Running head COMPREHENSIVE ASSESSMENT
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Running head: COMPREHENSIVE ASSESSMENT 1 COMPREHENSIVE ASSESSMENT 1 Comprehensive Client Family Assessment and Genogram Tania Gonzalez Diaz Walden University NURS:6640 March 14,2020 Comprehensive Assessment 1. Demographic information: The patient is a 17-year-old black girl. She is escorted by her parents to the clinic after a recommendation from the school counsellor. 2. Presenting problem: According to the father, "our daughter is not feeling well. She has not been attending classes and she tried to commit suicide. We think she is depressed". 3. History of present illness.: On today visit, patient present awake, alert and oriented, calm, cooperative, organized, with good hygiene.According to the young girl who was ready to share her feelings, she started feeling pressure from schoolwork when she was in her junior year. Her grades were not so good, and she felt useless and that is why she started being a truant. One year later, after starting her senior year, she feels the pressure is too much and she cannot manage to go through the year. One day before being referred to the clinic by the school counsellor, she was found bleeding in the school washroom after she slit her wrist. 4. Past psychiatric history: Since her frustration with school started a year ago, she has never been diagnosed with any psychiatric disorder. The parents though that she was simply going through a phase as a teenager and they were trying to help her cope with school and be a better person. No past psychiatric history. No history of Abuse. 5. Medical history: Despite her recent issue and the fact that she lost her weight suddenly, in the past few months, she is of perfect health. she had asthma and chicken pox when she was young, and she is allergic to penicillin. 6. Substance use history: She has no history of substance abuse. Her parents describe her as a very good girl. 7. Developmental history: Her mother had a successful pregnancy and gave birth to her through normal delivery. She grew up with her older siblings and she achieved all developmental milestones. They have been going to church every Sunday and she is part of the local church youths. Her parents have been married for a while and they are still together. She went through her education as a bright girl until her junior high level when she started failing and missing classes. 8. Family psychiatric history: Her older sister has epilepsy, but her seizures remain under control. There is no other form of psychiatric history in the family 9. Psychosocial history: She has always been an active member of the church youth and they have been doing many activities together since they were in Sunday school. She has also been making many friends from high school but recently, she just wants to be alone 10. History of abuse and trauma: T ...
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Solution
The additional information that is required is whethere ella has gone for depression checkups or
has been detected with depression and if she has received therapies.
The theory is the ecological theory which tells about the interaction between indisvisual and the
environment.This is given by URIE BRONFENBRENNER.This theory tells about yow the
adolescents are influenced by family, peers, religion, schools, the media, community, and world
events.
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environment.This is given by URIE BRONFENBRENNER.This theory tells about yow the
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Case#1A 24-year-old male graduate student without prior medical .docx
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The on-call psychiatry notes in Terry’s chart
Patient appears underweight and younger than her stated age. She is mild distress, has a nasogastric tube in place, and exhibits poor eye contact. She reports feeling “sad” and admitted to experiencing constant preoccupation about her physical appearance and says, “I am fat; I hate my body.” She also reports insomnia, low energy levels, and history of self-harm behavior by cutting her forearms. She reports that she is careful hiding her symptoms from her parents, whom she describes as strict disciplinarians. She also expresses concerns that she will disappoint them.
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Qu.
1Family Assessment and Psychotherapeutic ApproachesCol
1
Family Assessment and Psychotherapeutic Approaches
College of Nursing-PMHNP, Walden University
NRNP 6645: Psychotherapy with Multiple Modalities
June 13, 2021
2
Abstract
As providers, it is vital to be open-minded, if you are not aware or do not understand a person’s
culture, show your patients respect. Be engaged, respectful, and ask questions. Learn from your
patients, this helps develop a rapport. As providers we are obligated to provide optimal care, if
we feel a patient's needs are out of our scope, the client should be referred to a provider that can
give them the help they need and deserve (Nichols & Davis, 2020).
The purpose of this paper is to provide documentation and a psychiatric comprehensive
assessment of a patient and family during a family therapy interview that highlights differences
in a multicultural family, respecting cultural norms and differences, and develop an
individualized treatment plan.
Keywords: Family therapy
3
Family Assessment and Psychotherapeutic Approaches
Subjective:
CC (chief complaint): “I like to learn to live on my own and not depend on the kids.”
HPI: A 40-year-old female (Patti) and her five children (Sheela age 24, Sharleen aged 23
and present today, Shireen age 21 recently reunited with family, Armin Jr. age 18, and Sam age
15), of Iranian descent, has been in individual and family therapy for the last 18 months. Patti
came to the clinic related to chaos in the home after her daughter was finally reunited with the
family after ten years. The family initially had rejoiced and celebrated, and after a few weeks,
Shireen began to tell her mother and siblings the emotional, physical, and sexual abuse at the
hands of her father. She blamed and felt abandoned by her mother. Patti needed necessary
surgery to both her feet after an injury, that has now left her disabled and with chronic pain. The
additional burden of surgery and disability has increased tension and stress in the home. Patti
lives with her two sons; her daughters live on their own. Shireen recently moved out, marrying
someone the family does not know, with little contact. Mother speaks and sees Sheela and
Sharleen daily. Patti has increasingly felt alone, depressed, hopeless, and helpless wanting her
daughters to stay and help her at her home. A psychiatric provider has been referred for a
medication evaluation.
