NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example
Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD
NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Assignment Brief
Assignment Instructions Overview:
This assignment focuses on developing the skills necessary for assessing and diagnosing anxiety disorders, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). Students are required to conduct a thorough psychiatric evaluation using a comprehensive approach. The evaluation should include both subjective and objective data, along with critical-thinking steps that guide diagnostic decision-making based on DSM-5 criteria.
The goal is to apply clinical knowledge and diagnostic tools to assess the severity, duration, and impact of symptoms, as well as differentiate between possible diagnoses.
For top-quality coursework writing help and assignment writing services, trust Reliable Papers. Our expert team delivers 100% original human-written work tailored to your needs. Contact us via phone, WhatsApp, or live chat for assistance today and get the most reliable research paper help!
Understanding Assignment Objectives:
The main objectives of this assignment are to:
- Evaluate patients presenting with symptoms of anxiety, PTSD, and OCD.
- Use DSM-5 criteria to guide diagnostic decisions.
- Develop a differential diagnosis process by comparing symptoms and identifying the most accurate primary diagnosis.
- Apply ethical considerations and health promotion strategies during patient evaluation.
- Through this assignment, students will gain experience in recognizing various anxiety-related disorders and trauma-related conditions while practicing the art of patient-centered care.
The Student’s Role:
Students are expected to assume the role of a healthcare provider conducting a psychiatric assessment. This involves gathering a comprehensive history, performing mental status examinations, and documenting observations. Students will need to consider the patient’s background, experiences, and presenting symptoms when determining a differential diagnosis and developing an appropriate care plan.
The role also includes reflecting on the patient interaction, considering alternative approaches, and addressing any legal, ethical, or cultural factors that could influence diagnosis and treatment.
Competencies Measured:
This assignment will assess the following competencies:
- Clinical Evaluation: Ability to gather detailed subjective and objective data from patient history and psychiatric assessments.
- Diagnostic Reasoning: Application of DSM-5 criteria to identify and rule out potential mental health disorders.
- Critical Thinking: Development of a structured thought process in diagnosing anxiety disorders, PTSD, and OCD, supported by evidence-based practice.
- Ethical Considerations: Understanding of the legal and ethical dimensions of mental health treatment, including consent, confidentiality, and culturally competent care.
- Health Promotion: Integration of health promotion strategies into patient care, considering factors like age, ethnicity, and socioeconomic status that may impact diagnosis and treatment planning.
You can also read other assignment examples for the NRNP 6635 – Psychopathology and Diagnostic Reasoning Course below:
NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Paper Example
NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Example
NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Example
NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example
NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example
NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example
Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD
Subjective:
Chief Complaint (CC):
The patient reports that he “cannot handle negative situations.”
History of Present Illness (HPI):
Sergeant Berry Sullivan, a 27-year-old male, has presented for a mental health evaluation following an eight-year service in the military, during which he completed three extended tours in various war zones. He describes a challenging transition to civilian life after his military discharge, which occurred less than a year ago. During his service, Mr. Sullivan was exposed to multiple traumatic events, though he has refrained from providing detailed descriptions of these incidents. He reports that his symptoms, including an inability to cope with negative situations, have progressively worsened since leaving active duty. He denies experiencing flashbacks or nightmares, but notes feelings of irritability and hypervigilance. Additionally, he discloses a troubled childhood marked by an abusive, alcoholic father. Despite these stressors, he has never engaged in substance use due to his father’s alcoholism. Mr. Sullivan denies any prior history of psychiatric disorders, stating that he has never experienced anxiety, PTSD, or major depressive disorder (MDD) symptoms before his recent struggles.
Past Psychiatric History:
General Statement:
The patient was raised in a low-income family with an abusive, alcoholic father. After high school, he joined the military, where he served for eight years, experiencing combat in multiple war zones. He has no documented psychiatric history, but mentions that his paternal grandfather also served in the military and suffered from depression.
Hospitalizations:
No history of psychiatric hospitalizations or mental health treatment.
Medication Trials:
Mr. Sullivan has not undergone any medication trials for mental health conditions.
Psychotherapy or Previous Psychiatric Diagnosis:
The patient denies having previously received any form of psychotherapy or psychiatric diagnosis.
Substance Use History:
Mr. Sullivan has abstained from alcohol and illicit drugs throughout his life due to his father’s severe alcoholism.
