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NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Assignment

NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Assignment Brief

Assignment Instructions Overview:

In this assignment, students are required to assess and diagnose patients with mood disorders, focusing on accurate diagnostic methods and critical thinking. The assignment highlights the complexities of diagnosing depressive and bipolar disorders, considering that these conditions often present with periodic and cyclic symptomology. Diagnosis may also be influenced by external stressors and cultural backgrounds, potentially impacting the client’s treatment-seeking behavior.

Students are expected to utilize the Comprehensive Psychiatric Evaluation Template to conduct a thorough evaluation, incorporating subjective and objective data, differential diagnoses, and a reflective analysis of the patient’s case.

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Understanding Assignment Objectives:

The primary objective of this assignment is to develop a detailed understanding of mood disorders through practical assessment and diagnosis. Students will evaluate patients via case studies, identifying patterns and symptoms of mood disorders such as major depressive disorder (MDD) and bipolar disorder. This task also aims to enhance students’ ability to apply diagnostic criteria from the DSM-5-TR and to navigate the complexities of mental health treatment with cultural sensitivity and ethical awareness.

The Student’s Role:

Students are responsible for:

• Selecting and reviewing a video case study.
• Gathering and analyzing a patient’s subjective and objective history.
• Conducting a comprehensive psychiatric evaluation.
• Formulating at least three differential diagnoses using the DSM-5-TR.
• Explaining the reasoning behind the primary diagnosis.
• Reflecting on the diagnostic process and identifying areas for improvement.

The assignment also requires students to demonstrate clinical judgment, legal/ethical considerations, and awareness of health promotion strategies tailored to individual patients’ socioeconomic, cultural, and medical backgrounds.

Competencies Measured:

• Clinical Reasoning & Critical Thinking: Ability to apply psychiatric assessment skills to real-world case studies and generate differential diagnoses.
• Diagnostic Proficiency: Knowledge of DSM-5-TR criteria and its application in assessing mood disorders.
• Cultural Competence & Ethical Awareness: Sensitivity to cultural factors influencing mood disorders and adherence to ethical standards in psychiatric practice.
• Patient-Centered Care: Designing treatment plans that address mental health issues while considering broader aspects of patient health and well-being, including prevention strategies.

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 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

Comprehensive Psychiatric Evaluation

Patient Information:

• Name: A.M.
• Age: 34
• Gender: Male
• Race: African-American
• Marital Status: Divorced

Chief Complaint (CC):

“I feel like I’m always in a bad mood, and it’s hard for me to concentrate or enjoy anything. It’s been like this for months.”

History of Present Illness (HPI):

A.M. is a 34-year-old African-American male who presents with complaints of persistent low mood, lack of interest in daily activities, and difficulty concentrating. These symptoms began approximately eight months ago, following his divorce, and have progressively worsened. He reports feeling “exhausted all the time” despite sleeping excessively, yet he continues to wake up feeling fatigued. He mentions that his appetite has decreased, resulting in an unintentional weight loss of about 10 pounds over the past three months. His mood is often irritable, and he finds himself getting easily frustrated with family members and coworkers.

A.M. denies any suicidal ideation or previous suicide attempts but admits to occasional fleeting thoughts of death. He reports that these thoughts are not persistent or distressing enough to act upon. His symptoms have negatively impacted his performance at work, leading to several warnings from his supervisor about his reduced productivity and absenteeism.

He reports no previous history of mood disorders and has never sought psychiatric treatment before. He occasionally uses alcohol to “calm down,” drinking approximately 4–5 drinks per night for the past six months, which began after his divorce.

Past Psychiatric History:

• Previous Diagnosis: None reported.
• Previous Hospitalizations: None.
• Previous Treatments: None.
• Previous Medications: None.

Substance Use History:

• Alcohol: Drinks 4–5 alcoholic beverages per night, daily for the past six months. Denies drinking in the mornings or at work. He has not experienced withdrawal symptoms, but he acknowledges that he drinks to cope with stress and sadness.
• Drugs: Denies the use of illicit drugs or recreational drugs.
• Tobacco: Non-smoker.
• Caffeine: Drinks two cups of coffee daily.

Family Psychiatric/Substance Use History:

• Mother: Diagnosed with Major Depressive Disorder at age 45. Currently on medication.
• Father: No history of psychiatric illness.
• Siblings: Younger brother diagnosed with Generalized Anxiety Disorder.
• Substance Use: No history of substance use disorders in the immediate family.

Social History:

A.M. was born and raised in a middle-class African-American family. He is the eldest of three siblings and maintains a good relationship with them, although he is currently estranged from his ex-wife. He has a 7-year-old daughter from his marriage and shares custody with his ex-wife. A.M. completed college and has been working as a sales manager at a tech company for the past five years.

His divorce, finalized eight months ago, was contentious, and he describes the relationship as “emotionally draining.” He currently lives alone in an apartment and has limited social interactions outside of work and co-parenting responsibilities. He reports that he stopped engaging in his hobbies, such as playing basketball and attending social events, around the same time his symptoms began.

A.M. has no legal issues or history of trauma. He denies any history of physical or emotional abuse.

Medical History:

• Current Medical Conditions: Mild hypertension, managed with a low-sodium diet. No medications.
• Past Medical Conditions: None significant.
• Surgical History: None.
• Chronic Illnesses: None.
• Allergies: No known drug allergies.

Review of Systems (ROS):

• General: Reports feeling fatigued and weak. Unintentional weight loss of 10 pounds in the last three months.
• Cardiovascular: No chest pain, palpitations, or shortness of breath.
• Respiratory: No cough or difficulty breathing.
• Gastrointestinal: Reduced appetite; no nausea or vomiting.
• Neurological: No headaches, dizziness, or seizures.
• Musculoskeletal: No joint or muscle pain.
• Endocrine: No changes in temperature tolerance, no excessive thirst or urination.
• Psychiatric: Persistent low mood, loss of interest in previously enjoyable activities, feelings of worthlessness, irritability, concentration difficulties, occasional thoughts of death.

Mental Status Examination (MSE):

• General Appearance: A.M. is a well-groomed, appropriately dressed male who appears his stated age. He has good hygiene and maintains eye contact throughout the interview.
• Behavior: Cooperative but reserved during the interview. Fidgeted with his hands.
• Mood: Reports feeling “down” and “numb.”
• Affect: Blunted, restricted range of emotional expression.
• Speech: Normal rate and tone, though answers are brief and monotone.
• Thought Process: Linear but slowed; no evidence of flight of ideas or loose associations.
• Thought Content: No delusions, hallucinations, or paranoia. Denies current suicidal ideation but acknowledges occasional passive thoughts of death without intent or plan.
• Cognition: Alert and oriented to person, place, and time. Mild difficulty with concentration and focus during the interview.
• Insight: Fair; acknowledges that his mood is affecting his work and personal life but feels unsure about treatment options.
• Judgment: Intact; able to make reasonable decisions regarding his care.

Diagnostic Results:

No lab results were available at the time of the psychiatric evaluation. However, routine labs, including thyroid function tests (TFTs) and a complete blood count (CBC), were ordered to rule out any medical conditions contributing to his depressive symptoms.

Assessment:

Differential Diagnoses:

Major Depressive Disorder (MDD):

• Supporting Evidence: A.M. presents with a depressed mood, loss of interest or pleasure in activities (anhedonia), fatigue, sleep disturbances (hypersomnia), weight loss, and concentration difficulties. These symptoms have persisted for more than two weeks, meeting the DSM-5-TR criteria for MDD.
• DSM-5 Criteria Met: Depressed mood most of the day, nearly every day; markedly diminished interest in activities; significant weight loss without dieting; insomnia or hypersomnia; fatigue or loss of energy; diminished ability to think or concentrate; feelings of worthlessness.
• Ruled Out Factors: No manic or hypomanic episodes present, ruling out bipolar disorders.

Adjustment Disorder with Depressed Mood:

• Supporting Evidence: A.M. experienced a significant life stressor (divorce), which may have triggered his symptoms. However, the severity and duration of his symptoms extend beyond what is typically seen in adjustment disorder, and he meets more criteria for MDD.
• DSM-5 Criteria Met: Emotional or behavioral symptoms in response to an identifiable stressor. However, A.M.’s symptoms are more severe and persistent than what is typically seen in Adjustment Disorder.

Alcohol Use Disorder:

• Supporting Evidence: A.M. reports using alcohol daily to cope with stress, and this behavior has persisted for six months. However, he does not meet the full criteria for Alcohol Use Disorder at this time as his alcohol use has not resulted in significant impairment or distress. It is important to monitor his alcohol consumption as it may exacerbate his depressive symptoms.
• DSM-5 Criteria Not Met: He does not exhibit loss of control over drinking or significant negative consequences directly attributed to alcohol use.