Past Psychiatric History:
General Statement: Patti and her family began therapy 18 months ago after daughter
Shireen reunited with the family after 12 years of separation. Shireen shared significant abuse
she experienced, learning the trauma she went through brought on many emotions of the family
including blame, guilt, shame increasing stress on the family.
Caregivers: N/A
4
Hospitalizations: Patti denies any past psychiatric hospitalizations or history. The patient
has no history of substance abuse or residential treatment. Patti denies suicidal and homicid ...
Abnormal Psychology (Psychiatric history) Case Study
FOR TAKING CASE HISTORY FOR THE COMPLETION OF PRACTICAL WORK OF ABNORMAL PSYCHOLOGY
The AssignmentExamine Case Study A Young Caucasian Girl.docx
The Assignment
Examine
Case Study: A Young Caucasian Girl With ADHD
You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
·
Decision #1
o Which decision did you select?
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with
Decision #1 and the results of the decision. Why were they different?
·
Decision #2
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
·
Decision #3
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with
o Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Note: Support your rationale with a minimum of three academic resources no more than five years old in APA Format
Attention Deficit Hyperactivity Disorder
A Young Girl With ADHD
BACKGROUND
Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition.
The parents give the PMHNP a copy of a form titled
“Conner’s Teacher Rating Scale-Revised”.
This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on in.
16Assignment templateSubjectiv
1
6
Assignment template
Subjective Section
Chief complainant
The patient starts by saying, "I can't stop crying, all the time." The patient complains that since she gave birth to her child two months ago, she has been experiencing mood disorders and difficulties falling asleep even after the baby is already asleep. She complains that especially when the baby cries, she loses her appetite and is not comfortable with her new body shape and size. She says nothing interests her, even writing, which was one of the things she loved before she gave birth. She does not want to contact her friends, and everything seems to be upsetting her.
History of present illness (HPI)
L.T is a 32-year-old black female who resents for psychiatric evaluation due to mood depression. The patient has not been prescribed any psychotropic drugs recently.
Past psychiatric history
The patient has never been examined or treated for any mental disorders in the past. Recently she was hospitalized for a standard childbirth procedure.
Medication trials and current medication
She has not tried any medications in the past, neither is she under any medication currently.
Psychotherapy or previous psychiatric diagnosis
The patient has no history of psychiatric illness and has not been diagnosed or treated with any mental health disorder.
Pertinent substance use, social, and medical history
The patient denies any use of alcohol or cases of drug abuse in the family. Although she says that her uncle was not an opioid abuser, he committed suicide using GSW. She is married and currently lives with her husband with their two kids. She has been working in the retail business for the past five years, but currently, she is a housewife. The patient grew up with her sister together with her both parents. She has been diagnosed with hypertension recently, and she is taking drugs labelled as labetalol 100mg for HTN, which she says that she sometimes forgets to take them. The patient has no legal history or any issues related to violence.
Allergies
L.T is allergic to codeine. She gave birth two months ago, which automatically means that she is lactating. Currently, she is not using any form of contraceptive, and she has had no desire for sex since she gave birth.
ROS
General: No weight loss, fatigue or chills experienced by the patient.
HEET: Her vision is the same no issues of double vision or jaundice. Her ears, nose and throat are okay.
Skin: Her skin has not changed either is she having rashes.
Cardiovascular: No chest discomfort or pains.
Respiratory: She is not coughing or producing sputum, implying her respiratory is fine.
Gastrointestinal: She has eventually lost her appetite and wants to lose weight, although she is not vomiting or feeling abdominal pain.
Genitourinary: The urine colour or odour has not changed, and she is not experiencing any burns during urination. No headaches, no back or joint pains.
Hematologic: No bleeding realized or enlarged nodes.
Endocri ...
16Assignment templateSubjectiv
1
6
Assignment template
Subjective Section
Chief complainant
The patient starts by saying, "I can't stop crying, all the time." The patient complains that since she gave birth to her child two months ago, she has been experiencing mood disorders and difficulties falling asleep even after the baby is already asleep. She complains that especially when the baby cries, she loses her appetite and is not comfortable with her new body shape and size. She says nothing interests her, even writing, which was one of the things she loved before she gave birth. She does not want to contact her friends, and everything seems to be upsetting her.
History of present illness (HPI)
L.T is a 32-year-old black female who resents for psychiatric evaluation due to mood depression. The patient has not been prescribed any psychotropic drugs recently.
Past psychiatric history
The patient has never been examined or treated for any mental disorders in the past. Recently she was hospitalized for a standard childbirth procedure.
Medication trials and current medication
She has not tried any medications in the past, neither is she under any medication currently.
Psychotherapy or previous psychiatric diagnosis
The patient has no history of psychiatric illness and has not been diagnosed or treated with any mental health disorder.
Pertinent substance use, social, and medical history
The patient denies any use of alcohol or cases of drug abuse in the family. Although she says that her uncle was not an opioid abuser, he committed suicide using GSW. She is married and currently lives with her husband with their two kids. She has been working in the retail business for the past five years, but currently, she is a housewife. The patient grew up with her sister together with her both parents. She has been diagnosed with hypertension recently, and she is taking drugs labelled as labetalol 100mg for HTN, which she says that she sometimes forgets to take them. The patient has no legal history or any issues related to violence.
Allergies
L.T is allergic to codeine. She gave birth two months ago, which automatically means that she is lactating. Currently, she is not using any form of contraceptive, and she has had no desire for sex since she gave birth.