Family Psychiatric/Substance Use History:
Paternal History:
The patient’s father is an alcoholic and exhibited abusive behavior during his childhood. His paternal grandfather, also a military veteran, reportedly suffered from depression but never sought professional help.
Psychosocial History:
Mr. Sullivan was raised in a low-income household, and his upbringing was deeply affected by his father’s alcoholism and abuse. His mother remains in good health, but his father suffers from diabetes, liver cirrhosis, and hypertension (HTN). Mr. Sullivan has two siblings, an older sister and a younger brother. He lives with his fiancée and expresses a desire to have children in the future. He is currently unemployed and finding it difficult to adjust to civilian life, contributing to his increased stress and anxiety.
Medical History:
Current Medications:
Mr. Sullivan takes medication for asthma, a condition exacerbated by seasonal allergies, which he attributes to his time in the military.
Allergies:
The patient denies any known allergies.
Reproductive History (Hx):
Mr. Sullivan is not currently a parent, but he and his fiancée hope to have children.
Review of Systems (ROS):
General:
The patient is alert and oriented, with an appropriate appearance and demeanor for the interview. He does not appear to be in any acute distress.
HEENT (Head, Eyes, Ears, Nose, Throat):
No reports of trauma or injury.
Skin:
No rashes or skin irritations.
Cardiovascular:
Denies chest pain or discomfort, no evidence of edema in extremities.
Respiratory:
Reports shortness of breath and occasional difficulty breathing, which he attributes to his asthma and military-related allergies.
Gastrointestinal:
The patient has experienced occasional nausea and vomiting.
Genitourinary:
Denies any genitourinary symptoms, including abnormal urination.
Neurological:
No reported neurological symptoms such as numbness or tingling.
Musculoskeletal:
Denies joint or muscle pain, and no visible signs of swelling or discomfort.
Hematologic:
No history of unusual bruising, bleeding, or blood disorders.
Lymphatic:
Denies enlarged lymph nodes.
Endocrinologic:
No symptoms of polyuria, polydipsia, or polyphagia.
Objective:
Physical Examination:
Temperature (T): 98.8°F
Pulse (P): 86 beats per minute
Respiratory Rate (R): 18 breaths per minute
Blood Pressure (BP): 122/78 mmHg
Height (Ht): 5’8”
Weight (Wt): 160 lbs
Diagnostic Results:
A comprehensive psychiatric assessment is recommended, including standardized tools for evaluating depression, anxiety, and PTSD. Blood work should also be conducted to assess thyroid function (thyroid-stimulating hormone) and rule out any underlying medical conditions that could contribute to psychiatric symptoms.
Assessment:
Mental Status Examination (MSE):
Appearance: The patient appeared well-groomed, with appropriate hygiene for the situation.
Eye Contact: Eye contact was fair throughout the interview.
Speech: Speech was clear and normal in tone, rhythm, and volume.
Behavior: Cooperative and calm demeanor.
Psychomotor Activity: No evidence of involuntary movements.
Mood: Reported feeling “depressed.”
Thought Process: Thought processes were logical, goal-directed, and organized.
Thought Content: No delusions or evidence of psychosis. Denied suicidal ideation.
Perception: No hallucinations were reported or observed.
Cognition: The patient was alert and oriented to person, place, time, and situation.
Memory: Both short-term and long-term memory appeared intact based on the patient’s recollection of events.
Insight: Insight into his condition appeared fair.
Judgment: Judgment was assessed as fair.
Differential Diagnoses:
Post-Traumatic Stress Disorder (PTSD):
Mr. Sullivan exhibits several hallmark symptoms of PTSD, including hypervigilance, irritability, and difficulty adjusting to civilian life following traumatic combat experiences. His military history suggests prolonged exposure to traumatic events, making PTSD a highly likely diagnosis. PTSD is defined by the DSM-5 as occurring after exposure to actual or threatened death, serious injury, or sexual violence, either directly or indirectly. Symptoms may include intrusive memories, avoidance behaviors, negative mood changes, and hyperarousal.
Generalized Anxiety Disorder (GAD):
Anxiety disorders are common among veterans, especially those transitioning back into civilian life. Mr. Sullivan has reported difficulty coping with negative situations and has shown signs of persistent worry, which could indicate generalized anxiety disorder. According to the DSM-5, GAD is characterized by excessive worry about various events or activities for at least six months, along with symptoms such as restlessness, fatigue, difficulty concentrating, irritability, and muscle tension.
