Neurodevelopmental disorders begin in the developmental period of childhood and may continue through adulthood. They may range from very specific to a general or global impairment, and often co-occur (APA, 2022). They include specific learning and language disorders, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, and intellectual disabilities. Neurocognitive disorders, on the other hand, represent a decline in one or more areas of prior mental function that is significant enough to impact independent functioning. They may occur at any time in life and be caused by factors such as brain injury; diseases such as Alzheimer’s, Parkinson’s, or Huntington’s; infection; or stroke, among others.
For this Assignment, you will assess a patient in a case study who presents with a neurocognitive or neurodevelopmental disorder.
To Prepare:
- Review this week’s Learning Resources and consider the insights they provide. Consider how neurocognitive impairments may have similar presentations to other psychological disorders.
- Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
- 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.
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate 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-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
- 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.).
LEARNING RESOURCES:
Koch, C. (2016, January 1). Does brain size matter? Scientific American. https://www.scientificamerican.com/article/does-brain-size-matter1/
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
- Chapter 21, Neurocognitive Disorders
- Chapter 31, Child Psychiatry
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template
Week (enter week #): (Enter assignment title)
Student Name
College of Nursing-PMHNP, Walden University
NRNP 6635: Psychopathology and Diagnostic Reasoning
Faculty Name
Assignment Due Date
Subjective:
CC (chief complaint):
HPI:
Past Psychiatric History:
·
General Statement:
·
Caregivers (if applicable):
·
Hospitalizations:
·
Medication trials:
·
Psychotherapy or
Previous Psychiatric Diagnosis:
Substance Current Use and History:
Family Psychiatric/Substance Use History:
Psychosocial History:
Medical History:
·
Current Medications:
·
Allergies:
·
Reproductive Hx:
ROS:
· GENERAL:
· HEENT:
· SKIN:
· CARDIOVASCULAR:
· RESPIRATORY:
· GASTROINTESTINAL:
· GENITOURINARY:
· NEUROLOGICAL:
· MUSCULOSKELETAL:
· HEMATOLOGIC:
· LYMPHATICS:
· ENDOCRINOLOGIC:
Objective:
Physical exam: if applicable
Diagnostic results:
Assessment:
Mental Status Examination:
Differential Diagnoses:
Reflections:
References
© 2021 Walden University Page 1 of 3
VIDEO 48 NRNP 6635 WEEK 10 Neurocognitive and Neurodevelopmental Disorders
Training Title 48 Name: Sarah Higgins Gender: female Age: 11 years old T- 97.4 P- 58 R 14 98/62 Ht 4’5 Wt 65lbs Background: no history of treatment, developmental milestones met on time, vaccinations up to date. Sleeps 9-10hrs/night, meals are difficult as she has hard time sitting for meals, she does get proper nutrition per PCP. she has a younger brother. lives with her parents in Washington, D.C. No hx of head trauma. Symptom Media. (Producer). (2017). Training title 48 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-48
NRNP 6635 Week 9 Assignment Neurocognitive and Neurodevelopmental Disorders
______________________________________________________________________________
VIDEO #50 BEGIN TRANSCRIPT
00:00:15OFF CAMERA So, you told your supervisor you were having difficulty with concentration, and then it was your supervisor who set up this appointment, right, is it?
00:00:25HAROLD Yeah, I, I work at this large architectural engineering firm and it’s all great. Except, they’ve accelerated the deadlines now and it just puts a lot of pressure on. And I, I just can’t concentrate. I mean, everyone else is, doesn’t have a problem with it. But, but I just, I just can’t seem to be able to do the same job they’re doing.
00:00:50OFF CAMERA Okay, tell me about your problem with concentration.
00:00:55HAROLD Well, um, you know it’s just… Perfect example is, is they wanted me to design um, air ducts.
00:01:05OFF CAMERA Right.
00:01:05HAROLD Air ducts, simple. But I designed them through solid wall, a fire wall, and a supporting wall and I didn’t even realize what I was doing.
00:01:15OFF CAMERA Uh-huh.
00:01:15HAROLD You know, I mean, um, I’m making silly mistakes like that because, another time we had these windows, we already bought them, design, beautiful, they’re going to be in this entire building.
00:01:30OFF CAMERA Right.
00:01:30HAROLD Every floor. Well, I drew the window opening way too small. Now, I mean, if that would have gone ahead, it would have cost millions. I just, it’s, it’s just silly things like that.
00:01:45OFF CAMERA Uh-huh, is this a new kind of problem for you?
00:01:45HAROLD Well, I mean, I didn’t seem to have a problem when everything was relaxed, and the deadlines were normal.
00:01:50OFF CAMERA Right.
00:01:55HAROLD I could do the job. Everything was fine. But now we’re on these, these ridiculously tight deadlines and, and I just, can’t seem to do it. Everyone else can. It’s, there’s not a problem for them. And I end up like I’m not pulling my weight.
00:02:10OFF CAMERA Uh-huh.
00:02:10HAROLD And they think that and it’s true, I’m not.
00:02:10OFF CAMERA Now did you have these, uh, similar kind of problems back in school?
00:02:15HAROLD Well, yeah, I mean, in school everyone would go to the library to cram for big exams, so, I mean.
00:02:20OFF CAMERA Right.
00:02:20HAROLD That was a normal thing. And, yeah, I’d go but I’d end up looking out the window. Look it’s snowing, oh, it’s spring time. I’ll go for a walk. And, and if someone is whispering in a library well, I have to go to the other side. All my friends could study anywhere.
00:02:35OFF CAMERA Uh-huh, but, what other kind of difficulties do you seem to have?
00:02:40HAROLD Well, at the job we have, these uh, lectures, you know.
00:02:45OFF CAMERA Right. <
NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar
INSTRUCTIONS ON HOW TO USE EXEMPLAR AND TEMPLATE—READ CAREFULLY
If you are struggling with the format or remembering what to include, follow the
Comprehensive Psychiatric Evaluation Template
AND
the Rubric
as your guide. It is also helpful to review the rubric in detail in order not to lose points unnecessarily because you missed something required. Below highlights by category are taken directly from the grading rubric for the assignment in Weeks 4–10. After reviewing the full details of the rubric, you can use it as a guide.
In the
Subjective section, provide:
· Chief complaint
· History of present illness (HPI)
· Past psychiatric history
· Medication trials and current medications
· Psychotherapy or previous psychiatric diagnosis
· Pertinent substance use, family psychiatric/substance use, social, and medical history
· Allergies
· ROS
·
Read rating descriptions to see the grading standards!
In the
Objective section, provide:
· Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
· Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.
·
Read rating descriptions to see the grading standards!
In the
Assessment section, provide:
· Results of the mental status examination,
presented in paragraph form.
· At least three differentials with supporting evidence. List them from top priority to least priority. Compare the
DSM-5-TR diagnostic criteria for each differential diagnosis and explain what
DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis.
Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case
.
·
Read rating descriptions to see the grading standards!
Reflect on this case. Include: Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (
demonstrate critical thinking beyond confidentiality and consent for treatment
!), social determinates of health, health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
(The comprehensive evaluation is typica
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