ROS
General: No weight loss, fatigue or chills experienced by the patient.
HEET: Her vision is the same no issues of double vision or jaundice. Her ears, nose and throat are okay.
Skin: Her skin has not changed either is she having rashes.
Cardiovascular: No chest discomfort or pains.
Respiratory: She is not coughing or producing sputum, implying her respiratory is fine.
Gastrointestinal: She has eventually lost her appetite and wants to lose weight, although she is not vomiting or feeling abdominal pain.
Genitourinary: The urine colour or odour has not changed, and she is not experiencing any burns during urination. No headaches, no back or joint pains.
Hematologic: No bleeding realized or enlarged nodes.
Endocri ...
Assignment Assessing and Treating Patients With ADHDNot onl.docx
Assignment: Assessing and Treating Patients With ADHD
Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD.
To prepare for this Assignment:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD.
The Assignment: 5 pages
Examine
Case Study: A Young Caucasian Girl with ADHD.
You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and referenc.
Anxiety and Depression in Adolescents with IBD: A Mentoring Model
A proposed mentoring model for adolescents with inflammatory bowel diseases and comorbid anxiety and depression
Decision TreeNumber of Pages 5 (Double Spaced)Number of s.docx
Decision Tree
Number of Pages: 5 (Double Spaced)
Number of sources: 5
Writing Style: APA
Type of document: Research Paper
Academic Level:Master
Category: Nursing
VIP Support: N/A
Language Style: English (U.S.)
Order Instructions:
Assignment : Practicum: Decision Tree
For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.
Learning Objectives
Students will:
•
Evaluate clients for treatment of mental health disorders
•
Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders
The Assignment:
Examine Case the case study: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.
At each Decision Point, stop to complete the following:
Decision #1: Differential Diagnosis
o
Which Decision did you select?
o
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
o
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
Decision #2: Treatment Plan for Psychotherapy
o
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
o
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
Decision #3: Treatment Plan for Psychopharmacology
o
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
o
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
•
Also include how ethical considerations might impact your treatment plan and communication with clients and their families.
The Case study: Anxiety disorder, OCD, or something else?
BACKGROUND
Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get s.
a 300- to 500-word response in which you address the following.docx
a 300- to 500-word response in which you address the following:
Provide the full DSM-5 diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
Explain why it is important to use an interprofessional approach in treatment. Identity specific professionals you would recommend for the team, and describe how you might best utilize or focus their services.
Explain how you would use the client’s family to support recovery. Include specific behavioral examples.
Select and explain an evidence-based, focused treatment approach that you might use in your part of the overall treatment plan.
Explain how culture and diversity influence these disorders. Consider how gender, age, socioeconomic status, sexual orientation, and/or ethnicity/race affect the experience of living with an eating disorder.
You
do not
need to include an APA reference to the DSM-5 in your response. However, your response should clearly be informed by the DSM-5, demonstrating an understanding of the risks and benefits of treatment to the client. You do need to include an APA reference for the treatment approach and any other resources you use to support your response.
THe case study is
The Case of Tiana
Intake Date
: August 2019
DEMOGRAPHIC DATA
: This was a voluntary intake for this 16-year-old single African American female. Tiana lives with her family in New York City, where she was born. She is currently in the 10th grade. Her dad works in the garment district and her mom works for a major hotel as the front desk manager. Tiana has an older brother and sister and one younger brother.
CHIEF COMPLAINT
: “My mom wanted me to go to therapy. She thinks I should be more social like my older sister was at this age. I do not agree. I can handle my life. I am doing fine. My grades are good.”
HISTORY OF PRESENT ILLNESS
: Tiana admitted to throwing up when she overeats several times per week. She finds herself eating a lot of sweets when she is under stress and is concerned about gaining weight. She found websites on the Internet describing ways to keep her weight down. Tiana reports that she was much heavier when younger and wants to confirm she doesn’t get like that again. Her fear of gaining weight contributes to her not engaging in social interaction with others. If her peers see what she eats, they may judge her so she chooses not to socialize a lot.
Tiana reported that she is stressed in school trying to get good grades. She doesn’t want to socialize, it makes her anxious and she needs to focus on her school. She has attempted to attend school activities, but they just brought up a lot of anxiety with all the students l.
Find a recent merger or acquisition that has been announced in the.docx
Find a recent merger or acquisition that has been announced in the media. What are the implications for the merger or acquisition and plans for implementing the blending firms? Also, evaluate and describe two possible technological innovations that may have led to the merger or acquisition. Would you have obtained this new technology or innovation differently? Why? Include the reference information of the article. Respond substantively to at least two other learners.
.
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Find an example of a document that misuses graphics. This can be a document that you have received (please blot out any sensitive information and names) or a document that you find on the Internet. Discuss how the graphics are misused and what could be done to better them. Address the three “Cs” of technical writing: Clarity, Conciseness, and Correctness. Add one or two personal experiences with this topic.
.
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Similar to Running head COMPREHENSIVE ASSESSMENT
Case#1A 24-year-old male graduate student without prior medical .docx
Case#1
A 24-year-old male graduate student without prior medical or psychiatric history is reported by his mother to have been very anxious over the past 6 months, with increasing concern that people are watching him. He now claims to “hearing voices,” telling him what must be done to “ fix the country.” Important workup ? thyroid-stimulating hormone TSH, rapid plasma reagain (RPR), and brain imaging.