Plan:

Pharmacological:

• Initiate fluoxetine (Prozac) 20 mg PO daily, given its favorable side effect profile and effectiveness in treating MDD.
• Educate the patient on the potential side effects of fluoxetine, including gastrointestinal disturbances, headaches, and sexual side effects.

Therapy:

• Refer to Cognitive Behavioral Therapy (CBT) to address negative thought patterns and promote healthy coping strategies.

Substance Use Monitoring:

• Encourage a reduction in alcohol consumption, as it may worsen depressive symptoms. A referral to substance use counseling or Alcoholics Anonymous should be offered if drinking escalates.

Follow-Up:

• Schedule follow-up in two weeks to assess medication efficacy and monitor for side effects.
• Obtain lab results to rule out any medical causes of depression.

Reflection:

In hindsight, I would have explored A.M.’s family history in more detail, particularly his relationship with his mother, who has a history of Major Depressive Disorder. This could provide insight into how family dynamics may influence his view on seeking mental health treatment. From an ethical perspective, discussing A.M.’s alcohol use in a non-judgmental manner was important, as there is a potential for substance use to worsen his mental health if left unaddressed. A culturally sensitive approach to discussing his alcohol use should be maintained, given the stigma that may be present in his community. Additionally, I would focus more on A.M.’s role as a father and how his mental health may affect his relationship with his daughter, aiming to incorporate this into health promotion and disease prevention discussions.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Beck, A. T., & Alford, B. A. (2020). Depression: Causes and treatment. University of Pennsylvania Press.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th ed.). Cambridge University Press.

Detailed Assessment Instructions for the NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Assignment

NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders

Assignment: Assessing and Diagnosing Patients With Mood Disorders

Accurately diagnosing depressive disorders can be challenging given their periodic and, at times, cyclic nature. Some of these disorders occur in response to stressors and, depending on the cultural history of the client, may affect their decision to seek treatment. Bipolar disorders can also be difficult to properly diagnose. While clients with a bipolar or related disorder will likely have to contend with the disorder indefinitely, many find that the use of medication and evidence-based treatments have favorable outcomes.

To Prepare:

• Review this week’s Learning Resources. Consider the insights they provide about assessing and diagnosing mood 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 3

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a 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 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.).

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. 

references x 3 to include

 American Psychiatric Association. (2022). Bipolar and related disorders. In Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url= https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.x03_Bipolar_and_Related_Disorders

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Draft

Video Case selections for the Assignment

https://video.alexanderstreet.com/p/XQ51BX9oA

https://video.alexanderstreet.com/p/LZP6O7Yw4

https://video.alexanderstreet.com/p/Og8VpmVGN

https://video.alexanderstreet.com/p/ywmrYzzQn

Required Media

https://video.alexanderstreet.com/p/Z8WOvJyZ6

https://video.alexanderstreet.com/p/nRO2pKBpY

https://video.alexanderstreet.com/p/GR9vAWjML

https://video.alexanderstreet.com/p/nROLX6Ppp

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.
• Click the Week 3 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

 NRNP_6635_Week3_Assignment_Rubric

• Grid View
• List View

		Excellent	Good	Fair	Poor
Create 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		18 (18%) – 20 (20%) 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.	16 (16%) – 17 (17%) 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.	14 (14%) – 15 (15%) 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.	0 (0%) – 13 (13%) 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.
In 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.		18 (18%) – 20 (20%) The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.	16 (16%) – 17 (17%) The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are accurately documented.	14 (14%) – 15 (15%) 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.	0 (0%) – 13 (13%) The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or, objective documentation is missing.
In 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.		23 (23%) – 25 (25%) 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.	20 (20%) – 22 (22%) 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.	18 (18%) – 19 (19%) The response documents the results of the mental status exam with some vagueness or inaccuracy. 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 vagueness or inaccuracy.	0 (0%) – 17 (17%) 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.
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 taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).		9 (9%) – 10 (10%) Reflections are thorough, thoughtful, and demonstrate critical thinking.	8 (8%) – 8 (8%) Reflections demonstrate critical thinking.	7 (7%) – 7 (7%) Reflections are somewhat general or do not demonstrate critical thinking.	0 (0%) – 6 (6%) Reflections are incomplete, inaccurate, or missing.
Provide 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).		14 (14%) – 15 (15%) 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.	12 (12%) – 13 (13%) 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. NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders	11 (11%) – 11 (11%) 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.	0 (0%) – 10 (10%) Two or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence based.
Written 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 (5%) – 5 (5%) 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 (4%) – 4 (4%) 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 (3.5%) – 3.5 (3.5%) 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.	0 (0%) – 3 (3%) 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.
Written Expression and Formatting—English writing standards: Correct grammar, mechanics, and punctuation		5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors	4 (4%) – 4 (4%) Contains a few (one or two) grammar, spelling, and punctuation errors	3 (3%) – 3 (3%) Contains several (three or four) grammar, spelling, and punctuation errors	0 (0%) – 2 (2%) Contains many (≥ five) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Total Points: 100

Name: NRNP_6635_Week3_Assignment_Rubric

  

Week (enter week #): (Enter assignment title)

 

Student Name

College of Nursing-PMHNP, Walden University

NRNP 6635: Psychopathology and Diagnostic Reasoning

Faculty Name

Assignment Due Date

 

Subjective:

CC (chief complaint):

HPI:

Past Psychiatric History:

• General Statement:
• Caregivers (if applicable):
• Hospitalizations:
• Medication trials:
• Psychotherapy or Previous Psychiatric Diagnosis:

Substance Current Use and History:

Family Psychiatric/Substance Use History:

Psychosocial History:

NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders

Medical History:

 

• Current Medications:
• Allergies:

• Reproductive Hx:

ROS:

• GENERAL:
• HEENT:
• SKIN:
• CARDIOVASCULAR:
• RESPIRATORY:
• GASTROINTESTINAL:
• GENITOURINARY:
• NEUROLOGICAL:
• MUSCULOSKELETAL:
• HEMATOLOGIC:
• LYMPHATICS:
• ENDOCRINOLOGIC:

Objective:

Physical exam: if applicable

Diagnostic results:

Assessment:

Mental Status Examination:

Differential Diagnoses:

Reflections:

References

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NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Example

NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Assignment

NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Assignment Brief

Overview of Assignment Instructions

This assignment is designed to promote self-reflection on clinical skills, focusing on areas of strength and opportunities for improvement. It encourages students to assess their current knowledge and clinical competencies in relation to advanced practice nursing. The assignment also serves as a tool for students to set measurable goals for professional development during their practicum experiences.

Understanding Assignment Objectives

The primary objective of this self-assessment is to evaluate the student’s level of confidence and proficiency in performing key clinical skills required for advanced nursing practice. By identifying strengths and areas for improvement, students can formulate specific goals to enhance their clinical capabilities. This process is important for aligning personal development with the requirements of the practicum and the broader nursing profession. Additionally, the assignment helps students become more self-aware and deliberate in their approach to professional growth.

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The Student’s Role

Students are expected to critically assess their current skill set using the PMHNP Clinical Skills Self-Assessment Form. This involves evaluating their confidence in performing various clinical procedures and diagnosing psychiatric conditions. After rating themselves, students must summarize their key strengths and highlight areas where improvement is needed. Based on this analysis, students will develop three to four measurable goals for their practicum. These goals should reflect their aspirations for developing specific clinical skills, such as diagnostic reasoning, patient assessment, and therapeutic planning.

Competencies Measured

This assignment measures several competencies critical to advanced practice nursing. These include:

• Clinical assessment and diagnostic reasoning: Students will assess their ability to perform comprehensive evaluations, develop differential diagnoses, and utilize clinical reasoning in decision-making.
• Patient care planning: Competence in developing personalized care plans and delivering evidence-based treatments is evaluated. This encompasses the selection of appropriate interventions and the ability to monitor patient outcomes.
• Professional development: Students are also evaluated on their ability to set realistic, measurable goals for continuous improvement, demonstrating a commitment to lifelong learning in their nursing practice.

NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Example

Introduction

Advanced practice nurses, including Psychiatric-Mental Health Nurse Practitioners (PMHNPs), require a strong foundation of clinical skills to provide quality care. Clinical training allows PMHNPs to develop essential skills in patient assessment, diagnosis, and treatment of mental health conditions. Regular self-assessment helps identify strengths and areas needing improvement, enhancing clinical proficiency. Developing goals based on these self-assessments aligns with improving professional practice (Kleinpell et al., 2018). This self-assessment focuses on evaluating current competencies, identifying growth opportunities, and establishing objectives for further development during the practicum experience.

