PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1

Walden University PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1 assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1                       

Whether one passes or fails an academic assignment such as the Walden University PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1 depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1                       

The introduction for the Walden University PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1 is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

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How to Write the Body for PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1                       

After the introduction, move into the main part of the PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1  assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1                       

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for PRAC 6645 WEEK 7 ASSIGNMENT 2: COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1                       

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Subjective:

CC (chief complaint): “The school principal asked me to come in for an evaluation.”

HPI: K.P. is a 15-year-old Caucasian teenager who came to the clinic with her father after the school suggested that she undergo a mental examination. According to her father, she was taken home by her school principal after assaulting her class teacher, and she had to be assessed before returning to class. She said that her instructor had made an improper remark to her and that she wanted to retaliate against her for failing to complete her assignment. According to her father, she has been suspended four times in the previous 13 months for bringing a knife to school, hitting other pupils, and taking money away from other children’s backpacks. Her school performance has also dropped in the last year. When confronted about her behavior, she said that her stepmother irritates her at home and that she periodically leaves for several days as a consequence.  She was said to have bad interpersonal interactions, although she denied having suicidal thoughts, self-harming activities, substance misuse, or damage to herself or others.

Past Psychiatric History:

• General Statement: She refused to seek therapy for any mental disorder.
• Caregivers (if applicable): Father
• Hospitalizations: She refused admission due to psychiatric disease, self-harming habits, or suicidal/homicidal intentions.
• Medication trials: Her father stated that she had never taken antipsychotic medication.
• Psychotherapy or Previous Psychiatric Diagnosis: She denied having a mental illness or attending any type of therapy.

Substance Current Use and History: She stated that she had one incident of using marijuana but quit owing to paranoia and that she had no history of smoking tobacco, alcohol use, or recreational drug use.

Family Psychiatric/Substance Use History: Her father has a depression illness, her maternal grandpa has bipolar disorder, and her older sister has a significant depressive disorder, according to her. She denied that any member of her household had a substance use issue or that anyone had committed suicide.

Psychosocial History: She was born in Bergen County, New Jersey, and was raised by both parents until she was seven years old when her mother died; since then, she has been raised by her father. She stated that she has two elder sisters and that she still resides with their father and siblings. She is in the tenth grade, enjoys dancing, and has previously been arrested for attacking a neighbor. She did, however, state that she has no history of trauma and has no fears about her safety.

Medical History: None

• Current Medications: None
• Allergies: She has never been allergic to food, drugs, or the environment.

• Reproductive Hx: She stated that she gets monthly menstrual periods that always arrive after 28 days, that her latest period was 8 days ago, and that she has never indulged in any type of sexual activity.

ROS

• GENERAL: has no history of weariness, cold/heat intolerance, fever, hunger changes, recent weight fluctuations, or chills.
• HEENT: Head: She has no history of headaches, dizziness, or head trauma. She has no history of vision loss, blurring, eye discomfort, blurred vision, or eye discharges. She has no history of ear pain, discharge, loss of hearing, or ringing in the ears. Nose: She has never had sneezing, a runny nose, or sinus infections. Throat: She has no history of hoarseness or swallowing difficulty/pain.
• SKIN: no history of rashes, skin color changes, or itching.
• CARDIOVASCULAR: no history of arrhythmias, chest tightness, chest pain, or lower limb edema.
• RESPIRATORY: no history of chest discomfort, coughing, sputum production, wheezing, or trouble breathing.
• GASTROINTESTINAL: no history of loss of appetite, stomach discomfort, diarrhea, nausea, or vomiting.
• GENITOURINARY: no history of urinating with a burning feeling, incontinence, hematuria, oliguria, or frequency.
• NEUROLOGICAL: no history of memory loss, paralysis, numbness, dizziness, syncope, headache, or itching in her extremities.
• MUSCULOSKELETAL: no history of muscular discomfort, back pain, joint stiffness, or pain.
• HEMATOLOGICAL: no history of transfusions, easy bruising/bleeding, or anemia.
• LYMPHATICS: no history of splenectomy or node hypertrophy.
• ENDOCRINOLOGY: no history of cold/heat intolerance, excessive thirst, weight fluctuations, excessive perspiration, or excessive appetite.

Objective:

Diagnostic results: Routine lab tests were ordered including white blood cell count, TSH, vitamin B12, LFTS, Hepatitis C test, blood urea nitrogen, Hba1c, and urine and blood toxicology screening (Salekin et al., 2022).

Assessment:

Mental Status Examination: K.P. is a young Caucasian girl whose appearance and age are consistent. She is clean and well-kempt, dressed suitably for the weather, and her nutritional state is normal. She has strong communication abilities, but she cannot maintain long-term eye contact, and she has somewhat diminished cooperation and concentration. She stated that she is in a pleasant mood, but her affect is limited and she is quickly upset. She has a rational thought process, and her speech was delivered at the appropriate level and tone, and it was readily understood. She denies hearing weird sounds or seeing things, and having suicidal/homicidal ideas, and there is no indication that she has delusional thinking. She has medium intellect, acceptable abstraction, intact memory, global intelligence, and a poor understanding of her circumstances.