Questions:
1. What is the diagnosis of this patient?
2. What is the age onset of this disorder?
3. What socioeconomic group suffers from this disorder?
4. What is the subtype of this disorder in this patient ?
5. List five positive and negative symptoms that we can find in schizophrenia disorder>
6. What is the treatment?
7. What are five characteristics associated with better prognosis?
Case#2
Ms. Torrez is a 17-year-old Caucasian woman without prior psychiatric history who is brought to the Emergency room by ambulance after her parents called 911 when they found her having a seizure in their living room. She was admitted to the medical intensive care units in status epilepticus and was quickly stabilized with intramuscular lorazepam and fosphenytoin loading. Her heigh is 5 feet 6 inches, she is of medium build, and her weight is 101 lbs. (BMI16.3kg/m2). She does not suffer any medical conditions, and this is her first seizure. Laboratory workup shows an electrolyte imbalance as the most likely cause of the seizures. Although initially reluctant, she admits to purging with the use of ipecac several times this week. She reports that although she normally restricts her daily caloric intake to 500 calories, she regularly induces vomiting if her weight is above 100 lbs. Her last menstrual cycle was 1 year ago. Psychiatric consultation is requested in order to confirm the diagnosis
The on-call psychiatry notes in Terry’s chart
Patient appears underweight and younger than her stated age. She is mild distress, has a nasogastric tube in place, and exhibits poor eye contact. She reports feeling “sad” and admitted to experiencing constant preoccupation about her physical appearance and says, “I am fat; I hate my body.” She also reports insomnia, low energy levels, and history of self-harm behavior by cutting her forearms. She reports that she is careful hiding her symptoms from her parents, whom she describes as strict disciplinarians. She also expresses concerns that she will disappoint them.
Ms. Torrez’ parents describe her as a perfectionist. They say that she is involve in multiple school activities, takes advanced placement classes, and has been recently concerned about being accepted at her college of choice. They report that she maintains a 4.0 grade point average in high school, and they are expecting her to become a lawyer. Her parents have noticed that she is underweight and rarely see her eat but attributed this to stress from her many academic pursuits. Ms. Torrez’ mom was diagnosed with obsessive-compulsive disorder.
Qu.
1Family Assessment and Psychotherapeutic ApproachesCol
1
Family Assessment and Psychotherapeutic Approaches
College of Nursing-PMHNP, Walden University
NRNP 6645: Psychotherapy with Multiple Modalities
June 13, 2021
2
Abstract
As providers, it is vital to be open-minded, if you are not aware or do not understand a person’s
culture, show your patients respect. Be engaged, respectful, and ask questions. Learn from your
patients, this helps develop a rapport. As providers we are obligated to provide optimal care, if
we feel a patient's needs are out of our scope, the client should be referred to a provider that can
give them the help they need and deserve (Nichols & Davis, 2020).
The purpose of this paper is to provide documentation and a psychiatric comprehensive
assessment of a patient and family during a family therapy interview that highlights differences
in a multicultural family, respecting cultural norms and differences, and develop an
individualized treatment plan.
Keywords: Family therapy
3
Family Assessment and Psychotherapeutic Approaches
Subjective:
CC (chief complaint): “I like to learn to live on my own and not depend on the kids.”
HPI: A 40-year-old female (Patti) and her five children (Sheela age 24, Sharleen aged 23
and present today, Shireen age 21 recently reunited with family, Armin Jr. age 18, and Sam age
15), of Iranian descent, has been in individual and family therapy for the last 18 months. Patti
came to the clinic related to chaos in the home after her daughter was finally reunited with the
family after ten years. The family initially had rejoiced and celebrated, and after a few weeks,
Shireen began to tell her mother and siblings the emotional, physical, and sexual abuse at the
hands of her father. She blamed and felt abandoned by her mother. Patti needed necessary
surgery to both her feet after an injury, that has now left her disabled and with chronic pain. The
additional burden of surgery and disability has increased tension and stress in the home. Patti
lives with her two sons; her daughters live on their own. Shireen recently moved out, marrying
someone the family does not know, with little contact. Mother speaks and sees Sheela and
Sharleen daily. Patti has increasingly felt alone, depressed, hopeless, and helpless wanting her
daughters to stay and help her at her home. A psychiatric provider has been referred for a
medication evaluation.
Past Psychiatric History:
General Statement: Patti and her family began therapy 18 months ago after daughter
Shireen reunited with the family after 12 years of separation. Shireen shared significant abuse
she experienced, learning the trauma she went through brought on many emotions of the family
including blame, guilt, shame increasing stress on the family.
Caregivers: N/A
4
Hospitalizations: Patti denies any past psychiatric hospitalizations or history. The patient
has no history of substance abuse or residential treatment. Patti denies suicidal and homicid ...
Abnormal Psychology (Psychiatric history) Case Study
FOR TAKING CASE HISTORY FOR THE COMPLETION OF PRACTICAL WORK OF ABNORMAL PSYCHOLOGY
The AssignmentExamine Case Study A Young Caucasian Girl.docx
The Assignment
Examine
Case Study: A Young Caucasian Girl With ADHD
You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
·
Decision #1
o Which decision did you select?
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with
Decision #1 and the results of the decision. Why were they different?
·
Decision #2
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
·
Decision #3
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with
o Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Note: Support your rationale with a minimum of three academic resources no more than five years old in APA Format
Attention Deficit Hyperactivity Disorder
A Young Girl With ADHD
BACKGROUND
Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition.
