ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD AND OCD NRNP 6635
Sample Answer for ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD AND OCD NRNP 6635 Included After Question
“Fear,” according to the DSM-5-TR, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2022). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease.
For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5-TR criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5-TR criteria.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
- Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing anxiety, obsessive-compulsive, and trauma- and stressor-related 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.
By Day 7 of Week 4
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.).
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
- To submit your completed assignment, save your Assignment as WK4Assgn_LastName_Firstinitial
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
A Sample Answer For the Assignment: ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD AND OCD NRNP 6635
Title: ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD AND OCD NRNP 6635
Comprehensive Psychiatric Evaluation
Name: Mrs. I. F
Age: 47-year-old
Sex: Female
Source: Husband
CC (chief complaint): “My wife flipped a switch after the recent school shooting and she is constantly worried about our kids. She is watching the news 24/7, barely sleeping, and even when she does, it is only a few hours,”
HPI: I.F is a 47-years-old woman who was referred by her husband for psychiatric evaluation for anxiety. The husband reports that after a recent school shooting the patient “flipped a switch”. The patient barely sleeps and she watches the news 24/7. The patient admits that she has stronger feelings about losing people. She reports losing her parents when she was 19 years old. A drunk driver sideswiped her parents, pinning them to the freeway median. Her worries have increased of late due to a recent school shooting. She states that she has withdrawn her children from school since the public schools can’t afford protection for the children. She homeschools them nowadays and believes that her friends will withdraw their kids from school. She reports that her worries are not based on frantic phobia because she is educated about these matters. She states that her husband does not understand what it is like to lose a family that is why he sent her to a shrink. She concludes by stating that “I can prevent another Adam Lanza from pointing a gun at my babies. I won’t send them back to school. I won’t turn off the television, and I won’t stop informing myself. I will do what I can as a mother to protect my children.”
Past Psychiatric History: The patient has no history of mental health or substance use
treatment
Psychotherapy or Previous Psychiatric Diagnosis: None.
Substance Abuse History: The patient denies any history of use of caffeine, nicotine, illicit substance, or alcohol.
Family Psychiatric/Substance Use History: No family history.
Social History: The was born and raised in Northern Ireland, her parents brought her and her one sister to the U.S. when she was 15 to go to U.S. university where she met her husband. They live in Charleston, SC. She has a master’s degree in education and used to work from home but she quit her job five years ago after her last child, Colin. Her current hobby is watching CNN as she clears her laundry and prepares lessons for her homeschooling kids. She has no legal history but reports witnessing her parents die in a road accident when she was 19 years. A recent school shooting has heightened her worries and she states she is ready to do anything to protect her children.
Medical History: Patient has a Hx of hysterectomy
Current Medications: None.
Allergies: NKDA.
Reproductive Hx: Deferred.
ROS:
GENERAL: Denies fever weight loss/weight gain, lethargy, or weakness.
HEENT: Eyes: Denies visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose, Throat: Denies hearing loss, sneezing, congestion, runny nose, or sore throat.
SKIN: Denies rashes, moles, acne, itching, sores, dryness, changes in color, and changes in hair or nails. Denies easy bruising.
CARDIOVASCULAR: Denies chest pain, palpitations, SOB, fatigue with exertion, edema, or orthopnea.
RESPIRATORY: Denies cough or shortness of breath.
GASTROINTESTINAL: Denies diarrhea or constipation, and abdominal pain. Reports loss of appetite. Denies indigestion, reflux, or dysphagia.
GENITOURINARY: Denies dysuria, polyuria, hematuria, or incontinence.
NEUROLOGICAL: Denies dizziness, weakness, numbness, or tingling. Reports increased anxiety and worry about the safety of her children.
MUSCULOSKELETAL: Denies hypotonic, hypertonic pain, or weakness.
HEMATOLOGIC: Denies anemia, bleeding, or bruising.
LYMPHATICS: Denies enlarged nodes or a history of splenectomy.
ENDOCRINOLOGIC: Denies increased thirst, cold, or heat intolerance.
Physical Exam
GENERAL:
Vital Signs: T- 98.0 P- 82 R 18 136/62 Ht 5’0 Wt 123lbs
HEENT: Normocephalic and atraumatic. Sclera white, conjunctiva pink; PERRLA, Nasal mucosa mild-to-moderately erythematous and edematous. Oral mucosa pink with no lesions, tongue midline and pharynx without exudates.
NECK: Neck reveals no carotid bruits, no JVD, and no lymphadenopathy. There is no
evidence of thyromegaly.