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 2: Practicum Experience Plan (PEP) Paper Example

NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

Clinical Skills Self-Assessment

The PMHNP Clinical Skills Self-Assessment form evaluates competency in various areas of psychiatric practice, ranging from comprehensive psychiatric evaluations to psychotherapeutic treatment planning.

• Comprehensive Psychiatric Evaluation Skills I rate myself as confident in recognizing the clinical signs and symptoms of psychiatric illness, which is fundamental for making accurate diagnoses. However, I am mostly confident in differentiating between pathophysiological and psychopathological conditions, indicating a need for further knowledge and practice in this area. Performing and interpreting mental status examinations is a skill where I am still developing, needing supervision for confidence, while psychosocial assessments and family psychiatric histories are areas where I am more experienced.
• Diagnostic Reasoning My current ability to develop and prioritize differential diagnoses is at a beginning level. This reflects a need for more focused practice in applying the DSM-5 criteria and formulating diagnoses based on comprehensive assessments. Understanding the nuances between normal and abnormal psychological changes in different age groups is another area where improvement is necessary (Price & Reichert, 2017).
• Psychotherapeutic Treatment Planning Psychotherapeutic planning is essential in patient care, and I currently need to further enhance my skills in providing psychoeducation and promoting disease prevention techniques to clients and their caregivers. Although I am confident in some aspects, more practice is needed in selecting and implementing appropriate treatment strategies based on individualized patient assessments.

Summary of Strengths

One of my main strengths is my ability to deliver patient-centered care, enabling effective communication and empathetic interactions with patients from diverse backgrounds. This skill allows me to gather comprehensive patient histories and perform thorough assessments. I also have strong professional skills, maintaining boundaries, fostering therapeutic relationships, and collaborating effectively with multidisciplinary teams. My ability to document clinical findings accurately has proven valuable in creating detailed patient records and forming clinical judgments, particularly when diagnostic tests are unavailable (Chambers & Ryder, 2018).

Opportunities for Improvement

One key area for improvement is mastering the diagnostic reasoning process, particularly the development of differential diagnoses and the interpretation of mental status examinations. Increasing proficiency in these areas is crucial for accurate and efficient patient evaluation. Another area of growth is conducting comprehensive assessments in complex cases involving hostile or cognitively impaired patients. Further training and exposure to such challenging scenarios will enhance my confidence and skill set (Phillips, 2020).

Goals and Objectives for Practicum

Based on this self-assessment, I have set the following goals for my practicum experience:

• Goal 1: Improve diagnostic reasoning skills
  • Objective 1: Recognize and interpret clinical signs of various psychiatric disorders.
  • Objective 2: Develop and prioritize differential diagnoses using DSM-5 criteria.
  • Objective 3: Apply knowledge of psychopathology to evaluate patients accurately.
• Goal 2: Enhance mental status examination competency
  • Objective 1: Perform and interpret mental status exams independently.
  • Objective 2: Differentiate between normal and abnormal psychological symptoms across different age groups.
  • Objective 3: Use evidence-based assessment techniques to inform treatment plans.
• Goal 3: Develop psychotherapeutic treatment planning skills
  • Objective 1: Provide tailored psychoeducation to patients and caregivers.
  • Objective 2: Apply health promotion strategies and preventive techniques effectively.
  • Objective 3: Select and implement appropriate psychotherapeutic interventions based on patient assessments.

Conclusion

The clinical self-assessment provides valuable insights into current competencies and areas for growth, which form the foundation for setting clear, achievable goals for professional development during the practicum. By focusing on diagnostic reasoning, mental status examination, and psychotherapeutic planning, I aim to advance my clinical skills and provide high-quality, evidence-based care to patients with mental health disorders.

References

Chambers, C., & Ryder, E. (2018). Compassion and caring in nursing. Routledge.

Kleinpell, R., Cook, M. L., & Padden, D. L. (2018). American Association of Nurse Practitioners National Nurse Practitioner sample survey: Update on acute care nurse practitioner practice. Journal of the American Association of Nurse Practitioners, 30(3), 140-149.

Phillips, K. (2020). Mental illness is not anyone’s fault: A review of NAMI, the National Alliance on Mental Illness. Journal of Consumer Health on the Internet, 24(1), 75-81.

Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: Meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences, 7(2), 17.

Detailed Assessment Instructions for the NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Assignment

Assignment 2: Clinical Skills Self-Assessment

Before embarking on any professional or academic activity, it is important to understand the background, knowledge, and experience you bring to it. You might ask yourself, “What do I already know? What do I need to know? And what do I want to know?” This critical self-reflection is especially important for developing clinical skills such as those for advanced practice nursing.  

The Psychiatric-Mental Health Nurse Practitioner (PMHNP) Clinical Skills List and Clinical Skills Self-Assessment Form provided in the Learning Resources can be used to celebrate your progress throughout your practicum and identify skills gaps. The list covers all necessary skills you should demonstrate during your practicum experiences.

Just as you did in PRAC 6635, for this Assignment, you assess where you are now in your clinical skill development and make plans for this practicum. Specifically, you will identify strengths and opportunities for improvement regarding the required practicum skills. In this practicum experience, when developing your goals and objectives, be sure to keep assessment and diagnostic reasoning in mind.

Instructions Assignment

1. Use the PMHNP Clinical Skills Self-Assessment Form to complete the following:

• Rate yourself according to your confidence level performing the procedures identified on the Clinical Skills Self-Assessment Form.  
• Based on your ratings, summarize your strengths and opportunities for improvement.   
• Based on your self-assessment and theory of nursing practice, develop 3–4 measurable goals and objectives for this practicum experience. Include them on the designated area of the form.  
• Use at least 3 references.

2. Please review the Self-Assessment for the previous class NRNP – 6635 (See attachment), so you don’t repeat the strengths and opportunities for improvement and the goals  

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NRNP 6550 Week 1 Medicolegal Impacts on Health Promotion Discussion Example

NRNP 6550 Week 1 Discussion Including Response; Medicolegal Impacts on Health Promotion Assignment

NRNP 6550 Week 1: Medicolegal and Health Promotion Discussion Assignment Brief

Course: NRNP 6550 – Advanced Practice Care of Adults in Acute Care Settings II

Assignment Title: NRNP 6550 Week 1; Medicolegal Impacts on Health Promotion Discussion Assignment

Assignment Instructions Overview

This assignment focuses on analyzing the medicolegal impacts on health promotion, particularly through the lens of immunization recommendations across different age groups and for immunocompromised patients. Students will compare immunization recommendations, analyze their effects on immunocompromised or immunosuppressed patients, and examine how patient factors influence immunization recommendations.

Understanding Assignment Objectives

The primary objectives are to compare immunization recommendations for patients across various age groups, analyze the impact of these recommendations on immunocompromised patients, and understand how patient factors such as age and gender influence these recommendations. This understanding is crucial for ensuring that nurse practitioners provide tailored and effective health promotion strategies.

The Student’s Role

Students are expected to review the provided learning resources on medicolegal and health promotion considerations, reflect on the impact of these recommendations on health promotion strategies, and actively participate in discussions by posting their analysis and responding to their peers’ posts. This engagement will deepen their understanding of the complexities involved in immunization recommendations and their application in diverse patient populations.

Competencies Measured

The competencies measured include the ability to analyze immunization recommendations, understand their impact on different patient populations, and apply this knowledge in clinical practice. Students will also demonstrate critical thinking skills by comparing and contrasting immunization strategies and their implications for health promotion and disease prevention.

You Can Also Check Other Related Assessments for the NRNP 6550 – Advanced Practice Care of Adults in Acute Care Settings II Course:

 

NRNP 6550 Week 1 Medicolegal Impacts on Health Promotion Discussion Example

NRNP 6550 Week 1: Medicolegal and Health Promotion

Elements Included in Identifying a Billing Code

When identifying a billing code, several critical elements must be considered to ensure accurate and appropriate billing. These elements include patient information, which entails accurate details about the patient, including demographics and medical history (American Academy of Professional Coders, 2020). Diagnosis is another vital component, involving the specific medical condition or disease diagnosed, often identified using ICD-10 codes (National Center for Health Statistics, 2020). The services provided must be detailed, with descriptions of the medical services or procedures performed, identified using CPT (Current Procedural Terminology) codes (American Academy of Professional Coders, 2020). Additionally, the date of service must be accurately recorded, indicating the exact date when the service was provided. Provider information is also essential, including details about the healthcare provider and their National Provider Identifier (NPI). Finally, the location of service, which refers to the setting in which the service was provided, such as a hospital, clinic, or outpatient facility, must be included.