The parents give the PMHNP a copy of a form titled
“Conner’s Teacher Rating Scale-Revised”.
This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on in.
16Assignment templateSubjectiv
1
6
Assignment template
Subjective Section
Chief complainant
The patient starts by saying, "I can't stop crying, all the time." The patient complains that since she gave birth to her child two months ago, she has been experiencing mood disorders and difficulties falling asleep even after the baby is already asleep. She complains that especially when the baby cries, she loses her appetite and is not comfortable with her new body shape and size. She says nothing interests her, even writing, which was one of the things she loved before she gave birth. She does not want to contact her friends, and everything seems to be upsetting her.
History of present illness (HPI)
L.T is a 32-year-old black female who resents for psychiatric evaluation due to mood depression. The patient has not been prescribed any psychotropic drugs recently.
Past psychiatric history
The patient has never been examined or treated for any mental disorders in the past. Recently she was hospitalized for a standard childbirth procedure.
Medication trials and current medication
She has not tried any medications in the past, neither is she under any medication currently.
Psychotherapy or previous psychiatric diagnosis
The patient has no history of psychiatric illness and has not been diagnosed or treated with any mental health disorder.
Pertinent substance use, social, and medical history
The patient denies any use of alcohol or cases of drug abuse in the family. Although she says that her uncle was not an opioid abuser, he committed suicide using GSW. She is married and currently lives with her husband with their two kids. She has been working in the retail business for the past five years, but currently, she is a housewife. The patient grew up with her sister together with her both parents. She has been diagnosed with hypertension recently, and she is taking drugs labelled as labetalol 100mg for HTN, which she says that she sometimes forgets to take them. The patient has no legal history or any issues related to violence.
Allergies
L.T is allergic to codeine. She gave birth two months ago, which automatically means that she is lactating. Currently, she is not using any form of contraceptive, and she has had no desire for sex since she gave birth.
ROS
General: No weight loss, fatigue or chills experienced by the patient.
HEET: Her vision is the same no issues of double vision or jaundice. Her ears, nose and throat are okay.
Skin: Her skin has not changed either is she having rashes.
Cardiovascular: No chest discomfort or pains.
Respiratory: She is not coughing or producing sputum, implying her respiratory is fine.
Gastrointestinal: She has eventually lost her appetite and wants to lose weight, although she is not vomiting or feeling abdominal pain.
Genitourinary: The urine colour or odour has not changed, and she is not experiencing any burns during urination. No headaches, no back or joint pains.
Hematologic: No bleeding realized or enlarged nodes.
Endocri ...
16Assignment templateSubjectiv
1
6
Assignment template
Subjective Section
Chief complainant
The patient starts by saying, "I can't stop crying, all the time." The patient complains that since she gave birth to her child two months ago, she has been experiencing mood disorders and difficulties falling asleep even after the baby is already asleep. She complains that especially when the baby cries, she loses her appetite and is not comfortable with her new body shape and size. She says nothing interests her, even writing, which was one of the things she loved before she gave birth. She does not want to contact her friends, and everything seems to be upsetting her.
History of present illness (HPI)
L.T is a 32-year-old black female who resents for psychiatric evaluation due to mood depression. The patient has not been prescribed any psychotropic drugs recently.
Past psychiatric history
The patient has never been examined or treated for any mental disorders in the past. Recently she was hospitalized for a standard childbirth procedure.
Medication trials and current medication
She has not tried any medications in the past, neither is she under any medication currently.
Psychotherapy or previous psychiatric diagnosis
The patient has no history of psychiatric illness and has not been diagnosed or treated with any mental health disorder.
Pertinent substance use, social, and medical history
The patient denies any use of alcohol or cases of drug abuse in the family. Although she says that her uncle was not an opioid abuser, he committed suicide using GSW. She is married and currently lives with her husband with their two kids. She has been working in the retail business for the past five years, but currently, she is a housewife. The patient grew up with her sister together with her both parents. She has been diagnosed with hypertension recently, and she is taking drugs labelled as labetalol 100mg for HTN, which she says that she sometimes forgets to take them. The patient has no legal history or any issues related to violence.
Allergies
L.T is allergic to codeine. She gave birth two months ago, which automatically means that she is lactating. Currently, she is not using any form of contraceptive, and she has had no desire for sex since she gave birth.
ROS
General: No weight loss, fatigue or chills experienced by the patient.
HEET: Her vision is the same no issues of double vision or jaundice. Her ears, nose and throat are okay.
Skin: Her skin has not changed either is she having rashes.
Cardiovascular: No chest discomfort or pains.
Respiratory: She is not coughing or producing sputum, implying her respiratory is fine.
Gastrointestinal: She has eventually lost her appetite and wants to lose weight, although she is not vomiting or feeling abdominal pain.
Genitourinary: The urine colour or odour has not changed, and she is not experiencing any burns during urination. No headaches, no back or joint pains.
Hematologic: No bleeding realized or enlarged nodes.
Endocri ...
Assignment Assessing and Treating Patients With ADHDNot onl.docx
Assignment: Assessing and Treating Patients With ADHD
Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD.
To prepare for this Assignment:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD.
The Assignment: 5 pages
Examine
Case Study: A Young Caucasian Girl with ADHD.
You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and referenc.
