[email protected]

New Order

The Psychiatric Nursing Assignment Paper

The Psychiatric Nursing Assignment Paper

#5. 5 pages . Atleast 5 references from 2002- present . . Petunia Park , Template and exemplar to be sent via attachment
Review this week’s Learning Resources. Consider the insights they provide about assessing, diagnosing, and treating mood disorders.
Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.
Review the video, Case Study: Petunia Park. You will use this case as the basis of this Assignment. In this video, a faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar. The Psychiatric Nursing Assignment Paper

ORDER A PLAGIARISM-FREE PAPER HERE

Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Consider patient diagnostics missing from the video:
Provider Review outside of interview:

Temp 98.2 Pulse 90 Respiration 18 B/P 138/88

Laboratory Data Available: Urine drug and alcohol screen negative. CBC within normal ranges, CMP within normal ranges. Lipid panel within normal ranges. Prolactin Level 8; TSH 6.3 (H)
THE ASSIGNMENT
Develop a Focused SOAP Note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template: The Psychiatric Nursing Assignment Paper

Subjective: What details did the patient provide regarding their chief complaint and symptomatology 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 to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5 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.
Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.
Reflection notes: Reflect 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 that takes into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.)The Psychiatric Nursing Assignment Paper.

#9 . 2 pages . Attach 3 scholarly articles . writer may add extra. At least 5 references.
The DSM-5-TR is a diagnostic tool. It has evolved over the decades, as have the classifications and criteria within its pages. It is used not just for diagnosis, however, but also for billing, access to services, and legal cases. Not all practitioners are in agreement with the content and structure of the DSM-5-TR, and dissociative disorders are one such area. These disorders can be difficult to distinguish and diagnose. There is also controversy in the field over the legitimacy of certain dissociative disorders, such as dissociative identity disorder, which was formerly called multiple personality disorder.

In this Assignment, you will examine the controversy surrounding dissociative disorders. You will also explore clinical, ethical, and legal considerations pertinent to working with patients with these disorders.
Review this week’s Learning Resources on dissociative disorders.
Use the Walden Library to investigate the controversy regarding dissociative disorders. Locate at least three scholarly articles that you can use to support your Assignment.
Explain the controversy that surrounds dissociative disorders.
Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.
Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important The Psychiatric Nursing Assignment Paper.

Patient Information: The patient’s name is PP, she is a female and is 25 years old.

Subjective:

CC (chief complaint): The patient goes to the healthcare facility with the main aim of undergoing a healthcare assessment claiming that she has been under medications but has recently stopped them because they have a negative effect in her and she feels they have been squashing her personality and they have not been helping her.

HPI:  Petunia Park is a 25-year-old patient who goes to the hospital for a mental health assessment. She tests positive for depression and she has been taking different medications and has recently stooped them since they have been squashing her personality and she feels that she does not need them. She has also stopped taking the medication since she feels she does not need them. Nevertheless, these medications have not effectively managed the clinical symptoms she is facing and she has been unwilling to continue with the medication.

Substance Current Use:  The patient claims that before, she tried taking alcohol but never had a good experience with it and she stopped taking it. She also tried other drugs like Marijuana and Cocaine but she stopped taking them and has never even thought if trying them. Currently, she has been taking nicotine and shows lack of willingness in stopping taking it The Psychiatric Nursing Assignment Paper.

Medical History:

 

  • Current Medications: Currently, she is taking medications to help in managing hypothyroidism. She is also taking birth control pills for polycystic ovaries and medications to manage depression. However, she does not recall the name of the medications but she only remembers that they begin with letter “L.”
  • Allergies: The patient has no known allergies to any food or drugs.
  • Reproductive Hx: Petunia Park claims that she has a boyfriend and despite this, she loves going out and even having casual sex with her friends. She claims that the sex she has with other men is done in a safe way and does not place her at any risk.

ROS:

  • GENERAL: The client is very talkative and she is in good health.
  • HEENT: Petunia Park lacked any abnormal presentations in the throat, nose, ears, and eyes meaning that there was no concern in her health.
  • SKIN: She lacks any rashes or bruises on the skin.
  • CARDIOVASCULAR: The lungs and heart were normal.
  • RESPIRATORY: The patient did not show any signs of shortness of breath or breathlessness.
  • GASTROINTESTINAL: There were none of the abdominal concerns such as vomiting, nausea and abdominal pain.
  • GENITOURINARY: Petunia Park has no abnormal presentation or infection in the genitourinary system.
  • NEUROLOGICAL: Throughout the interview, the client was alert.
  • MUSCULOSKELETAL: The patient did not experience any joint or muscular inflammation.
  • HEMATOLOGIC: The patient did not have any anemia or blood abnormalities.
  • LYMPHATICS: The lymph nodes were not inflamed.
  • ENDOCRINOLOGIC: The patient did not have any endocrinology conditions. Even if it was clear that the patient took medications for hypothyroidism The Psychiatric Nursing Assignment Paper.

