Comprehensive Psychiatric Evaluation And Patient Case Presentation

Comprehensive Psychiatric Evaluation and Patient Case Presentation

Chief Complaint

I don’t have to give my name, people are after me, and I have to be careful.”

 

V.O. is a 35-year-old African American female who presented to ED with erratic and bizarre behavior. Patient was brought in because she was walking in and out of traffic, not answering appropriately to police queries, yelling, screaming, and singing, refusing to tell her name, paranoid and delusional. During assessment patient furnishes delayed responses to queries, aloof and oblivious, to events going on around her, detached and internally preoccupied; responding to internal stimuli, impaired clarity of thought, disrupted train of thought, distracted and disorganized thought and behavior, suspicious, distrustful, and hypervigilant. (UDS is positive for THC, cocaine, methadone and ETOH level 84 and medication non-compliance. No drug/food allergies reported. No family history of psychiatric reported. Denies having suicidal/homicidal ideations denies feeling depressed and denies auditory hallucinations. Denies history of suicidal attempts Comprehensive Psychiatric Evaluation And Patient Case Presentation.

Vital sign: BP 131/65, P 74, R 16, T 97.5, SPO2 98%RA, Weight 149lbs

PAST PSYCHIATRIC HISTORY

Schizoaffective disorder bipolar type.

Patient has had multiple psychiatric hospitalizations in different hospitals

PAST MEDICAL HISTORY Comprehensive Psychiatric Evaluation And Patient Case Presentation

Asthma

PERSONAL/SOCIAL HISTORY

Patient reports being single, never married, have 2 children that live with their father, homeless, unemployed, and receive monthly SSI. HCG negative, UDS positive for THC, cocaine, methadone and ETOH level 84. Denies owning any firearms and denies any legal history.

MENTAL STATUS EXAMINATION:

Patient is alert and oriented to person and situation.

Appearance: Disheveled, Unkempt

Attitude: Anxious, distrustful, guarded, impulsive, suspicious Normal developed

Posture: rigid

Eye contact: downcast

Expression: blank

Speech: delayed, incoherent, minimal

Insight: poor

Judgment: poor

Affect: Irritable, labile

Mood Irritable

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Attention: distracted, poor attention

Memory immediate: intact

Memory recent past: intact

Memory remote past: intact

Thought process: flight of ideas, loose association, tangentiality, and withdrawal

Thought content: delusions

Perceptual Disturbance: hallucinations

Medications:

Risperdal 2 mg PO QHS for psychosis

Depakote ER 500 mg PO Q daily for mood

Ativan 2 mg IM q 4 hrs. PRN for anxiety

Haldol 5 mg IM q hrs. PRN for agitation

Benadryl 50 mg IM Q 6 hrs. PRN for EPS

Ambien 10 mg PO QHS PRN for insomnia

Flovent 220 mcg inhalers administer 2 puffs q 12 hrs. for SOB/Wheezing Comprehensive Psychiatric Evaluation And Patient Case Presentation.

Diagnosis

Paranoid schizophrenia

Polysubstance abuse

PLEASE ADD ONE MORE DIAGNOSIS TO MAKE IT 3 BASED ON THE CASE STUDY. Subjective: What details did the patient provide regarding their personal and medical history? What are their symptoms of concern? How long have they been experiencing them, and what is the severity? How are their symptoms impacting their functioning? Comprehensive Psychiatric Evaluation And Patient Case Presentation

· Objective: What observations did you make during the interview and review of systems?

· Assessment: What were your differential diagnoses? Provide a minimum of three (3) possible diagnoses. List them from highest to lowest priority. What was your primary diagnosis, and why?

· Reflection notes: What would you do differently in a similar patient evaluation?

PLEASE ADD ONE MORE DIAGNOSIS TO MAKE IT 3 BASED ON THE CASE STUDY.

· Include at least five (5) scholarly resources to support the assessment and diagnostic reasoning Comprehensive Psychiatric Evaluation And Patient Case Presentation.

WHY NURSES SHOULD STUDY OBESITY

Obesity is increasingly becoming a matter of great medical concern in modern health facilities. Tackling obesity should be prioritized in many health care facilities since it’s on the raise as the many researches carried out have shown. The specific impact of obesity is difficult to assess but its effect to general morbidity and premature death are known.

