Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing psychotic disorders.
TO PREPARE:
Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing psychotic disorders. Consider whether experiences of psychosis-related symptoms are always indicative of a diagnosis of schizophrenia. Think about alternative diagnoses for psychosis-related symptoms.
Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft,
TRANSCRIPT OF VIDEO FILE: Training Title 24
00:00:00______________________________________________________________________________
00:00:00BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15OFF CAMERA Your roommates, Rachel and Liz, shared some information with me. They said that you were fine, and that shortly after your aunt died, that you started acting in a different sort of strange way. Started having thoughts and hearing things that others couldn’t hear.
00:00:35JESS They think I’m living in a movie. Rachel and Liz. That’s who they think I am. I see a lot of movies. So maybe they’re right. Maybe I am a movie
00:00:45OFF CAMERA I’m not sure I understand how you can be a movie.
00:00:45JESS Because they listen to our apartment.
00:00:50[Whispers]
00:00:50JESS They listen from next door.
00:00:50OFF CAMERA Who listens?
00:00:55JESS Russian men and whores. They drill all night long. That’s how they send their information back. Drilling.
00:01:05OFF CAMERA Drilling. They send messages by drilling?
00:01:10JESS Doesn’t surprise me. Most people don’t understand.
00:01:15OFF CAMERA Your roommates said that your favorite aunt that died, she’s the one who raised you.
00:01:20JESS Maybe she did. Maybe she didn’t. Who told you? Can you prove it? I can’t.
00:01:30OFF CAMERA Liz and Rachel told me.
00:01:30JESS Good for them.
00:01:35OFF CAMERA And your roommates said you had some new neighbors that moved in. Are these the neighbors you’re talking about?
00:01:45JESS They’re not neighbors. They’re Russians. They don’t answer their door. I tried to banging on their door and they didn’t answer. Figures. I mean they only speak English. They don’t speak English, they speak Russian in code.
00:02:00OFF CAMERA You know, your roommate, Rachel, told me your new neighbors speak Spanish. They speak Spanish.
00:02:10JESS They lie. But what do you expect?
00:02:15OFF CAMERA What do they do? Your neighbors?
00:02:20JESS I don’t want to talk about this any more.
00:02:25OFF CAMERA You know, Jess, I imagine what you are experiencing right now feels very frightening. I hear from a lot of the people who, hear voices that maybe aren’t there, that it’s very frightening. And it’s upsetting. Are you experiencing anything like that?
00:02:40JESS Yes. I hear them talking when no one else can. I mean not Rachel, not Liz. That’s why I went down to my car yesterday. Because if I’m very, very still, the Russians can’t code me.
00:02:55OFF CAMERA What do you mean code you?
00:03:00JESS You know. You act like you don’t know, but you know.
00:03:05OFF CAMERA How long did you stay in your car?
00:03:10JESS Six hours. I watched them move in and out.
00:03:15OFF CAMERA So do you sometimes see things that your roommates don’t see?
00:03:20JESS No. But I know things that they don’t know.
00:03:30OFF CAMERA Jess, I realize it is difficult sometimes for people to tell me things but it really helps me with their background. Has anything happened recently? Anything traumatic?
00:03:40JESS I think that secret government papers are traumatic. Like blueprints. I mean, they have blueprints of buildings. My apartment is a building.
00:03:55OFF CAMERA What are the blueprints?
00:03:55JESS They’re all over the walls. That’s what they want.
00:04:00OFF CAMERA The neighbors?
00:04:00JESS The Russians. They’re terrorists. You’ll find out too late.
00:04:10OFF CAMERA Has anyone else seen these blueprints Jess?
00:04:10JESS I can stop them from seeing them. I covered the walls, I marked up the walls. I just need more markers.
00:04:20OFF CAMERA Jess, do you drink alcohol or take drugs?
00:04:25JESS My body is my temple. No.
00:04:30OFF CAMERA Have you been taking any prescription medications?
00:04:35JESS Yes I did. I was.
00:04:40OFF CAMERA So you stopped taking your medications?
00:04:45JESS Yes I stopped taking my medications. The medications were part of the problem. But you know all about that, don’t you?