Major Depressive Disorder (MDD):
Mr. Sullivan’s report of a depressed mood, feelings of hopelessness, and loss of interest in activities could suggest a diagnosis of MDD. According to the DSM-5, MDD is characterized by a two-week period of pervasive low mood and anhedonia, with associated symptoms like changes in appetite, sleep disturbances, fatigue, and difficulty concentrating.
Reflection:
In reflecting on this case, I would ensure a more thorough exploration of Mr. Sullivan’s emotional responses to his traumatic experiences, particularly focusing on any potential avoidance behaviors or emotional numbing. Additionally, I would ask more specific questions about his daily functioning and relationships, which could provide further insight into the severity of his PTSD symptoms. Legal and ethical considerations include the importance of addressing the stigma associated with mental health in military populations and ensuring that the patient feels supported in seeking treatment. Culturally sensitive care is also essential, considering the patient’s background and military service.
References
Bryant, R. A. (2019). Post‐traumatic stress disorder: A state‐of‐the‐art review of evidence and challenges. World Psychiatry, 18(3), 259-269.
Chin, D. L., & Zeber, J. E. (2020). Mental health outcomes among military service members after severe injury in combat and TBI. Military Medicine, 185(5-6), e711-e718.
Koyuncu, A., İnce, E., Ertekin, E., & Tükel, R. (2019). Comorbidity in social anxiety disorder: Diagnostic and therapeutic challenges. Drugs in Context, 8.
Smith, G. P., & Hartelius, G. (2020). Resolution of dissociated ego states relieves flashback-related symptoms in combat-related PTSD: A brief mindfulness-based intervention. Military Psychology, 32(2), 135-148.
Waitzkin, H., Cruz, M., Shuey, B., Smithers, D., Muncy, L., & Noble, M. (2018). Military personnel who seek health and mental health services outside the military. Military Medicine, 183(5-6), e192-e200.
Detailed Assessment Instructions for the NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Assignment
Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD
Description
Fear,” according to the DSM-5, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease.
Photo Credit: Hill Street Studios / Blend Images / Getty Images
For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5 criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5 criteria.
To Prepare:
- Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing anxiety, obsessive-compulsive, and trauma- and stressor-related disorders.
- 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.
By Day 7 of Week 4
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 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.
- 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.).
<iframe src=”https://ezp.waldenulibrary.org/login?qurl=https://video.alexanderstreet.com/embed/training-title-21?account_id=14872&usage_group_id=95102″ width=”640″ height=”390″ frameborder=”0″ allow=”encrypted-media” allowfullscreen></iframe>
Get The Best Nursing Paper Writing Service and Unlock Your Academic Success
Are you overwhelmed with complex nursing assignments, tight deadlines, or specific instructions that seem challenging to meet? Look no further – ReliablePapers.com is your go-to destination for all your nursing paper writing needs! Our expert nursing essay writers are dedicated to providing you with high-quality, original, and customized nursing papers that guarantee the best grades possible.
Why choose ReliablePapers.com?
- Professional Nursing Writers: Our team of professional writers specializes in nursing essay papers, ensuring your assignment is in the hands of experts who understand the writing of nursing topics.
- Affordable Prices: We understand the financial constraints of college students. Our online nursing papers are available at very cheap prices, making our services accessible to all. Whether you need assistance with nursing coursework writing, want to buy a nursing essay online, or are in search of reliable nursing assignment help, we’ve got you covered.
- Customized Nursing Paper Solutions: Whether you need assistance with a complex topic, have a tight deadline, or are seeking a guide on how to write your nursing assignment, we’ve got you covered. Our writers will tailor their approach to meet your specific needs.
- Originality Guaranteed: Say goodbye to plagiarized papers! Our writers will provide you with an outstanding nursing essay paper written from scratch, ensuring it adheres to any topic, deadline, and instructions you provide.
Save your time for what matters most and let ReliablePapers.com take care of your essay. Don’t settle for subpar papers or risk submitting plagiarized content. Choose the best nursing paper writing service today!
Unlock your academic success by trusting ReliablePapers.com – Your Partner in Excellence.
Hire an Expert Paper Writer on Any Subject, Any Topic, Any Deadline! Submit your paper instructions by placing your order here to get started!