CHEST/LUNG: Chest expansion is symmetrical. Lungs are clear to auscultation and
percussion bilaterally.
HEART: Heart has a regular rate and rhythm. Normal S1 and S2.
Abdomen: Abdomen is soft, benign, non – tender. Bowel sounds are normoactive. No
CVA tenderness
Diagnostic results:
The patient developed fears and worries after a recent school shoot-out three weeks ago. It is essential to use DSM-5 criteria for acute
stress disorder to diagnose the patient. DSM-5 describes ASD as the development of specific fear behaviors that last from 3 days to 1 month after a traumatic event (Bryant, 2018). Further, the DSM-5 criteria offer an essential diagnostic tool to execute differential diagnoses and get a conclusive diagnosis. According to the criteria, the patient should have a stressor like direct exposure to death, serious injury or sexual violence, or witnessed a trauma. They should also project with intrusion symptoms like unwanted upsetting memories, nightmares, flashbacks, emotional distress, or physical reactivity. The third criterion is avoidance where the patient either avoids trauma-related thoughts or feelings or trauma-related external reminders. Patients should showcase negative alterations in cognition and mood. They can either not recall key features of the trauma, have overly negative thoughts, exaggerate blame, have a negative affect, feel isolated, diminished interest in activities, or have difficulty experiencing positive affect. Alterations in arousal and reactivity are also needed like difficulty sleeping, difficulty concentrating, heightened startle reaction, hypervigilance, irritability, and risky or destructive behavior (Bryant, 2018). The symptoms should last between 3 days to 1 month, create distress or functional impairment, and are not linked to medication, substance abuse, or other illness.
Assessment
Mental Status Examination:
The patient is a 47-year-old Irish female who looks her stated age. She is cooperative and appropriately dressed for the age and season. Her speech is clear and coherent with a normal volume and tone. She projects a negative affect with delusional thinking without looseness of association or flight of ideas. She projects increased vigilance with a persistent negative emotional state. She denies auditory or visual hallucinations as well as suicidal and homicidal ideation. She is alert and oriented with her recent and remote memory intact. Her concentration and insight are good.
Differential Diagnosis
Acute Stress Disorder:
The patient presentation aligns with the DSM-5 criteria for ASD. She reports experiencing a shocking event where she lost her parents at the age of 19. A recent school shoot-out three weeks ago triggered her traumatic experience causing emotional distress and a need to protect her children. She has withdrawn her children from public school to avoid exposure to traumatic incidence. She states that she sees the children’s faces from the shoot-out. She has overly negative thoughts about losing her children and assert that she is not ready to lose anyone she loves as she lost her parents. She blames herself because she could not have prevented her parents from the accident and therefore has to do everything possible to protect her children. She also has a negative affect. She barely sleeps and is hypervigilant by watching TV all the time to get informed and to protect her children. Her symptoms were triggered three weeks ago after the school shoot-out. The symptoms are not linked to medication, substance abuse, or other illnesses.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder and ASD share similar symptoms. They also follow similar DSM-5 criteria since a patient must have a stressor, intrusion symptoms, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reaction (Çelik, 2018). The diagnosis is ruled out because PTSD symptoms begin within three months of the traumatic incidents or even years afterward.
Generalized Anxiety Disorder
According to the DSM-5, GAD is diagnosed when a patient has excessive anxiety and worry that occurs for more days and lasts for at least 6 months (Park & Kim, 2020). The patient cannot control the worry and it results in restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tensions, or sleep disturbances. The symptoms should cause clinically significant distress or impair functional areas. It should not be linked to substance abuse or other illness. The patient projects uncontrollable worry that has resulted in sleep disturbances, restlessness, and muscle tension. It has caused clinically significant distress and cannot be linked to drug abuse or medication. However, the diagnosis is ruled out because the symptoms have not lasted for six months and can be linked to reminders of traumatic events in PTSD (Park & Kim, 2020).
Reflection
The current case showcases the impact of a traumatic event on an individual. The patient is emotionally affected especially because the shoot-out event triggers another traumatic event that occurred when she was 19 years old. The preceptor’s conclusion that the patient has ASD is agreeable because ASD refers to intense, unpleasant, and dysfunctional reaction that occurs shortly after a traumatic event and last less than a month. A PTSD diagnosis cannot be confirmed because the symptoms have not persisted longer than a month. The case study instills a need to understand mental disorders symptoms and distinguishing factors to avoid the wrong diagnosis.