Levels of Prevention

Prevention in healthcare is categorized into three levels: primary, secondary, and tertiary prevention. Primary prevention focuses on preventing the onset of diseases or injuries before they occur. This level includes activities such as immunizations, lifestyle modifications (such as a healthy diet and regular exercise), and health education programs (Barkley & Myers, 2020). Secondary prevention aims at early detection and intervention to prevent the progression of disease. Examples include screening tests such as mammograms for breast cancer, colonoscopies for colorectal cancer, and LDL cholesterol screening to detect early signs of cardiovascular disease (Barkley & Myers, 2020). Tertiary prevention involves managing and reducing the impact of an ongoing illness or injury that has lasting effects. This includes rehabilitation programs for stroke patients, chronic disease management programs for diabetes, and support groups for mental health conditions (Barkley & Myers, 2020).

Recommended Health Screenings by Age

Health screenings are essential tools for early detection and prevention of diseases. For cancers such as prostate and breast cancer, specific screenings are recommended by age. Prostate cancer screenings, such as the PSA (Prostate-Specific Antigen) test, are recommended for men starting at age 50, or earlier for those at higher risk (Barkley & Myers, 2020). Breast cancer screenings, including mammograms, are recommended every 1-2 years for women aged 50-74. Regular cholesterol screenings (LDL) are recommended for adults starting at age 20 and should be repeated every 4-6 years (Barkley & Myers, 2020). For osteoporosis, bone density testing is recommended for women aged 65 and older, and for men aged 70 and older, or younger for those at high risk (Barkley & Myers, 2020).

Vaccine Recommendations

Vaccination recommendations are crucial for preventing various infectious diseases. For pertussis (Tdap), it is recommended that one dose be administered during each pregnancy, preferably during the early part of gestational weeks 27-36 (Centers for Disease Control and Prevention [CDC], 2020). Adults who have never received Tdap should get it once, followed by Td (tetanus, diphtheria) boosters every 10 years. Tetanus booster shots are recommended every 10 years. For pneumococcal vaccines, the PCV13 is recommended for all children under 5 years, adults 65 years or older, and people with certain medical conditions (CDC, 2020). The PPSV23 is recommended for all adults 65 years or older and for people aged 2 through 64 years with certain medical conditions (CDC, 2020).

Types of Vaccines

Vaccines are classified into several types based on their composition. Live, attenuated vaccines contain a version of the living microbe that has been weakened. Examples include the MMR (measles, mumps, rubella) vaccine and the varicella (chickenpox) vaccine (CDC, 2020). Inactivated vaccines contain the killed version of the germ that causes a disease. Examples include the polio vaccine and the hepatitis A vaccine (CDC, 2020). Subunit, recombinant, polysaccharide, and conjugate vaccines use specific pieces of the germ—like its protein, sugar, or capsid. Examples include the HPV vaccine and the meningococcal vaccine (CDC, 2020).

Discussion: Medicolegal Impacts on Health Promotion

Immunization Recommendations Across the Lifespan

When examining immunization schedules, it is evident that childhood vaccines are heavily emphasized. However, vaccinations are vital in preventing diseases across all age groups. The Centers for Disease Control and Prevention (CDC) recommend annual influenza vaccinations for all age groups (CDC, 2020). For patients aged 11-24, it is recommended that the tetanus, diphtheria, and pertussis (Tdap) vaccination be administered once between the ages of 11 and 12 years, with boosters every ten years thereafter (CDC, 2020). The meningococcal 2-dose series should be administered between 11-12 years of age and again at 16 years of age, with a catch-up vaccination between 13-15 years of age and a booster at 16-18 years of age (CDC, 2020). The human papillomavirus (HPV) vaccination is recommended between 11 and 12 years of age, with catch-up vaccinations for all teens through the age of 18 if not adequately vaccinated (CDC, 2020).

For adults aged 25-64, the influenza vaccine remains a yearly recommendation. Tdap should be administered once if not previously received, followed by Td boosters every ten years (CDC, 2020). Adults with no evidence of immunity to measles, mumps, and rubella (MMR) should receive one dose of the MMR vaccine. The varicella vaccination is recommended for adults without evidence of immunity to varicella and who have not received a varicella-containing vaccine (CDC, 2020).

For older adults aged 65 and above, the influenza vaccine continues to be recommended annually. Additionally, the pneumococcal vaccination (PPSV23) is recommended for all adults aged 65 years and older, with the PCV13 and PPSV23 considered for those with chronic medical or immunocompromising conditions (CDC, 2020). The shingles vaccination should be administered to those aged 50 years or older (CDC, 2020).

Impact on Immunocompromised Patients

Immunocompromised patients, including those with conditions such as HIV, require special consideration regarding vaccination. For children and adolescents aged 11-24 years, the HPV vaccine is safe and recommended for those with HIV (CDC, 2020). The meningococcal vaccine is crucial for individuals with complement deficiencies or asplenia (CDC, 2020). In the adult population aged 25-64 years, the inactivated influenza vaccine is recommended for immunocompromised patients to avoid the risk associated with live vaccines (CDC, 2020). Pneumococcal vaccines (both PCV13 and PPSV23) are essential for preventing pneumonia in those with chronic medical conditions or immunosuppression (CDC, 2020).

For older adults aged 65 years and older, pneumococcal vaccinations (PCV13 and PPSV23) are particularly important to protect against pneumococcal diseases, which can be severe in this population (CDC, 2020). The recombinant zoster vaccine (RZV) is preferred for shingles prevention in immunocompromised patients due to its non-live formulation, which is safer compared to live vaccines (CDC, 2020).

References

American Academy of Professional Coders. (2020). What is CPT? https://www.aapc.com/resources/medical-coding/cpt.aspx

Barkley, T. W., Jr., & Myers, C. M. (2020). Practice considerations for the adult-gerontology acute care nurse practitioner (3rd ed.). Barkley & Associates.

Centers for Disease Control and Prevention (CDC). (2020). Recommended Vaccinations.

National Center for Health Statistics. (2020). International classification of diseases, tenth revision, clinical modification (ICD-10-CM). Centers for Disease Control and Prevention. http://www.cdc.gov/nchs/icd/icd10cm.htm

Detailed Assessment Instructions for the NRNP 6550 Week 1 Medicolegal Impacts on Health Promotion Discussion Assignment

NRNP 6550 Week 1- Medicological and Health Promotion

Describe what elements are included when identifying a billing code.

1. Identify and describe the three levels of prevention.  Be able to provide examples
2. Identify health screenings that are recommended by age
   1. Cancers such as prostate and breast, LDL screening, osteoporosis
3. Identify recommendations for administration of pertussis, tetanus, and pneumococcal vaccines
4. Distinguish between live, attenuated, and inactivated vaccines

Week 1: Medicolegal and Health Promotion

The story of humankind contains many impressive accomplishments. Yet, in order to turn the page on any advancement, it is often necessary to address its impact, including any ethical or legal considerations that must be addressed.

This is certainly true of health accomplishments. Medical professionals continue to learn new ways to address both existing and emerging health concerns. With each achievement comes the need to address the extent to which regulation and/or ethics impacts behavior, informs decision-making, and guides health promotion activities.

This week, you examine this impact. You analyze medicolegal impacts on health promotion by comparing differences in immunizations for differing age populations and consider the impact on immunocompromised patients. You also identify concepts related to medicolegal recommendations and health promotion initiatives.

Learning Objectives

Students will:

• Compare immunization recommendations for patients across the lifespan
• Analyze the effects of immunizations on immunocompromised or immunosuppressed patients
• Analyze the effects of patient factors on immunization recommendations

Discussion: Medicolegal Impacts on Health Promotion

Vaccination can prevent the emergence and spread of disease. It is no surprise that it is a supported public health promotion issue. Many of the diseases targeted by vaccines are childhood diseases that impact the young; hence vaccination can prevent infants, children, and teens from potentially harmful diseases that can even be deadly.  

But immunizations are not just for children. Protection from some childhood vaccines can wear off over time. Adults may also be at risk for vaccine-preventable disease due to age, job, lifestyle, travel, or other health conditions.

For this Discussion, review the immunization recommendations for patients across the lifespan. Reflect on how these recommendations might differ for patients who are immunocompromised or on immunosuppressive therapy. Consider how patient factors, such as age group and gender, might affect which immunizations are recommended by nurse practitioners for their patients.

To Prepare:

• Review the Learning Resources on medicolegal and health promotion considerations.
• Reflect on how medicolegal recommendations may impact health promotion strategies for the advanced practice nurse.

