AC is a 17-year-old high-school senior who presents for a yearly physical at her mother’s insistence for evaluation of fatigue. The mother, who accompanies her today, notes that AC is “tired all the time.” AC states that this has been going on for several months and, when questioned further, she acknowledges irritability, tearfulness, decline in grades, and lack of enjoyment and participation in her usual activities (track team, choir). AC has had difficulty falling asleep at night. She has gained approximately 15 pounds over the past few months due to poor dietary habits (skips breakfast, late-night eating, French fries two to three times per week), and lack of physical activity. AC acknowledges that she has been stressed due to her pending college applications, previous break up with her boyfriend, and loss of a valued part-time job. She has been sexually active in the past, but is not currently. She acknowledges infrequent alcohol and marijuana use, but denies substance abuse. She has been spending increasing amounts of time using the Internet, rather than engaging in social activities. AC acknowledges feelings of hopelessness and states that she feels that she “won’t amount to anything” unless she gets a college acceptance and a scholarship, yet she denies any thoughts of hurting herself. Her mother is very concerned about these behaviors.
Based on the information you have about AC’s situation, determine which of the following variable types are important to focus on for her assessment:
Physiological
Psychological
Spiritual
Sociocultural
Developmental
Note: All variable types may not apply. Prioritize those that are most important for this patient.
Once you have selected the pertinent focus, find a minimum of two evidence-based clinical practice guidelines or resources to guide a complete health assessment of AC. Consider
the reason she presents,
social history,
family history, and
ongoing risk for disease.
1.Write a narrative summary (e.g., progress note) of a minimum of 525 words in which you explain
the variables you prioritized for AC and why, and  the clinical practice guidelines or resources you selected and why.

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