Differential Diagnoses:

1. Conduct Disorder: This is a mental condition that is widespread in adolescents and is characterized by repeated rule violations and antisocial behavior patterns. Chronic conflict with friends, instructors, and parents, lying, deceitfulness, stealing regularly, hostility toward animals and people, property damage, engaging in physical confrontations, bullying, threatening, and intimidating others, and major rule violations characterize it (Fairchild et al., 2019). The patient in the case study reported hitting her instructor, harassing her friends, constantly getting into physical confrontations, taking money from several other student lockers, bringing a knife to class, and having terrible interpersonal interactions.
2. Oppositional defiant disorder: This is a prevalent behavioral condition in children that is characterized by patterns of uncooperative, defiant, and hostile conduct toward people in authority (Souroulla et al., 2019). It is distinguished by a short temper, accusing others of the individual’s mistakes, verbalizing hateful words when frustrated, frequent fury, fairly regular arguments with seniors, attempting to purposely frustrate others, seeking revenge, vigorously refusing to conform with rules, and recurring resentment and anger temper tantrums.
3. Attention-deficit/hyperactivity disorder (ADHD): ADHD is a neurological condition distinguished by a recurrent pattern of attention deficit and/or hyperactivity that hinders the development or functioning of the affected individual (Liu et al., 2023). There are three main types of this disorder, and they are distinguished by forgetting or beginning to lose things quickly, talking excessively, daydreaming excessively, difficulty taking turns, difficulty getting along with friends, difficulty opposing temptations, and making dumb mistakes, as well as squirming or fidgeting.

Reflections: In a similar case, I would make certain that the patient has established a welcoming atmosphere and do separate interviews with the patient and the caregiver (Waldman et al., 2021). Effective parental supervision is one of the social determinants of conduct disorder since it is well acknowledged as a component of the growth of a child and teenage conduct issues. The health promotion of conduct disorder raises community awareness and includes preventative interventions (Park et al., 2022). She will be lectured on the need of adhering to the drugs as well as attending all therapy sessions to help her find strategies to vent and regulate her anger.

Case Formulation and Treatment Plan:

Primary Diagnosis: Conduct Disorder

Psychotherapy: Individual psychotherapy, like cognitive behavioral therapy, focuses on problem-solving abilities, relationship development via conflict resolution, and learning techniques to reduce negative effects in their environment (Bajpai et al., 2022).

Pharmacotherapy: Ritalin 2.5 mg twice a day was started, along with cognitive-behavioral therapy (Sagar et al., 2019).

Patient education: Teach parents age-appropriate practices and expectations for their clients, such as realistic curfews, household tasks, and acceptable at-home conduct (Fairchild et al., 2019). Educate the patient on how to reduce violence and increase treatment compliance.

Health Promotion:  Advise the patient to consider exercise and meditation to improve her mental health and self-awareness (Sagar et al., 2019).

Follow-up: After two weeks, the patent needed to return to the clinic for an additional examination of the treatment outcome (Salekin et al., 2022).

References

Bajpai, P., Sharma, A., & Chaube, N. (2022). Projective assessment of Indian juveniles with conduct disorder. Asia Pacific Journal of Counselling and Psychotherapy, 1–21. https://doi.org/10.1080/21507686.2022.2098350

Fairchild, G., Hawes, D. J., Frick, P. J., Copeland, W. E., Odgers, C. L., Franke, B., Freitag, C. M., & De Brito, S. A. (2019). Conduct disorder. Nature Reviews Disease Primers, 5(1). https://doi.org/10.1038/s41572-019-0095-y

Liu, N., Jia, G., Qiu, S., Li, H., Liu, Y., Wang, Y., Niu, H., Liu, L., & Qian, Q. (2023). Different executive function impairments in medication-naïve children with attention-deficit/hyperactivity disorder comorbid with oppositional defiant disorder and conduct disorder. Asian Journal of Psychiatry, 81, 103446. https://doi.org/10.1016/j.ajp.2022.103446

Park, J., Lee, D. Y., Kim, C., Lee, Y. H., Yang, S.-J., Lee, S., Kim, S.-J., Lee, J., Park, R. W., & Shin, Y. (2022). Long-term methylphenidate use for children and adolescents with attention deficit hyperactivity disorder and risk for depression, conduct disorder, and psychotic disorder: a nationwide longitudinal cohort study in South Korea. Child and Adolescent Psychiatry and Mental Health, 16(1). https://doi.org/10.1186/s13034-022-00515-5

Sagar, R., Patra, B., & Patil, V. (2019). Clinical practice guidelines for the management of conduct disorder. Indian Journal of Psychiatry, 61(8), 270. https://doi.org/10.4103/psychiatry.indianjpsychiatry_539_18

Salekin, R. T., Charles, N. E., Barry, C. T., Hare, R. D., Batky, B. D., Mendez, B., & Neumann, C. S. (2022). Proposed Specifiers for Conduct Disorder (PSCD): Factor structure and psychometric properties in a residential school facility. Psychological Assessment, 34(10), 985–992. https://doi.org/10.1037/pas0001162

Souroulla, A. V., Panteli, M., Robinson, J. D., & Panayiotou, G. (2019). Valence, arousal, or both? Shared emotional deficits associated with Attention Deficit and Hyperactivity Disorder and Oppositional/Defiant-Conduct Disorder symptoms in school-aged youth. Biological Psychology, 140, 131–140. https://doi.org/10.1016/j.biopsycho.2018.11.007

‌Waldman, I. D., Rhee, S. H., Levy, F., & Hay, D. A. (2021). Causes of the overlap among symptoms of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. In Attention, genes, and ADHD (pp. 115-138). Psychology Press.

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COMPREHENSIVE PSYCHIATRIC EVALUATION NOTE AND PATIENT CASE PRESENTATION, PART 1

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