Anxiety and Depression in Adolescents with IBD: A Mentoring Model
A proposed mentoring model for adolescents with inflammatory bowel diseases and comorbid anxiety and depression
Decision TreeNumber of Pages 5 (Double Spaced)Number of s.docx
Decision Tree
Number of Pages: 5 (Double Spaced)
Number of sources: 5
Writing Style: APA
Type of document: Research Paper
Academic Level:Master
Category: Nursing
VIP Support: N/A
Language Style: English (U.S.)
Order Instructions:
Assignment : Practicum: Decision Tree
For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.
Learning Objectives
Students will:
•
Evaluate clients for treatment of mental health disorders
•
Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders
The Assignment:
Examine Case the case study: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.
At each Decision Point, stop to complete the following:
Decision #1: Differential Diagnosis
o
Which Decision did you select?
o
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
o
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
Decision #2: Treatment Plan for Psychotherapy
o
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
o
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
Decision #3: Treatment Plan for Psychopharmacology
o
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
o
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
•
Also include how ethical considerations might impact your treatment plan and communication with clients and their families.
The Case study: Anxiety disorder, OCD, or something else?
BACKGROUND
Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get s.
a 300- to 500-word response in which you address the following.docx
a 300- to 500-word response in which you address the following:
Provide the full DSM-5 diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
Explain why it is important to use an interprofessional approach in treatment. Identity specific professionals you would recommend for the team, and describe how you might best utilize or focus their services.
Explain how you would use the client’s family to support recovery. Include specific behavioral examples.
Select and explain an evidence-based, focused treatment approach that you might use in your part of the overall treatment plan.
Explain how culture and diversity influence these disorders. Consider how gender, age, socioeconomic status, sexual orientation, and/or ethnicity/race affect the experience of living with an eating disorder.
You
do not
need to include an APA reference to the DSM-5 in your response. However, your response should clearly be informed by the DSM-5, demonstrating an understanding of the risks and benefits of treatment to the client. You do need to include an APA reference for the treatment approach and any other resources you use to support your response.
THe case study is
The Case of Tiana
Intake Date
: August 2019
DEMOGRAPHIC DATA
: This was a voluntary intake for this 16-year-old single African American female. Tiana lives with her family in New York City, where she was born. She is currently in the 10th grade. Her dad works in the garment district and her mom works for a major hotel as the front desk manager. Tiana has an older brother and sister and one younger brother.
CHIEF COMPLAINT
: “My mom wanted me to go to therapy. She thinks I should be more social like my older sister was at this age. I do not agree. I can handle my life. I am doing fine. My grades are good.”
HISTORY OF PRESENT ILLNESS
: Tiana admitted to throwing up when she overeats several times per week. She finds herself eating a lot of sweets when she is under stress and is concerned about gaining weight. She found websites on the Internet describing ways to keep her weight down. Tiana reports that she was much heavier when younger and wants to confirm she doesn’t get like that again. Her fear of gaining weight contributes to her not engaging in social interaction with others. If her peers see what she eats, they may judge her so she chooses not to socialize a lot.
Tiana reported that she is stressed in school trying to get good grades. She doesn’t want to socialize, it makes her anxious and she needs to focus on her school. She has attempted to attend school activities, but they just brought up a lot of anxiety with all the students l.
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Financial mangers make decisions today that will affect the firm in the future. The dollars used for investment expenditures made today are different from the cash flows to be realized in the future. What are these differences? What are some of the techniques that can be used to adjust for these differences?
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Financial Laws and RegulationsComplete an APA formatted 2 page pap.docx
Financial Laws and Regulations
Complete an APA formatted 2 page paper (not including the title and reference pages) answering the following questions:
What are five elements pertaining to the establishment of a false claim under the False Claims Act?
HIPAA privacy standards were designed to accomplish what three broad objectives? Explain each.
Stark II laws prohibit physician referrals to entities in which the physician has a financial relationship. What are 10 specific designated health services (DHS) for which referrals by physicians who have financial relationships with the entity providing the DHS are prohibited?
Discuss the following:
Qui tam
HIPAA Privacy Rule
EMTALA
Compliance programs
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Financial Management DiscussionWhen reviewing the financial st.docx
Financial Management Discussion
When reviewing the financial statements of a company, there are many different ratios to choose from. Choose a ratio that looks at liquidity, solvency and profitability and discuss its importance.
75- 150 words required.
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Final Written Art Project (500 words) carefully and creatively wri.docx
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WRITTEN ART PROJECT
Create a disjunctive or non-narrative piece
that engages all three aspects of reality that we have been discussing throughout the quarter: 1) larger political, social, and economic realities 2) personal or human dramatic situation and 3) detritus of existence. Make sure each of these are well represented and that they do not merely serve as a backdrop or props for other parts of your piece. In other words, make sure each of these aspects of reality is given its due as determining of your or others reality.
Possible Strategies and Advice:
Switch between first and third person perspectives. Make use of actual seeings—what you see. Describe and only occasionally explain or meditate. Meditate a great deal but be sure you are specific . Enact and don’t preach.
Create a concept (a title for your piece) that gives the reader a sense of the intent of your work.
This concept should serve to suggest complementary or conflictual relations between the different parts of your piece. Ultimately in placing all your parts together, in proximity to one another, you want the “whole” to be greater than the sum of the parts.