By Day 3

Post a comparison of the differences in immunizations that are recommended for patients ages 11–24, 25–64, and 65 years of age and older. Then, explain how these immunizations might impact patients who are immunocompromised or on immunosuppressive therapy. Be specific and provide examples by age group and gender.  

By Day 6

Respond to at least two of your colleagues on two different days and expand upon your colleagues’ posts by recommending which immunizations should be recommended to address immunocompromised or immune suppressed patients and explain why. 

You can also read another study guide on nursing assignments for students from another post on NUR-502 Theoretical Foundations for Nursing Roles And Practice Course Assignments & Examples.

Learning Resources

Required Readings (click to expand/reduce)

Barkley, T. W., Jr., & Myers, C. M. (2020). Practice considerations for the adult-gerontology acute care nurse practitioner (3rd ed.). Barkley & Associates.

• Chapter 87, “Guidelines for Health Promotion and Screening” 
• Chapter 88, “Major Causes of Mortality in the United States” 
• Chapter 89, Immunization Recommendations” 

American Academy of Professional Coders. (2020). What is CPT?

https://www.aapc.com/resources/medical-coding/cpt.aspx

American Academy of Professional Coders. (2018). 2018 procedure desk reference.

https://static.aapc.com/aapc/images/booksamples/Sample_2018_PDR_AAPC.pdf?fbclid=IwAR1tmBzS-Ii6RfIG5J-WQmnbisO750wvWAiPWVgLtyQoVk1N0D9izE-H4UA

American Association of Nurse Practitioners. (2020a). Multistate reimbursement alliance (MSRA): Enhancing NP support for insurance credentialing, contracting and reimbursement.

https://www.aanp.org/practice/business-practice-management/reimbursement

American Association of Nurse Practitioners. (2020b). Practice information by state: What you need to know about NP practice in your state. http://www.aanp.org/legislation-regulation/state-legislation-regulation/state-practice-environment

American Nurses Credentialing Center. (n.d.). Adult-gerontology acute care nurse practitioner certification (AGACNP-BC).

https://www.nursingworld.org/our-certifications/adult-gerontology-acute-care-nurse-practitioner/

Kleinsinger, F. (2018). The unmet challenge of medication nonadherence. The Permanente Journal. https://doi.org/10.7812/tpp/18-033

National Center for Health Statistics. (2020). International classification of diseases, tenth revision, clinical modification (ICD-10-CM). Centers for Disease Control and Prevention. http://www.cdc.gov/nchs/icd/icd10cm.htm

Document: iHuman Directions and Required Management Template (Word document)

Throughout this course, you will be required to complete case study Assignments with i-Human Patients. This manual provides guidance on accessing and using these simulations. It is HIGHLY recommended that you explore the manual’s various training resources in preparation for the upcoming Assignments. 

Required Media (click to expand/reduce)

Rubric Detail see for grading details 

Select Grid View or List View to change the rubric’s layout.

Name: NRNP_6550_Week1_Discussion_Rubric

	Excellent Point range: 90–100		Fair Point range: 70–79	Poor Point range: 0–69
Main Posting: Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.	40 (40%) – 44 (44%) Thoroughly responds to the discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least 3 current credible sources.		31 (31%) – 34 (34%) Responds to some of the discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with fewer than 2 credible references.	0 (0%) – 30 (30%) Does not respond to the discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only 1 or no credible references.
Main Posting: Writing	6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Further adheres to current APA manual writing rules and style.		4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting: Timely and full participation	9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main discussion by due date.		7 (7%) – 7 (7%) Posts main discussion by due date.	0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main discussion by due date.
First Response: Post to colleague’s main post that is reflective and justified with credible sources.	9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.		7 (7%) – 7 (7%) Response is on topic, may have some depth.	0 (0%) – 6 (6%) Response may not be on topic, lacks depth.
First Response: Writing	6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in Standard, Edited English.		4 (4%) – 4 (4%) Response posed in the discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%) Responses posted in the discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
First Response: Timely and full participation	5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.		3 (3%) – 3 (3%) Posts by due date.	0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Second Response: Post to colleague’s main post that is reflective and justified with credible sources.	9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.		7 (7%) – 7 (7%) Response is on topic, may have some depth.	0 (0%) – 6 (6%) Response may not be on topic, lacks depth.
Second Response: Writing	6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in Standard, Edited English.		4 (4%) – 4 (4%) Response posed in the discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%) Responses posted in the discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
Second Response: Timely and full participation	5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.		3 (3%) – 3 (3%) Posts by due date.	0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Total Points: 100

Name: NRNP_6550_Week1_Discussion_Rubric

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NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Example

NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Assignment

NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Assignment Brief

Course: NRNP 6665 – Psychiatric Mental Health Nurse Practitioner Care Across the Lifespan I

Assignment Title: NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Assignment

Assignment Instructions Overview

This assignment involves a critical analysis of a comprehensive, integrated psychiatric assessment for an adolescent. You will review a provided video vignette and evaluate the assessment techniques used, identifying areas of strength and potential improvement. Additionally, you will discuss the importance of thorough psychiatric assessments for children/adolescents, suitable symptom rating scales, and treatment options specific to this population.

Understanding Assignment Objectives

The primary goal of this assignment is to enhance your understanding of psychiatric assessment techniques tailored for children and adolescents. By engaging in this exercise, you will develop the ability to critically evaluate clinical practices and apply appropriate diagnostic tools and treatment strategies for younger patients.

The Student’s Role

As a student, your role is to:

• Review and analyze the provided video vignette.
• Identify and critique the assessment methods demonstrated by the practitioner.
• Discuss the significance of comprehensive psychiatric assessments for the pediatric population.
• Propose relevant symptom rating scales and treatment options for children/adolescents.
• Engage with peers by offering insights and alternative perspectives on their analyses.

Competencies Measured

This assignment measures the following competencies:

• Ability to evaluate and critique psychiatric assessment techniques for children and adolescents.
• Skill in recommending effective assessment questions for this demographic.
• Understanding the importance of comprehensive psychiatric assessments in developing accurate diagnoses and treatment plans.
• Knowledge of appropriate symptom rating scales for pediatric psychiatric assessments.
• Identification of suitable psychiatric treatments for children and adolescents.
• Comprehension of the vital role parents/guardians play in the assessment and treatment process of young patients.

You Can Also Check Other Related Assessments for the NRNP 6665 – Psychiatric Mental Health Nurse Practitioner Care Across the Lifespan I Course:

NRNP 6665 Ethical and Legal Foundations of PMHNP Care Discussion Assignment Example

NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Example

Week 1 Discussion: Comprehensive Integrated Psychiatric Assessment

What did the practitioner do well? In what areas can the practitioner improve?

Practitioner Strengths:

• Open-Ended Questions: The practitioner used open-ended questions, which facilitated detailed responses from the adolescent, Tony. This approach helped gather comprehensive information about Tony’s feelings and behaviors.
• Exploring Emotions: The practitioner effectively explored Tony’s emotional state, including feelings of hopelessness and anger, which are crucial in assessing depression and anxiety.
• Summarizing Statements: The practitioner summarized Tony’s statements, which validated his feelings and ensured understanding.

Areas for Improvement:

• Confidentiality and Consent: The practitioner did not address confidentiality, privacy, and consent at the beginning of the session. It is essential to explain these aspects to establish trust and clarify the boundaries of the therapeutic relationship.
• Family Involvement: There was no mention of involving Tony’s family or obtaining collateral information from them. Family input can provide additional context and support for the adolescent.
• Environment: Creating a more child-friendly environment could make the session more comfortable for young patients. This could include having art on the walls or other engaging elements.

At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

Yes, there are compelling concerns. Tony expressed feelings of anger, hopelessness, and a lack of interest in activities he used to enjoy, such as basketball and school. He also mentioned thoughts of not wanting to be alive. These symptoms are indicative of depression and possible suicidal ideation, which require immediate attention and intervention.

What would be your next question, and why?

The next question should be: “Can you tell me more about your thoughts of not wanting to be alive? Have you ever thought about how you might hurt yourself?” This question is crucial to assess the severity of Tony’s suicidal ideation and to determine the level of immediate risk.

Additional Discussion Points:

Explain why a thorough psychiatric assessment of a child/adolescent is important.

A thorough psychiatric assessment of a child or adolescent is essential because it allows for accurate diagnosis and effective treatment planning. Children and adolescents are at a developmental stage where mental health issues can significantly impact their growth, education, social relationships, and overall well-being. Early and precise assessment can prevent the progression of mental health disorders and improve long-term outcomes (Hilt & Nussbaum, 2016).

Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.

• Pediatric Symptom Checklist (PSC): This is a brief screening questionnaire that helps identify psychosocial problems in children. It is widely used in primary care settings and has versions for different age groups.
• Strengths and Difficulties Questionnaire (SDQ): This tool measures emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. It is suitable for children aged 4-17 and can be completed by parents, teachers, or the adolescents themselves.

Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.

• Play Therapy: This form of therapy uses play to help children express their feelings and deal with psychological issues. It is particularly effective for younger children who may not have the verbal skills to articulate their emotions.
• Family-Based Treatment (FBT): This approach involves the family in the treatment process, which is especially important for conditions like eating disorders. FBT empowers parents to support their child’s recovery, which may not be as relevant in adult treatments.

Explain the role parents/guardians play in assessment.

Parents and guardians play a critical role in the assessment process by providing historical context, observations of behavior, and information about the child’s development and family dynamics. Their involvement helps ensure a comprehensive understanding of the child’s issues and supports the implementation of treatment plans (Srinath et al., 2019).

References

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(2), 158–175.

Graf, M., Lederman, S., Raphael, E., & Kafri, R. (2023). Home-based treatment for children and adolescents with acute mental health disorders: A literature review. Journal of Child and Adolescent Psychiatric Nursing, 36(2), 681-686.

Detailed Assessment Instructions for the NRNP 6665 Comprehensive Integrated Psychiatric Assessment Discussion Assignment

NRNP 6665 Week 1 Discussion: Comprehensive Integrated Psychiatric Assessment

Photo Credit: Seventyfour / Adobe Stock

Many assessment principles are the same for children and adults; however, unlike with adults/older adults, where consent for participation in the assessment comes from the actual client, with children it is the parents or guardians who must make the decision for treatment. Issues of confidentiality, privacy, and consent must be addressed. When working with children, it is not only important to be able to connect with the pediatric patient, but also to be able to collaborate effectively with the caregivers, other family members, teachers, and school counselors/psychologists, all of whom will be able to provide important context and details to aid in your assessment and treatment plans.

Some children/adolescents may be more difficult to assess than adults, as they can be less psychologically minded. That is, they have less insights into themselves and their motivations than adults (although this is not universally true). The PMHNP must also take into consideration the child’s culture and environmental context. Additionally, with children/adolescents, there are lower rates of neurocognitive disorders superimposed on other clinical conditions, such as depression or anxiety, which create additional diagnostic challenges.

In this Discussion, you review and critique the techniques and methods of a mental health professional as the practitioner completes a comprehensive, integrated psychiatric assessment of an adolescent. You also identify rating scales and treatment options that are specifically appropriate for children/adolescents.

TO PREPARE

• Review the Learning Resources and consider the insights they provide on comprehensive, integrated psychiatric assessment. Watch the Mental Status Examination B-6 and Simulation Scenario-Adolescent Risk Assessment videos.
• Watch the YMH Boston Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.

By Day 3 of Week 1

Based on the YMH Boston Vignette 5 video, post answers to the following questions:

• What did the practitioner do well? In what areas can the practitioner improve?
• At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
• What would be your next question, and why?

Then, address the following. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.

• Explain why a thorough psychiatric assessment of a child/adolescent is important.
• Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
• Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
• Explain the role parents/guardians play in assessment.

Support your response with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

Read a selection of your colleagues’ responses.

BY DAY 6 OF WEEK 1

Respond to at least two of your colleagues on 2 different days by offering additional insights or alternative perspectives on their analysis of the video, other rating scales that may be used with children, or other treatment options for children not yet mentioned. Be specific and provide a rationale with evidence.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 1 Discussion

Week 1: Child and Adolescent Assessment

All diagnoses, from infancy to adulthood, begin with an examination. While an organic basis for most medical disorders can be determined through the use of diagnostic testing, the field of psychiatry is different in that patients cannot be sent to the lab for blood tests to determine the degree of depression. Similarly, patients cannot be sent to the radiology department for a “scan” to determine the severity of their bipolar disorder. Instead, the field of psychiatry must use psychiatric assessments, such as the comprehensive integrated physical exam, diagnostic interviews, and questionnaires to make diagnoses. These tools must be specialized to address the needs of children and adolescents.

Diagnostic assessment of the child and adolescent is a specialized area of expertise. The PMHNP will often see children who have already been seen by a primary care provider. Many PCPs are comfortable handling attention-deficit/hyperactivity disorder (ADHD) and other straightforward childhood disorders. That means that the PMHNP will often treat the more complicated patients. This week, you explore psychiatric assessment techniques and tools for children and adolescents. You also examine the role of the parent/guardian in the assessment process for this patient population.

Learning Objectives

Students will:

• Evaluate comprehensive integrated psychiatric assessment techniques for children and adolescents
• Recommend assessment questions for child and adolescent patients
• Explain the importance of thorough psychiatric assessment for children and adolescents
• Identify rating scales that are appropriate for child/adolescent psychiatric assessment
• Identify psychiatric treatments appropriate for children and adolescents
• Explain the role of the parent/guardian in child/adolescent psychiatric assessment

Optional Discussion Forum: PMHNP Study Support Lounge

The PMHNP Study Support Lounge is offered throughout the course as a place of academic refuge where you can ask questions, offer insights, and interact with your peers. Your Instructor may also weigh in to provide global feedback to the group based on trends, common problems, and common strengths in student posts.

You are encouraged to provide constructive, helpful feedback to your peers. Advanced practice nurses always benefit from the feedback of others. Your Study Support Lounge posts may be procedural (“How do I attach a Kaltura video to a Discussion post?”), conceptual (“How does this relate to the other therapy approaches we have studied?”), or analytical (“What do these diagnostic results actually mean in the context of this specific patient case?”). Although not mandatory, this is an opportunity to interact and study together as you navigate the assignments, so you are highly encouraged to take part in this activity. Full participation in activities like this is a statistically significant predictor of success.

To Participate in this Optional Discussion:

• PMHNP Study Support Lounge
• Acknowledgment
• Practicum Manual Acknowledgment

The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.

• Field Experience: MSN Nurse Practitioner Practicum Manual

Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.

Learning Resources

Required Readings (click to expand/reduce)

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

• Chapter 1, “Introduction”
• Chapter 4, “The 15-Minute Pediatric Diagnostic Interview”
• Chapter 5, “The 30-Minute Pediatric Diagnostic Interview”
• Chapter 6, “DSM-5 Pediatric Diagnostic Interview”
• Chapter 9, “The Mental Status Examination: A Psychiatric Glossary”
• Chapter 13, “Mental Health Treatment Planning”

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(2), 158–175. http://doi.org/10.4103/psychiatry.IndianJPsychiatr…

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

• Chapter 32, “Clinical assessment and diagnostic formulation”

Required Media (click to expand/reduce)

Symptom Media. (2014). Mental status exam B-6. [Video]. https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/mental-status-exam-b-6/cite?context=channel:volume-2-new-releases-assessment-tools-mental-status-exam-series

Western Australian Clinical Training Network. (2016, August 4). Simulation scenario-adolescent risk assessment [Video]. YouTube. 

YMH Boston. (2013, May 22). Vignette 5 – Assessing for depression in a mental health appointment [Video]. YouTube. 

Recommended Reading (click to expand/reduce)

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

• Chapter 31, “Child Psychiatry”