00:04:55OFF CAMERA Jess, do you have any thoughts of hurting yourself, or hurting any other people?
00:05:00JESS Rachel and Lizzy? I don’t think they’re in on it. Time will tell.
00:05:10[sil.]
00:05:10END TRANSCRIPT
Training Title 24
Name: Ms. Jess Davies
Gender: female
Age: 30 years old
T- 98.6 P- 86 R 20 120/70 Ht 5’2 Wt 126lbs
Background: Jess is brought for evaluation by her 2 roommates who are concerned with
behaviors. She had some issues with depression after aunt died but worsened in the 12 days after
she witnessed her brother killed via GSW in a gas station burglary. She is estranged from her
parents and her brother was her only sibling. She is only sleeping 2 hours/24hrs; she will only eat
canned foods. She smokes cannabis daily since she was 17 and goes out on weekdays couple times with her roommates and has couple drinks of beer. She was prescribed alprazolam1mg
twice daily as needed by her PCP for 15 days. She works in a bakery. Allergies: medical tape
NRNP_6635_Week7_Assignment_Rubric
NRNP_6635_Week7_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCreate documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected. In the Subjective section, provide: • Chief complaint• History of present illness (HPI)• Past psychiatric history• Medication trials and current medications• Psychotherapy or previous psychiatric diagnosis• Pertinent substance use, family psychiatric/substance use, social, and medical history• Allergies• ROS
20 to >17.0 pts
Excellent
The response throughly and accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis.
17 to >15.0 pts
Good
The response accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis.
15 to >13.0 pts
Fair
The response describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis, but is somewhat vague or contains minor innacuracies.
13 to >0 pts
Poor
The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. Or, subjective documentation is missing.
20 pts
This criterion is linked to a Learning OutcomeIn the Objective section, provide:• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.
20 to >17.0 pts
Excellent
The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.
17 to >15.0 pts
Good
The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are accurately documented.
15 to >13.0 pts
Fair
Documentation of the patient’s physical exam is somewhat vague or contains minor innacuracies. Diagnostic tests and their results are documented but contain minor innacuracies.
13 to >0 pts
Poor
The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or, objective documentation is missing.
20 pts
This criterion is linked to a Learning OutcomeIn the Assessment section, provide:• Results of the mental status examination, presented in paragraph form.• At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
25 to >22.0 pts
Excellent
The response thoroughly and accurately documents the results of the mental status exam…. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides a thorough, accurate, and detailed justification for each of the disorders selected.
22 to >19.0 pts
Good
The response accurately documents the results of the mental status exam…. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides an accurate justification for each of the disorders selected.
19 to >17.0 pts
Fair
The response documents the results of the mental status exam with some vagueness or innacuracy…. Response lists at least three different possible disorders for a differential diagnosis of the patient and provides a justification for each, but may contain some vaguess or innacuracy.
17 to >0 pts
Poor
The response provides an incomplete or inaccurate description of the results of the mental status exam and explanation of the differential diagnoses. Or, assessment documentation is missing.
25 pts
This criterion is linked to a Learning OutcomeReflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
10 to >8.0 pts
Excellent
Reflections are thorough, thoughtful, and demonstrate critical thinking.
8 to >7.0 pts
Good
Reflections demonstrate critical thinking.
7 to >6.0 pts
Fair
Reflections are somewhat general or do not demonstrate critical thinking.
6 to >0 pts
Poor
Reflections are incomplete, inaccurate, or missing.
10 pts
This criterion is linked to a Learning OutcomeProvide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).
15 to >13.0 pts
Excellent
The response provides at least three current, evidence-based resources from the literature to support the assessment and diagnosis of the patient in the assigned case study. The resources reflect the latest clinical guidelines and provide strong justification for decision making.
13 to >11.0 pts
Good
The response provides at least three current, evidence-based resources from the literature that appropriately support the assessment and diagnosis of the patient in the assigned case study.
11 to >10.0 pts
Fair
Three evidence-based resources are provided to support assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification.
10 to >0 pts
Poor
Two or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence based.