ARTIST STATEMENT
Please describe the intent of your piece and how you think its disjunctive form allows you to create a sense of reality that you wish to create. Please consider key words and concepts from the module syllabus as well as the ideas that have emerged from course discussions and thought challenges. You might also find these artist’s statements of use:
Chekov
Remove everything that has no relevance to the story. If you say in the first chapter that there is a rifle hanging on the wall, in the second or third chapter it absolutely must go off. If it’s not going to be fired, it shouldn’t be hanging there.
Marguerite Duras
Sometimes I realize that if writing isn’t, all things, all contraries confounded, a quest for vanity and void, it’s nothing. (
The Lover,
8)
Leslie Scalapino
I intended this writing to be the repetition of historically real events the writing of which punches a hole in reality. . . . There was when writing the work something else going interiorily besides what’s going on in segments.
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Final Research Paper Research the responsibility of a critical t.docx
Final Research Paper
Research the responsibility of a critical thinker in a contemporary society. You may choose any topic that deals with a contemporary social concern. Examine the principles of critical thought in relation to the chosen societal concern, and consider the importance of ethics, moral reasoning, a research-based process to search for truth, and the advantages of information technology in gathering data.
Potential social concerns include, but are not limited to health (e.g., obesity, smoking, or underage drinking), poverty (e.g., homelessness, basic needs, or transportation issues), family relations and dynamics (e.g., teen violence, physical abuse, depression, or suicide), social media (e.g., privacy), immigration (e.g., illegal), and education (e.g., plagiarism and/or cheating).
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Financial management homeworkUnit III Financial Planning, .docx
Financial management homework
Unit III
Financial Planning, the Financial System and Governance
Review:
Learning Activities (Non-Graded):
See Study Guide
Read:
Chapter 4:
Financial Planning
Chapter 5:
The Financial System, Corporate Governance, Interest, and the Financial Crisis of 2008
Submit:
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Final ProjectThe Final Project should demonstrate an understanding.docx
Final Project
The Final Project should demonstrate an understanding of the reading assignments, class discussions, your own research and the application of new knowledge. It should utilize previous skills developed in foundational health care courses and apply them within the context and viewpoint of a health care administrator and their role in managing health and human services.
For the Final Project, select one of the following topics and conduct scholarly and professional research while integrating the course’s learning outcomes to address a selected topic:
Research specific leadership and management traits and theories necessary for managing a multidisciplinary and multicultural health care organization to promote organizational effectiveness.
Present how strategic planning, performance improvement, and information systems are interrelated and fundamental to the delivery of quality health care.
Examine the financial characteristics of health care delivery along with managing costs, revenues, and human resources.
Analyze ethical and legal concepts, including specific federal regulations, required of health care organizations to ensure the delivery of high quality health care that protects patient safety.
Research Requirements
Academic research and papers must meet certain standards of quality that are recognized by the academic community. What constitutes quality academic research?
The use of primary (original), credible sources written by experts in the field of study.
Ensuring secondary sources are supported by research in primary sources.
Making sure all research is relevant and that material used is pertinent to the area of study.
In graduate work, the use of peer-reviewed journal articles (journal articles reviewed by recognized experts in the relevant field of study) is required.
Keep in mind that educational websites may be appropriate, in some cases, but should be evaluated carefully.
The Ashford University Library offers many excellent databases and other resources to assist you in conducting scholarly research.
What sources are not acceptable for academic research and referencing?
Encyclopedias
Dictionaries
Wikipedia, other wikis, or blogs
Websites and other sources that do not provide quality researched materials (e.g., they do not use credible sources to support the information in the document).
All research must reflect professional academic protocol and must be documented according to APA standards as outlined in the Ashford Writing Center.
Creating the Final Project
You may choose to present your research is the form of an eight- to ten-page research paper (excluding title and reference pages) or a comprehensive 10- to 15-slide PowerPoint presentation (excluding title and reference slides) with detailed speaker notes. In either case, the content of the assignment must include each of the elements listed below:
Introduction
Describe the issue. Include why it was selected, the perspective of your appr.
Final ProjectImagine that you work for a health department and hav.docx
Final Project
Imagine that you work for a health department and have been asked to make a presentation to a group of health care professionals on the role and responsibilities of community and public health.
After reviewing the materials throughout the course and based on what you have learned, create a PowerPoint presentation of at least six slides that covers the following topics:
Describe the role of community and public health in the well-being of populations.
Describe the public health organizational structure.
Examine the legal and ethical dimensions of public and community health services.
Analyze funding of public and community health services.
Discuss the role of communication in community and public health programs.
Creating the Final Project
The Final Project:
Must be created using a screencast program such as Jing, Screencast-O-Matic, Screenr, or other audio/video program.
Must be a minimum of six PowerPoint slides in length (excluding title and reference slide), and formatted according to APA style as outlined in the Ashford Writing Center.
Must include a title slide with the following:
Title of presentation
Student’s name
Course name and number
Instructor’s name
Date submitted
Must include a succinct thesis that is presented on the opening slide.
Must address the topics with critical thought.
Must use at least four scholarly sources (not including the course text), including a minimum of two from academic journals found in the Ashford University Library. Other sources should be obtained from appropriate epidemiological information.
Must document all sources in APA style, as outlined in the Ashford Writing Center.
Must include a separate reference slide, formatted according to APA style as outlined in the Ashford Writing Center.