NRNP 6665 Week 1 Assignment: Child and Adolescent Assessment Rubric

Name:  Assignment Rubric

	Excellent	Good	Fair	Poor
Summarize your interpretation of the frequency data provided in the output for respondent’s age, highest school grade completed, and family income from prior month.	32 (32%) – 35 (35%) The response accurately and clearly explains, in detail, a summary of the frequency distributions for the variables presented. The response accurately and clearly explains, in detail, the number of times the value occurs in the data. The response accurately and clearly explains, in detail, the appearance of the data, the range of data values, and an explanation of extreme values in describing intervals that sufficiently provides an analysis that fully supports the categorization of each variable value. The response includes relevant, specific, and appropriate examples that fully support the explanations provided for each of the areas described.	28 (28%) – 31 (31%) The response accurately summarizes the frequency distributions for the variables presented. The response accurately explains the number of times the value occurs in the data. The response accurately explains the appearance of the data, the range of data values, and explains extreme values in describing intervals that provides an analysis which supports the categorization of each variable value. The response includes relevant, specific, and accurate examples that support the explanations provided for each of the areas described.	25 (25%) – 27 (27%) The response inaccurately or vaguely summarizes the frequency distributions for the variables presented. The response inaccurately or vaguely explains the number of times the value occurs in the data. The response inaccurately or vaguely explains the appearance of the data, the range of data values, and inaccurately or vaguely explains extreme values. An analysis that may support the categorization of each variable value is inaccurate or vague. The response includes inaccurate and irrelevant examples that may support the explanations provided for each of the areas described.	0 (0%) – 24 (24%) The response inaccurately and vaguely summarizes the frequency distributions for the variables presented, or it is missing. The response inaccurately and vaguely explains the number of times the value occurs in the data, or it is missing. The response inaccurately and vaguely explains the appearance of the data, the range of data values, and an explanation of extreme values, or it is missing. An analysis that does not support the categorization of each variable values is provided, or it is missing. The response includes inaccurate and vague examples that do not support the explanations provided for each of the areas described, or it is missing.
Summarize your interpretation of the descriptive statistics provided in the output for respondent’s age, highest school grade completed, race and ethnicity, currently employed, and family income from prior month.	45 (45%) – 50 (50%) The response accurately and clearly summarizes in detail the interpretation of the descriptive statistics provided. The response accurately and clearly evaluates in detail each of the variables presented, including an accurate and complete description of the sample size, the mean, the median, standard deviation, and the size and spread of the data.	40 (40%) – 44 (44%) The response accurately summarizes the interpretation of the descriptive statistics provided. The response accurately explains evaluates each of the variables presented, including an accurate description of the sample size, the mean, the median, standard deviation, and the size and spread of the data.	35 (35%) – 39 (39%) The response inaccurately or vaguely summarizes the interpretation of the descriptive statistics provided. The response inaccurately or vaguely evaluates each of the variables presented, including an inaccurate or vague description of the sample size, the mean, the median, the standard deviation, and the size and spread of the data.	0 (0%) – 34 (34%) The response inaccurately and vaguely summarizes the interpretation of the descriptive statistics provided, or it is missing. The response inaccurately and vaguely evaluates each of the variables presented, including an inaccurate and vague description of the sample size, the mean, the median, the standard deviation, and the size and spread of the data, or it is missing.
Written 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 is provided which delineates all required criteria.	5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.	4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.	3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.	0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.	4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors.	3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors.	0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.	5 (5%) – 5 (5%) Uses correct APA format with no errors.	4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors.	3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors.	0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors.
Total Points: 100

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NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Example

NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment

NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment Brief

Course: NRNP 6540 – Advanced Practice Care of Older Adults

Assignment Title: NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment

Assignment Instructions Overview

This assignment involves creating an evaluation plan for an elderly patient based on a case study provided by the instructor. The focus is on assessing the patient’s health and functional ability to determine if their needs are being met. Students are required to use comprehensive geriatric assessments to identify age-related changes that may interfere with the patient’s functional status.

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Understanding Assignment Objectives

The primary objective of this assignment is to develop a detailed evaluation plan for an elderly patient. Students must:

• Assess the patient’s health and functional stability.
• Identify appropriate assessment tools to evaluate wellness and functional ability.
• Consider factors such as the setting of the evaluation, involvement of other professionals or family members, and potential challenges like language barriers or cognitive impairment.
• Determine immunization requirements relevant to the patient’s health promotion and disease prevention.

The Student’s Role

Students will assume the role of a nurse practitioner responsible for evaluating the health and functional status of an elderly patient. This involves:

• Reviewing the provided case study thoroughly.
• Developing an evaluation plan that includes specific assessment tools.
• Justifying the choice of assessment tools and considering their validation for the patient population.
• Addressing potential issues during the assessment, such as cognitive impairment or sensory deprivation.
• Recommending necessary immunizations for health promotion and disease prevention.

Competencies Measured

This assignment measures several key competencies essential for advanced practice nurse practitioners, including:

• Clinical reasoning and decision-making skills.
• Ability to conduct comprehensive geriatric assessments.
• Proficiency in using validated assessment tools for elderly patients.
• Understanding of immunization requirements for older adults.
• Communication skills, particularly in explaining the evaluation plan and addressing potential challenges.

You Can Also Check Other Related Assessments for the NRNP 6540 – Advanced Practice Care of Older Adults Course:

NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Example

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NRNP 6540 Assessing Cardiovascular and Pulmonary Disorders Assignment Example

NRNP 6540 Assessing Diagnosing and Treating Abdominal Urological and Gynecological Disorders Assignment Example

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NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Example

As individuals age, they are more likely to develop various chronic health conditions that can significantly impact their quality of life. Advanced practice nurse practitioners (APNPs) frequently interact with elderly patients, and it is crucial to evaluate and address these conditions to maintain the patients’ functional ability. Common age-related health issues include obstructive sleep apnea (OSA), hypertension, chronic anemia, restless leg syndrome, osteoporosis, and cognitive impairment. Comprehensive assessments are essential to identify and manage these conditions effectively.

Case Study Overview

Mr. Raymond Young, a 92-year-old retired college professor, presents a case that exemplifies the complexity of caring for elderly patients. Despite his advanced age and several chronic health issues, Mr. Young is able to perform all basic activities of daily living independently. His medical history includes obstructive sleep apnea, hypertension managed with lifestyle modifications, mild chronic anemia, restless leg syndrome, and osteoporosis. He has also experienced falls and has reported instances of getting lost while driving to familiar locations. These issues suggest potential underlying problems related to immobility, sensory deprivation, and cognitive dysfunction that require thorough evaluation.

Evaluation Plan

Developing an evaluation plan for Mr. Young involves several critical steps. First, the assessment should be conducted in a setting that ensures the patient’s comfort and safety, such as his home or a familiar clinical environment. Involving family members, particularly his wife, in the evaluation process can provide additional insights into his daily functioning and any changes observed over time. Collaboration with other healthcare professionals, including a geriatrician, neurologist, and physical therapist, may also be necessary to provide a comprehensive evaluation.

Assessment Tools

Several assessment tools are appropriate for evaluating Mr. Young’s cognitive function, mobility, and overall health status. The Mini-Mental State Examination (MMSE) is a widely used tool for assessing cognitive function in older adults. It evaluates attention, orientation, memory, registration, recall, calculation, language, and visuospatial skills through a series of 30 questions (Arevalo-Rodriguez et al., 2021). Given Mr. Young’s history of cognitive impairment, the MMSE is suitable for monitoring any progression of cognitive decline. However, it is important to note that while the MMSE is validated for use in older adults, it may have limitations in patients with varying educational backgrounds or language barriers (Arevalo-Rodriguez et al., 2021).

The Comprehensive Geriatric Assessment (CGA) is another essential tool, incorporating multiple scales to evaluate various aspects of an elderly patient’s health. This multidisciplinary instrument includes the Berg Balance Scale to assess balance, the Falls Efficacy Scale to evaluate the fear of falling, and the Timed Up and Go Test to measure mobility (Appeadu & Bordoni, 2023). Given Mr. Young’s history of falls, these assessments can help identify specific risk factors and guide interventions to prevent future incidents.

For evaluating Mr. Young’s driving competency, performance-based road tests and driving simulation studies can be utilized. These tests assess the coordination of cognitive and physical tasks required for safe driving. Additionally, psychometric evaluations, such as the MMSE, can provide insights into cognitive functions relevant to driving (Toups et al., 2022).

Addressing Potential Issues

Several factors might present challenges during Mr. Young’s assessment. Cognitive impairment could affect his ability to recall past events accurately, which may hinder the history-taking process. Ensuring that questions are clear and straightforward can help mitigate this issue. Additionally, his educational background and any language barriers should be considered when administering cognitive tests to ensure accurate results. Cultural competency is crucial, as cultural beliefs and practices can influence how symptoms are perceived and reported by the patient (Khanna & Metgud, 2020).

Immunization Requirements

Vaccinations play a vital role in promoting health and preventing disease among older adults. Mr. Young should receive recommended vaccines to protect against common infections that can have severe consequences in the elderly. These include the annual influenza vaccine, pneumococcal vaccine, tetanus, and polio vaccines (Michel & Frangos, 2022). Ensuring that Mr. Young is up-to-date with his immunizations can help prevent infections that may exacerbate his existing health conditions.

Conclusion

A comprehensive and multidisciplinary approach is essential for evaluating and managing the health of elderly patients like Mr. Young. Utilizing appropriate assessment tools and considering potential issues related to cognitive function, educational background, and cultural factors can enhance the accuracy of the evaluation. Additionally, maintaining up-to-date immunizations is crucial for promoting overall health and preventing disease in older adults.

