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Name: PRAC_6675_Week4_Discussion_Participant_Rubric
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Points: Points Range: Responses exhibit synthesis, critical thinking, and application to practice settings. Responses provide clear, concise opinions and ideas that are supported by at least two scholarly sources. Responses demonstrate synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Presenters’ prompts/questions posed in the case presentations are thoroughly addressed. Responses are effectively written in standard, edited English. Feedback: |
Points: Points Range: Responses exhibit critical thinking and application to practice settings. Responses provide clear, concise opinions and ideas that are supported by 2 or more credible sources. Communication is professional and respectful to colleagues. Presenters’ prompts/questions posed in the case presentations are addressed. Responses are effectively written in standard, edited English. Feedback: |
Points: Points Range: Responses are on topic and may have some depth. Responses may lack clear, concise opinions and ideas, and only one or no credible sources are cited. Responses posted in the Discussion may lack effective professional communication. Presenters’ prompts/questions posed in the case presentations are inadequately addressed. Feedback: |
Points: Points Range: Responses may not be on topic and lack depth. No credible sources are cited. Responses posted in the Discussion lack effective professional communication. Responses to colleagues’ prompts/questions are missing. Feedback: |
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Please see if they can be ready tonight. Thank you. Discussion Questions 1. Identify other ways to encourage medication compliance in a patient with a paranoid personality disorder. 2. Identify other alternative therapies that will be beneficial in managing an individual with a paranoid personality disorder. 3. Identify one other type of psychotherapy that will effectively manage paranoid personality disorder. Discussion Questions / Prompts: 1. Distinguish anxiety disorders and their common symptoms, specifically panic disorder, and generalized anxiety disorder 1. Identify screening instruments for anxiety and depression 1. Demonstrate understanding of the pharmacologic and nonpharmacologic treatments for panic and anxiety disorders Discussion Questions: 1. Would you have another differential diagnosis for this patient? If yes, why? 2. Would you recommend any other medications for the patient? What is your rationale? 3. What other therapy would you have recommended for the patient and his family? Participants: Review the Grand Rounds Participant Rubric to ensure you meet the scoring criteria. Rubric is enclosed. NRNP/PRAC 6665 & 6675 Comprehensive Focused SOAP Psychiatric Evaluation Template College of Nursing-PMHNP, Walden University NRNP 6675 PRAC: Care Across the Life Span II Date:
Objectives: At the end of this presentation, this class will be able to: 1. Distinguish anxiety disorders and their common symptoms, specifically panic disorder and generalized anxiety disorder 2. Identify screening instruments for anxiety and depression 3. Demonstrate understanding of the pharmacologic and nonpharmacologic treatments for panic and anxiety disorders Subjective: CC: “I am having panic attacks and can’t sleep; I’m just not right and I need help.” HPI: S.A. is a 54-year-old white male who presents for initial psychiatric evaluation with complaint of panic attacks, anxiety and insomnia for the past two years. He reports one episode of psychosis two years ago while undergoing divorce. He was off his prescription opiods then. He married his wife for 26 years but got divorced in 2021. He was unexpectedly served with a divorce paper after returning from searching for a job in Los Angeles. He feels it’s difficult to get back to work. . He reports low self-esteem and self-doubts. He feels broken, hopeless, and helpless. He is positive for dysphoria and anhedonia. He reported recurrent panic attacks that occur 3-4 times daily, followed by shortness of breath, shaking, flushing, and fear of death. He previously visited the emergency department few times for help. He reports increased appetite, eating excessively, and insomnia. He worries a lot about work and finances, which worsens his insomnia. He reports feeling anxious, poor concentration, his mind going blank, and feeling restless and on the edge. His rates his anxiety level 7-9/10. He denies any suicidal or homicidal ideations stating “ I’m a spiritual person, I don’t believe in that.” After the divorce in 2021, he reports feeling the devil’s presence in the house, which continued for three months. He did not seek for help. He reports increased alcohol consumption during that time. Also, then, he talked much, became impulsive, had nervous twitching, and made poor decisions. Past Psychiatric History: No impatient psych. Reported psychotherapy treatment due to his back injury, no longer attending. Medication Trials: No psychotropic medication, reported he was prescribed opiods for back injury he sustained at work. Substance Current Use and History: He reports increased alcohol consumption while undergoing divorce and after, but received no treatment. He usually drinks 2-3 drinks, three times a week. He is a non-smoker. He deniesr illicit substance use. Psychosocial History: Patient is divorced white, heterosexual male who was born and raised in NY. He moved to San Diego at 8 1 Week 4: Complex Case Study – Presentation Master of Science in Nursing, Walden University PRAC-6675-33: PMHNP Care Across the Lifespan 11 Practicum Date:
Complex Case Study This case study is about a 13-year-old Caucasian female to male transgender patient. He wanted to be addressed with masculine pronouns, but his parents are not accepting his transgender identity causing him a lot of stress, anxiety, and depression for the past two years (Sadock et al,2015). The purpose of this paper is to assess and diagnose a transgender youth, develop a focused SOAP note with differential diagnosis, and formulate a treatment plan of care and a case presentation. Learning Objectives: By the end of this presentation, my audience should be able to : · Recognized the signs and symptoms contributing to distress in a transgender individual. · Outline the typical presentation of transgender youth with gender dysphoria. · Identify the appropriate treatment plan for transgender youth with depressive and anxiety disorder and the rationale for the treatment (Garg et al., 2022). Patient Information: Initials: PK Age: 13 years Sex: Male Race: Caucasian
Subjective Chief complaint: “They don’t understand is my life.” HPI: 13 years old Caucasian female to male transgender youth presented to the clinic for psychiatric evaluation. The patient reports he recently came out as transgender. Stated, “when I told my parents and other family members to call me Alex and address me as he and him they refuse to honor my wish”. He stated I like to wear only boys’ clothes and want to do things like boys but my parents are not accepting my wish and won’t let me. Reports increased anxiety, depression, difficulty concentrating on school work, and afraid he is going to fail his final examination (Sadock et.al, 2015). He expresses frustrations in developing secondary characteristics associated with females. Reports feeling very sad for the past month and sleeping a lot during the day because he does not want to see anybody. He endorses low self-esteem, eats a lot more causing him to gain 7 pounds weight within a month, anger, and suicidal thought. But he denies any plans of harming herself, and others currently (Walkup, 2017).
Past Psychiatric History: Medications trials and current medications: No medication trial reported · Currently taking Fluoxetine 40 mg orally daily. For anxiety and depression.
Psychotherapy or previous psychiatric diagnosis: · Reports family psychotherapy- 6 months ago. · History of anxiety and depression r/t gender identity issues.
Substance Current Use: · Denied any past or current substance use.
Family Psychiatric/Substance Use History
NRNP/PRAC 6665 & 6675 Comprehensive Focused SOAP Psychiatric Evaluation Template
Week 4: Grand Rounds Discussion: Complex Case Study Presentation College of Nursing-PMHNP, Walden University PRAC 6675: PMHNP Care Across the Lifespan II Graduate Studies Date: At the end of the presentation, the audience will understand the objectives below.
Objectives for this presentation: 1. The audience will be able to summarize the defining characteristics of paranoid personality disorder as identified in the DSM 5 manual. 2. The audience will understand how to diagnose paranoid personality disorder accurately. 3. The audience will gain insight into possible pharmacological management of paranoid personality disorder 4. The audience will be able to identify nonpharmacological management of paranoid personality disorder. Subjective: CC (chief complaint): “ I suspect my neighbors want to hurt me”. HPI: R.H is a 46-year-old African American female who presents for follow-up with a concern of feeling suspicious of her neighbors. She reported feelings of suspicion, which began when she was about 22 years old. She explained that she suspects her neighbor is conspiring to hurt her, but she cannot justify her suspicion. She explained that her neighbor insulted her, which led her to bear grudges toward her neighbor. This incident resulted in her paying her friend to have the windscreen of her neighbor’s car shot. She reported that her friend took her money and did not shoot the neighbor’s car windscreen resulting in her developing homicidal thoughts towards her friend. She narrated going to a psychiatric hospital for homicidal ideation towards the said friend and got hospitalized for two days. She reported explaining to the hospital that she was under the influence of drugs when she thought of having her neighbor’s windscreen shot. The hospital then signed a duty to warn against her. She highlighted that after being discharged from the hospital, she was free of homicidal thoughts toward her friend and attempted to apologize to her neighbor for the intention to have her car windscreen shot. But her neighbor had a peace order issued against her. She reported that she constantly grudges against people and is unforgiving of insults. She highlighted feeling afraid to confide in anyone to prevent such information from being maliciously used against her. She also reported another incident with a different friend who plans to ruin her reputation. She explained that this new friend deceived her into allowing her to walk with her dog, and afterward, the dog bit the friend. She said she doubts her friends and close associates as everyone seems to be plotting ways to indict her. She highlighted that her suspicions make her react very angrily in most situation 
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