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Running head COMPREHENSIVE ASSESSMENT
- 1. Running head: COMPREHENSIVE ASSESSMENT 1 COMPREHENSIVE ASSESSMENT 1 Comprehensive Client Family Assessment and Genogram Tania Gonzalez Diaz Walden University NURS:6640 March 14,2020 Comprehensive Assessment 1. Demographic information: The patient is a 17-year-old black girl. She is escorted by her parents to the clinic after a recommendation from the school counsellor. 2. Presenting problem: According to the father, "our daughter is not feeling well. She has not been attending classes and she tried to commit suicide. We think she is depressed". 3. History of present illness.: On today visit, patient present awake, alert and oriented, calm, cooperative, organized, with good hygiene.According to the young girl who was ready to share her feelings, she started feeling pressure from schoolwork when she was in her junior year. Her grades were not so good, and she felt useless and that is why she started being a truant. One year later, after starting her senior year, she feels the pressure is too much and she cannot manage to go through the year. One day before being referred to the clinic by the school counsellor, she was found bleeding in the school washroom after she slit her wrist.
- 2. 4. Past psychiatric history: Since her frustration with school started a year ago, she has never been diagnosed with any psychiatric disorder. The parents though that she was simply going through a phase as a teenager and they were trying to help her cope with school and be a better person. No past psychiatric history. No history of Abuse. 5. Medical history: Despite her recent issue and the fact that she lost her weight suddenly, in the past few months, she is of perfect health. she had asthma and chicken pox when she was young, and she is allergic to penicillin. 6. Substance use history: She has no history of substance abuse. Her parents describe her as a very good girl. 7. Developmental history: Her mother had a successful pregnancy and gave birth to her through normal delivery. She grew up with her older siblings and she achieved all developmental milestones. They have been going to church every Sunday and she is part of the local church youths. Her parents have been married for a while and they are still together. She went through her education as a bright girl until her junior high level when she started failing and missing classes. 8. Family psychiatric history: Her older sister has epilepsy, but her seizures remain under control. There is no other form of psychiatric history in the family 9. Psychosocial history: She has always been an active member of the church youth and they have been doing many activities together since they were in Sunday school. She has also been making many friends from high school but recently, she just wants to be alone 10. History of abuse and trauma: There is no history of abuse or trauma. The parents say that they love and take good care of their daughter and provide everything she wants. 11. Review of systems: She states that she has been feeling sad and irritable all the time. She has not been eating well because of lack of appetite and she finds trouble getting and sustaining sleep. She feels like her life makes no sense because she has
- 3. been doing very bad in school and she feels bad about it. She denied any heart palpitation, anxiety, sweating or panic attacks. However, she says that she always felt the sense of doom and that is why she went ahead and slit her wrist. HEENT: normal, Respiratory/Chest/Lungs: CTA AP&L: no respiratory problems, no SOB; Breast: Normal, GI: Normal, GU: Normal, Neuro: AAOx3, Endocrine: Normal; Genital/Rectal: Normal condition, 12. Physical assessment: Head and neck are normal. Chest and abdominal examination are normal. No headache, no dizzy, are normal and musculoskeletal examination is normal. 13. Mental status exam: She appears normal and well dressed for the weather. She readily shares her feelings and her shoulders are constantly sagging. She avoids eye contact and expresses guilt for her actions. She has logical judgement and understands the need not to cause harm to herself and the implications to her family. Her perception is normal, and her speech is shaky and traumatized. There are no movement abnormalities. 14. Differential diagnosis: Major depressive disorder, Bipolar disorder, Anxiety disorder 15. Case formulation: The client is a young teenage girl of African American origin. She is 17-year-old and experiencing sadness, worthlessness, hopelessness, fatigue, depressed mood, lack of interest in education and life and she has unsuccessfully attempted suicide. These are symptoms that meet the criteria for diagnosing MDD (American Psychiatric Association, 2013). The stressor for this client is her studies and pressure from family to achieve. In American adolescents, studies have shown that they deal with depression in different ways including aggressive behavior to others and having others reach out (Al-Khattab, Oruche, Perkins & Draucker, 2016). In this case, the client might have attempted suicide for many reasons including as a cry for help. There is need to include the parents in helping her cope with the situation at school. Being an adolescent and a woman might have also increased her susceptibility especially when social support was not enough when she needed it as
- 4. scholars have established in a research (Van Droogenbroeck, Spruyt & Keppens, 2018). 16. Treatment plan: The client should be started on a cognitive therapy first in order to change her thought process and pattern with a view of promoting positive thinking and changing her behavioral pattern as well (Chand & Arif, 2019). In the case that antidepressants are considered necessary, the parents shall be consulted, and they shall be informed about the risks and benefits of using them before they give consent to any pharmacological treatment. However, CBT should be effective with the support from family and teachers at school. Genogram Great Grandparents All Deceased All grandparents Deceased Parents Alive
- 5. Client ID Male Female References Al-Khattab, H., Oruche, U., Perkins, D., & Draucker, C. (2016). How African American adolescents manage depression: Being with others. Journal of the American Psychiatric Nurses Association, 22(5), 387-400 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub Van Droogenbroeck, F., Spruyt, B., & Keppens, G. (2018). Gender differences in mental health problems among adolescents and the role of social support: results from the Belgian health interview surveys 2008 and 2013. BMC psychiatry, 18(1), 6. Chand, S., & Arif, H. (2019). Depression. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430847/ DM ALD CHD
- 7. Ok OK MDD