References

Appeadu, M., & Bordoni, B. (2023, June 4). Falls and Fall Prevention in the Elderly. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560761/

Arevalo-Rodriguez, I., Smailagic, N., Roqué-Figuls, M., Ciapponi, A., Sanchez-Perez, E., Giannakou, A., Pedraza, O. L., Bonfill Cosp, X., & Cullum, S. (2021). Mini-Mental State Examination (MMSE) for the Early Detection of Dementia in People with Mild Cognitive Impairment (MCI). Cochrane Database of Systematic Reviews, 2021(7). https://doi.org/10.1002/14651858.cd010783.pub3

Khanna, A., & Metgud, C. (2020). Prevalence of cognitive impairment in elderly population residing in an urban area of Belagavi. Journal of Family Medicine and Primary Care, 9(6), 2699. https://doi.org/10.4103/jfmpc.jfmpc_240_20

Michel, J.-P., & Frangos, E. (2022). The Implications of Vaccines in Older Populations. Vaccines, 10(3), 431. https://doi.org/10.3390/vaccines10030431

Toups, R., Chirles, T. J., Ehsani, J. P., Michael, J. P., Bernstein, J. P. K., Calamia, M., Parsons, T. D., Carr, D. B., & Keller, J. N. (2022). Driving Performance in Older Adults: Current Measures, Findings, and Implications for Roadway Safety. Innovation in Aging, 6(1), igab051. https://doi.org/10.1093/geroni/igab051

Detailed Assessment Instructions for the NRNP 6540 Assessment of Older Adults Evaluation Plan Discussion Assignment

NRNP 6540 Raymond Young Week 1 Assessment of Older Adults Instructions

As patients age, they are more likely to develop health issues. While some of these health issues are normal changes due to aging, some of them are abnormal and require further evaluation. Consider a 92-year-old patient who has been diagnosed with several disorders, including obstructive sleep apnea, hypertension, mild chronic anemia, restless leg syndrome, and osteoporosis. Despite these disorders, he can independently perform all basic activities of daily living, walk a quarter mile without difficulty, and pass functional and cognitive assessments. However, he did report that he fell a few times and had lost his way while driving to a familiar location (Carr & Ott, 2010).

As an advanced practice nurse caring for geriatric patients, you will likely encounter patients like this. While he can pass the basic assessments, the report of falls and confusion might indicate underlying issues of immobility, sensory deprivation, and/or cognitive dysfunction that require further attention. To identify these potential underlying issues and distinguish between normal and abnormal changes due to aging, healthcare providers use a variety of assessments. These assessments are a key tool in the care of geriatric patients.

This week, you examine assessment tools and evaluation plans used to assess geriatric patients presenting with potential issues of immobility, sensory deprivation, and cognitive dysfunction.

^{Reference:
Carr, D. B., & Ott, B. R. (2010). The older adult driver with cognitive impairment: “It’s a very frustrating life.” Journal of the American Medical Association, 303(16), 1632–1641. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915446/}

NRNP 6540 Raymond Young Week 1 Assessment of Older Adults Learning Objectives

Students will:

• Analyze assessment tools used to assess older adults
• Design evaluation plans for patients with immobility, sensory deprivation, and/or cognitive dysfunction
• Identify immunization requirements related to health promotion and disease prevention for older adults

Learning Resources

Required Readings (click to expand/reduce)

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Changes with aging. In Advanced practice nursing in the care of older adults (2nd ed., pp. 2–5). F. A. Davis.

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Health promotion. In Advanced practice nursing in the care of older adults (2nd ed., pp. 6–18). F. A. Davis.

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Exercise in older adults. In Advanced practice nursing in the care of older adults (2nd ed., pp. 19–24). F. A. Davis.

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Comprehensive geriatric assessment. In Advanced practice nursing in the care of older adults (2nd ed., pp. 26–33). F. A. Davis.

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Symptoms and syndromes. In Advanced practice nursing in the care of older adults (2nd ed., pp. 34–94). F. A. Davis.

Centers for Disease Control and Prevention. (2020). Recommended adult immunization schedule for ages 19 years or older. https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf

Coll, P. P., Costello, V. W., Kuchel, G. A., Bartley, J., & McElhaney, J. E. (2019). The prevention of infections in older adults: Vaccination. Journal of the American Geriatrics Society, 68(1), 207–214. https://doi.org/10.1111/jgs.16205

Hartford Institute for Geriatric Nursing. (2020). General assessment series. In Try This: Series. Author. https://consultgeri.org/try-this/general-assessment

U.S. Preventive Services Task Force. (n.d.). Information for health professionals. Retrieved June 8, 2020 from https://www.uspreventiveservicestaskforce.org/uspstf/information-health-professionals

U.S. Preventive Services Task Force. (2019). Appendix III. USPSTF LitWatch process. https://www.uspreventiveservicestaskforce.org/uspstf/procedure-manual-appendix-iii-uspstf-litwatch-process

Recommended Reading (click to expand/reduce)

Goldberg, C. (2019). Role of physical exam, general observation, skin screening and vital signs. https://meded.ucsd.edu/clinicalmed/assets/docs/Vital%20Signs%20and%20Introduction%20to%20the%20Exam.pdf

Recommended Media (click to expand/reduce)

Engage-IL (Producer). (2017m). Geriatric health promotion and disease prevention [Video]. https://engageil.com/modules/geriatric-health-promotion-and-disease-prevention/

Note: View the Geriatric Health Promotion and Disease Prevention video module available in this free course. If you choose to view the Engage-IL media, you will need to create a free account at the Engage-IL website. 

Engage-IL (Producer). (2017w). The process of aging [Video]. https://engageil.com/modules/the-process-of-aging/

Note: View the Process of Aging video module available in this free course.

Discussion: Evaluation Plan

As geriatric patients age, their health and functional stability may decline resulting in the inability to perform basic activities of daily living. In your role as a nurse practitioner, you must assess whether the needs of these aging patients are being met. Comprehensive geriatric assessments are used to determine whether these patients have developed or are at risk of developing age-related changes that interfere with their functional status. Since the health status and living situation of older adult patients often differ, there are a variety of assessment tools that can be used to evaluate wellness and functional ability. For this Discussion, you will consider which assessment tools would be appropriate for a patient in a case scenario.

Photo Credit: LIGHTFIELD STUDIOS / Adobe Stock

To prepare:

• Review this week’s Learning Resources, considering how assessment tools are used to evaluate patients.
• Your Instructor will assign a case study to use for this Discussion. Review the case study and, based on the provided information, think about a possible patient evaluation plan. As part of your evaluation planning, consider where the evaluation would take place, whether any other professionals or family members should be present, appropriate assessment tools and guidelines, and any other relevant information you may wish to address.
• Consider whether the assessment tool you identified was validated for use with this specific patient population and if this poses issues. Think about additional factors that might present issues when performing assessments such as language, education, prosthetics, missing limbs, etc.
• Consider immunization requirements that may be needed for this patient.

By Day 3

Post an explanation of your evaluation plan for the patient in the case study provided, and explain which type of assessment tool you might use for the patient. Explain whether the assessment tool was validated for use with this patient’s specific patient population and whether this poses issues. Include additional factors that might present issues when performing assessments, such as language, education, prosthetics, etc. Also explain the immunization requirements related to health promotion and disease prevention for the patient.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in one or more of the following ways:

• Suggest alternative assessment tools and explain why these tools might be appropriate for your colleagues’ patients.
• Recommend strategies for mitigating issues related to use of the assessment tools your colleagues discussed.
• Explain other health promotion considerations for patients in this population or with related issues.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link, and then select Create Thread to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

NRNP 6540 Raymond Young Week 1 Assessment of Older Adults Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NRNP_6540_Week1_Discussion_Rubric

Grid View

List View

Excellent

Point range: 90–100       Good

Point range: 80–89         Fair

Point range: 70–79         Poor

Point range: 0–69

Main Posting:

Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

40 (40%) – 44 (44%)

Thoroughly responds to the discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least 3 current credible sources.

35 (35%) – 39 (39%)

Responds to most of the discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least 3 credible references.

31 (31%) – 34 (34%)

Responds to some of the discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with fewer than 2 credible references.

0 (0%) – 30 (30%)

Does not respond to the discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only 1 or no credible references.

Main Posting:

Writing

6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Further adheres to current APA manual writing rules and style.

5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation

9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main discussion by due date.

8 (8%) – 8 (8%)

Posts main discussion by due date.

Meets requirements for full participation.

7 (7%) – 7 (7%)

Posts main discussion by due date.

0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic, may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.

First Response:

Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

4 (4%) – 4 (4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:

Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic, may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.

Second Response:

Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

4 (4%) – 4 (4%)

Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:

Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100

Name: NRNP_6540_Week1_Discussion_Rubric

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