Body mass index (BMI) method is what is used to measure and determine if a person is obese as described by World Health Organization. This formulae is used in both male and female and gives the most vital indicator of overweight (BMI of 25 or above) and obesity. The BMI is only used as a guide as it does not put into account for muscle mass or for fat distribution which differ between individuals. In the United States the Obesity rates continues to rise at epic proportions. In order to tackle the menace, nurses and other medical professional should be in a position to handle and understand obesity. WHY NURSES SHOULD STUDY OBESITY

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The nurses need to know all aspects of obesity which include screening, predispositions, pathophysiology and management of the disease in order to help patients. The knowledge the nurses get will be important in lowering the number of cases of obesity in the country and in long run stop this growing epidemic. The number of obesity cases in children is raising rapidly and hence nurses who have knowledge on its management will be in a better position to help. By educating the nurses about obesity, the risk factors and co-morbidities that manifest due to obesity, will be handled in a professional manner and lead the Country to live in healthier ways.

Nurses will be taught on various causes of obesity in children which include lack of doing enough physical activities and prolonged immobility. Other causes factors leading to obesity include overeating in excess and combined with limited physical activities which will be well inculcated in their learning process. The learning about obesity will help nurses understand the pathophysiology of this life style disease, which is simply taking more calories than required.  Nurses will be introduced to the theory about child metabolism and hormone irregularities, which contributes to dysfunction of hormones and energy storage for a long period of time

References

Mulherin, K., Miller, Y. D., Barlow, F. K., Diedrichs, P. C., & Thompson, R. (2013). Weight stigma in maternity care: women’s experiences and care providers’ attitudes. BMC pregnancy and childbirth, 13(1), 19.

Swift, J. A., Hanlon, S., El‐Redy, L., Puhl, R. M., &Glazebrook, C. (2013). Weight bias among UK trainee dietitians, doctors, nurses and nutritionists. Journal of human nutrition and dietetics, 26(4), 395-402. WHY NURSES SHOULD STUDY OBESITY

Concept Exploration Sample Essay

Concept exploration Discussion Prompt

Choose a theory from your undergraduate education in any discipline. It should be a commonly used theory for the general public such as Maslow, Darwin, Descartes, or others you used in physiology courses, chemistry, business courses, etc. Do not use a nursing theory.  Provide the theory in your response.  Identify the two concepts and the proposition between them.  Explain the concepts. How might the terms used differ from the general use of the term?  How might the term be confused or misinterpreted? Format your theory in the form “psychosocial development (Concept A) progresses through (Proposition) stages (Concept B)” Concept Exploration Sample Essay.

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Expectations

Initial Post:

APA format with intext citations

Word count minimum of 250

References: 2 high-level scholarly references within the last 5 years in APA format.

Plagiarism free.

Turnitin receipt Concept Exploration Sample Essay.

Assessment Description Sample Paper

Write a 650-1300 word response to the following questions:

1. Explain multicultural communication and its origins.

2. Compare and contrast culture, ethnicity, and acculturation.

3. Explain how cultural and religious differences affect the health care professional and the issues that can arise in cross-cultural communications.

4. Discuss family culture and its effect on patient education.

5. List some approaches the health care professional can use to address religious and cultural diversity.

6. List the types of illiteracy Assessment Description Sample Paper.

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7. Discuss illiteracy as a disability.

8. Give examples of some myths about illiteracy.

9. Explain how to assess literacy skills and evaluate written material for readability.

10. Identify ways a health care professional may establish effective communication.

11. Suggest ways the health care professional can help a patient remember instructions.

This assignment is to be submitted as a Microsoft Word document. Assessment Description Sample Paper

patient data capture and information sharing

You work for a health care organization that frequently needs to share information with other providers. Your organization has a very important relationship with a diagnostics center in particular where you frequently need to share patient information such as lab results, X-rays, and other diagnostic information.

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• You have been asked to review your company’s protocols on sharing and receiving patient information for outside providers to ensure that your organization is in compliance with the latest standards and regulations.
  • Write an executive summary that examines the compliance procedures and practice guidelines that these organizations would need to establish to achieve optimum operational effectiveness while complying with federal, state, and local laws governing patient information security and records retention.
  • Analyze the current trends in patient data capture and information sharing among health care providers, assessing their impact on your organization’s operations.