Asignment3

NRNP 6635: Psychopathology and Diagnostic Reasoning
Week 3: Mood Disorders
While most people experience the sadness or grief at some point in their lives, it is typically of short duration and may occur in response to some type of loss. Clinically significant depression, on the other hand, is more disruptive and serious. It lasts longer and has more symptoms that interfere with daily functioning.
This week, you will explore the differences among mood disorders such as depressive, bipolar, and related disorders, and you will examine challenges in properly differentiating among them for the purpose of accurately rendering a diagnosis. You also will look at steps that can be taken to increase the likelihood that patients who are diagnosed with these disorders benefit from treatment and refrain from physically harming themselves or others.

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.
For the assignment:
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.).
Include an introduction, purpose statement, reflection, and conclusion

Learning Resources

Case study
use Training title #43 video, transcript and case history report
https://video-alexanderstreet-com.eu1.proxy.openathens.net/p/QkOkjLL00
https://video.alexanderstreet.com/embed/training-title-43
Index, Episode 43 (Santa Monica, CA: Symptom Media, 2016)
Training Title 43

Translate
00:00:00TRANSCRIPT OF VIDEO FILE:
00:00:00______________________________________________________________________________
00:00:00BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15OFF CAMERA Hello Mr. Loman. How are you doing today?
00:00:15PATIENT Um… I have a bit of a head cold, but I’m feeling pretty good.
00:00:20OFF CAMERA Are you taking your medications regularly?
00:00:25PATIENT Yeah, uh, about four times a day. Every meal and just before bed.
00:00:30OFF CAMERA Do these medications make you feel any different?
00:00:30PATIENT Yeah, um, I feel a little bit shaky. And kind of stiff. I especially noticed that when I was playing ping pong in the day room.
00:00:40OFF CAMERA Yes, those are side effects from, from these medications. They won’t hurt you even though it makes you feel uncomfortable. Although you are stiff and shake some, make certain to stay on these medications. They do seem to help you with your thinking and controlling yourself. Can you tell the difference?
00:01:00PATIENT Oh yeah, the little things hardly affect me at all anymore. In fact, I uh, I was wondering if, maybe I could go home today.
00:01:15OFF CAMERA Well uh, I know you would enjoy going home. But why don’t we wait a few days ok, so we can make absolutely sure we have you on the right medication and absolutely sure that this is the correct dose. Ok?
00:01:35[Patient nods his head forlornly]
00:01:40PATIENT Ok.
00:01:40OFF CAMERA Do you remember what you’re thinking and, and uh, was like that first day when you came in?
00:01:45PATIENT Well, I… felt excited. I had a lot of energy. I don’t think I could see very well, things seemed scary like going really fast. I… I just didn’t feel like myself.
00:02:05OFF CAMERA Yeah. I understand that you did a lot of things that just were not like you. Your mother said, and these are embarrassing things, but that you pulled down your pants at the mall, and you uh, spent a lot of money and you yelled, a lot of sexual and mean comments at other, at other people. And then I observed that when you came in, your speech was very fast and very disorganized.
00:02:35PATIENT Yeah, that um… that is just not like me.
00:02:45OFF CAMERA Yeah, so, how do you feel about going home, and seeing friends, and family members, people who were seeing how you were acting.
00:03:00PATIENT Not, not very good. I, uh… don’t think they would want to talk to me again. They probably think I’m a loony.
00:03:10OFF CAMERA Uh, so it’s going to be very important when you go home to, to stay on these medicines. So you can be back in control.
00:03:20PATIENT Yeah. I don’t want to lose control again.
00:03:30OFF CAMERA Good. Good. I know taking medicines is not fun, but it’s really going to be important for you to do that. Are there some other things you’re doing to prepare for going home?
00:03:45PATIENT Well, I’m making some gifts for my family in the common room. Um, I’m talking to them on the phone a lot. I uh, I’m really missing being home.
00:04:05[sil.]
00:04:05END TRANSCRIPT