15 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph development and organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 to >4.0 pts
Excellent
A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. …Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
4 to >3.5 pts
Good
Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. …Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3.5 to >3.0 pts
Fair
Purpose, introduction, and conclusion of the assignment is vague or off topic. … Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%-79% of the time.
3 to >0 pts
Poor
No purpose statement, introduction, or conclusion were provided. … Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English writing standards: Correct grammar, mechanics, and punctuation
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.0 pts
Good
Contains a few (one or two) grammar, spelling, and punctuation errors
3 to >2.0 pts
Fair
Contains several (three or four) grammar, spelling, and punctuation errors
2 to >0 pts
Poor
Contains many (≥ five) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts
Total Points: 100
PreviousNext
Training Title 9
00:00:00TRANSCRIPT OF VIDEO FILE:
00:00:00______________________________________________________________________________
00:00:00BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15OFF CAMERA Ms. Branning, Mr. Nehring asked suggested you see me. He said your having some issues at work.
00:00:20MS. BRANNING You could call them that.
00:00:20OFF CAMERA What kind of difficulty are you having at work?
00:00:25MS. BRANNING Well Mr. Nehring wants to fire me.
00:00:30OFF CAMERA Why do you think Mr. Nehring wants to fire you?
00:00:30MS. BRANNING Because Eric is in love with me. And it’s probably getting in the way. And he wants to fire me.
00:00:40OFF CAMERA Who is Eric?
00:00:40MS. BRANNING Eric is my supervisor.
00:00:45OFF CAMERA Are the two of you in a relationship?
00:00:45MS. BRANNING No! Eric has his own girlfriend, I have my own boyfriend. But Mr. Nehring got it in his head that this is my fault. And they’ve been ganging up against me.
00:01:00OFF CAMERA What happened to make you feel this way?
00:01:00MS. BRANNING Eric is lustful for me. Lust. Lustful.
00:01:10OFF CAMERA Well has Eric done anything inappropriate?
00:01:10MS. BRANNING No, he doesn’t have to.
00:01:15OFF CAMERA What do you mean?
00:01:15MS. BRANNING Well, he has this way of walking toward me and he gives me the easiest assignments to do and he asks me to voice my opinion a lot in our weekly meetings. And I’m beautiful. I mean, not to be boastful or anything but I’m a strong woman. And people are attracted to that. And others, like Mr. Nehring feel threatened by it. He probably feels I could replace him in a couple years. And I could.
00:01:45OFF CAMERA But there have been no instances of sexual harassment.
00:01:50MS. BRANNING No. And now they want to fire me, and it’s probably because they don’t want me to get in the way of their day. I’m probably a distraction or something.
00:02:00OFF CAMERA According to Mr. Nehring you haven’t made a sale in three weeks.
00:02:05MS. BRANNING Oh, it’s been a slow time period. I guess it wouldn’t be bad thing if they fired me. I mean after all of this, all the bad it’s done for my health. You know I should really sue for discrimination, you know the stress and the health problems.
00:02:25OFF CAMERA You’ve been having health problems?
00:02:25MS. BRANNING Yes. Yes. It keeps getting worse.
00:02:30OFF CAMERA Can you describe it for me?
00:02:30MS. BRANNING Well you know there’s this pain in my neck, it aches, it spreads to my back, I think there’s a lump, right here. I’m really worried.
00:02:55OFF CAMERA And what do you feel is the cause?
00:02:55MS. BRANNING I told you, pain, suffering, broken heart. I think it’s cancer.
00:03:05OFF CAMERA Have you been seen by a doctor?
00:03:10MS. BRANNING No. But it’s probably cancer. And it’s slowly killing me. And it’s all because of them. And Eric’s obsession with me.
00:03:20OFF CAMERA Ms Branning, I don’t think you have to worry, a broken heart can’t cause cancer.
00:03:25MS. BRANNING You never know until it happens.
00:03:30[sil.]
00:03:30END TRANSCRIPT
Collepals.com Plagiarism Free Papers
Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.
Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS
Why Hire Collepals.com writers to do your paper?
Quality- We are experienced and have access to ample research materials.
We write plagiarism Free Content
Confidential- We never share or sell your personal information to third parties.
Support-Chat with us today! We are always waiting to answer all your questions.