The moral and ethical sanctity of confidentiality is a basic need when handling mental health disorders. Nevertheless, psychiatrists are expected to anticipate the needs of their patients and come up with strategies to minimize harm to their patients. They should also not discriminate against a mental patient by subjecting them to abusive, violent, or degrading treatment. Conditions in places where a person lives, learns, works, and plays impact health risks and outcomes. For instance, the proximity of the current patient to a traumatic event resulted in emotional distress that manifested as a mental disorder. It is essential to engage and empower individuals and communities to adopt healthy behaviors and make changes that limit the development of chronic disease and other morbidities. In approaching the patient differently, I would avoid prompting discussion of issues that cannot be resolved and avoid pressuring her on subjects she does not wish to discuss.
ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD AND OCD NRNP 6635 References
Alexander Street. (2017). Training Title 85.https://video.alexanderstreet.com/embed/training-title-85
Bryant, R. A. (2018). The current evidence for acute stress disorder. Current psychiatry reports, 20(12), 1-8. https://doi.org/10.1007/s11920-018-0976-x
Çelik, F. (2018). Clinical manifestations of post-traumatic stress disorder. Klinik Psikofarmakoloji Bulteni, 28, 334-334.
Park, S. C., & Kim, Y. K. (2020). Anxiety Disorders in the DSM-5: changes, controversies, and future directions. Anxiety Disorders, 187-196. https://doi.org/10.1007/978-981-32-9705-0_12
“Fear,” according to the DSM-5-TR, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2022). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease.
For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5-TR criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5-TR criteria.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
- Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing anxiety, obsessive-compulsive, and trauma- and stressor-related 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.
By Day 7 of Week 4
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.).
Submission information
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- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
A Sample Answer 2 For the Assignment: ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD AND OCD NRNP 6635
Title: ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD AND OCD NRNP 6635
Anxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.
Case Overview
The case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.
The patient factors that may influence medication prescribing include age, the severity of the patient’s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient’s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.
Decision #1
Start Zoloft 50 mg orally daily.
Why I Selected This Decision
Sertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.
Why I Did Not Select the Other Options
Imipramine was not an ideal choice because it is a 2nd line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).
What I Was Hoping To Achieve
I hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.
How Ethical Considerations May Impact the Treatment Plan
Ethical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.
Decision #2
Increase Zoloft to 75 mg daily.
Why I Selected This Decision
The Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug’s side effects adequately.
Why I Did Not Select the Other Options
Increasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).
What I Was Hoping To Achieve
I hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.
How Ethical Considerations May Impact the Treatment Plan
Nonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.
Decision #3
Maintain the current dose.
Why I Selected This Decision
The current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).
Why I Did Not Select the Other Options
Increasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.
What I Was Hoping To Achieve
I was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.
How Ethical Considerations May Impact the Treatment Plan
The ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).
Conclusion
The specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient’s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient’s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client’s decisions when developing the treatment plan.
ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD AND OCD NRNP 6635 References
Bipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care. Indian journal of psychological medicine, 41(2), 108–112. https://doi.org/10.4103/IJPSYM.IJPSYM_59_19
DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder. Annals of internal medicine, 170(7), ITC49–ITC64. https://doi.org/10.7326/AITC201904020
Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options. Frontiers in psychiatry, 1412. https://doi.org/10.1176/appi.focus.19203
He, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & Ma, X. (2019). Comparative efficacy and acceptability of first-line drugs for the acute treatment of generalized anxiety disorder in adults: a network meta-analysis. Journal of psychiatric research, 118, 21-30. https://doi.org/10.1016/j.jpsychires.2019.08.009
Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert opinion on pharmacotherapy, 19(10), 1057–1070. https://doi.org/10.1080/14656566.2018.1491966
ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD AND OCD NRNP 6635 Rubric
| NRNP_6635_Week4_Assignment_Rubric | ||||||
| Criteria | Ratings | Pts | ||||
| This criterion is linked to a Learning Outcome Create documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected. 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 |
|
20 pts | ||||
| This criterion is linked to a Learning Outcome 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. |
|
20 pts | ||||
| This criterion is linked to a Learning Outcome 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. |
|
25 pts | ||||
| This criterion is linked to a Learning Outcome Reflect on this case. 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.). |
|
10 pts | ||||
| This criterion is linked to a Learning Outcome Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old). |
|
15 pts | ||||
| This criterion is linked to a Learning Outcome Written Expression and Formatting—Paragraph development and organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
|
5 pts | ||||
| This criterion is linked to a Learning Outcome Written Expression and Formatting—English writing standards: Correct grammar, mechanics, and punctuation |
|
5 pts | ||||
| Total Points: 100 | ||||||