Objective:

Diagnostic results:  The patient did not go through any laboratory tests but he was treated based on the DSM-5 diagnostic criteria.

Primary Diagnosis: The patient suffers from bipolar II disorder and its ICD 10-CM code is F31.81. The DSM 5 criteria shows that a  patient ha smajor depressive disorder which is succeeded by a  hypomania episode. The mood oscillates between the two different oresnetations. The patients gets the aggressive tendencies of getting easily attracted and an increase focus towards euphora, the gaols and thoughts which can be considered to be unusually rushed. In such case, the patient had most symptoms even if she was told that she had depression previously.

Differential Diagnoses:

Depression: This is a condition that affects an individual by having an episode of persistent low moods, which is accompanied by feelings of guilt and worthlessness. The condition is under the code ICD 10 and F33.0 (Park & Zarate, 2019). The patient can present suicidal ideations while others may not try attempting suicide. The condition can be seen from the DSM-5 category and an individual loses interest in the life activities that they were previously used to. In this case, the client has several presentations of low mood and there were times when she was overly active and full of energy (Park & Zarate, 2019)The Psychiatric Nursing Assignment Paper. It would also be ruled out that it never meets the DSM 5 criteria since the client never lost interest in social activities, and had no suicidal ideations but he only felt as if he has no mood to do anything.

Hypothyroidism:  The patient undergoes unspecified presentation related to the condition in E03.9 in ICD 10. Its clinical features include psychological symptoms like depression, thought processes, slow movement, weight gain and tiredness (Chovato et al., 2019).  The patient also experienced a decreased attention span, hypersomnia, lethargy, sleep apnea, and instability with the psychotic symptoms. There are no right symptom presentations that is the patient’s primary diagnosis (Chiovato et al., 2019).  The patients lack intolerance to cold that was detected and the patients have alternating energy points and mood as a possible alternative for the diagnosis. For example, the patient does not show hypersomnia patients but it is indicated that she goes for long days without sleep.
Schizophrenia: The patients undergo an unspecified presentation and Schizophrenia is ICD 10 code in F20.9.  The clients suffering from this condition have clinical symptoms like gross disorganization, disorganized speech, delusions, hallucinations and even catatonic behavior. The patients also experience an altered view of the world and how things should be done (McCutcheon et al., 2020)The Psychiatric Nursing Assignment Paper. The client also shows auditory hallucinations and initially, the symptoms are most frequent for the patient to undergo a diagnosis and there are no symptoms she presents with that show there is an alternative diagnosis.

Assessment:

Mental Status Examination: Petunia Park was well oriented in terms of the place, time, and people in the onset of the interview. The patient was correctly dressed and responded to the questions well. She also asked questions to the healthcare provider and his speech was coherent with the audible volume, and tone even if some questions irritated her. She was charmed and seemed to be lively when giving a response to the questions asked. Her memory was intact even if she pointed out an auditory hallucination before.

Diagnostic Impression:  Petunia Park has bipolar II disorder with an ICD 10-C, code in 31.81.   Based on the DSM 5 criteria, the patient would present one major depressive episode which is succeeded by a hypomania episode making the mood to oscillate between the two different presentations.  The patients would also get distracted easily, experience aggressive tendencies, euphoria, increased focus on her goals and have a thinking that is often rushed. From the case interview, Petunia Park has most symptoms of depression as she had in the previous hospital visit The Psychiatric Nursing Assignment Paper.

Reflections: Before, the client was diagnosed with depression and he was given medications which never made any impact on him. The previous diagnosis was not comprehensive to cover any fluctuations in her mood and the suboptimal results she had. Everything could be done differently and I would examine the patient to determine the causes of the other presentations she was experiencing instead of volunteering. The current diagnosis is accurate and it would increase the possibility of helping Petunia Park to manage her condition well.

ORDER TODAY

Case Formulation and Treatment Plan:  It would have been necessary for the healthcare professional to give Petunia Park Lithium. Lithium is an effective mood stabilizer given to bipolar patients. It would be crucial to enroll the patients on counseling to facilitate behavioral change, which would assist her in correctly managing the condition. Improving her health would be vital in urging the patients to avoid substance use as the prolonged use that would open room for another. It would be right to educate her on the importance of complying to treatment and improving on the presentation The Psychiatric Nursing Assignment Paper.

References

Chiovato, L., Magri, F., & Carlé, A. (2019). Hypothyroidism in context: where we’ve been and where we’re going. Advances in therapy, 36(2), 47-58.

McCutcheon, R. A., Marques, T. R., & Howes, O. D. (2020). Schizophrenia—an overview. JAMA psychiatry, 77(2), 201-210.

Park, L. T., & Zarate Jr, C. A. (2019). Depression in the primary care setting. New England Journal of Medicine, 380(6), 559-568 The Psychiatric Nursing Assignment Paper