Week 2: Clinical Hour and Patient Logs PRAC 6645

Walden University Week 2: Clinical Hour and Patient Logs PRAC 6645-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University Week 2: Clinical Hour and Patient Logs PRAC 6645 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 Week 2: Clinical Hour and Patient Logs PRAC 6645                       

Whether one passes or fails an academic assignment such as the Walden University Week 2: Clinical Hour and Patient Logs PRAC 6645 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 Week 2: Clinical Hour and Patient Logs PRAC 6645                       

The introduction for the Walden University Week 2: Clinical Hour and Patient Logs PRAC 6645 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 Week 2: Clinical Hour and Patient Logs PRAC 6645                       

After the introduction, move into the main part of the Week 2: Clinical Hour and Patient Logs PRAC 6645  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 Week 2: Clinical Hour and Patient Logs PRAC 6645                       

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 Week 2: Clinical Hour and Patient Logs PRAC 6645                       

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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Week 2: Clinical Hour and Patient Logs PRAC 6645

Week 2: Clinical Hour and Patient Logs PRAC 6645

Generalized Anxiety Disorder (GAD)

Name: M.K

Age: 25 years

Gender: Female

Diagnosis: Generalized anxiety disorder

M.K is a 25-year-old African-American female patient who was brought to the facility by her partner, who indicated that the patient keeps on saying that she doesn’t want to be alive anymore and it would be better if she takes away her life. The suicidal thoughts have been there in the past weeks, with the patient spending some periods crying a lot for no reason. The patient has not tried any medication, and the husband indicated that it would be wise to come to the facility. The patient also experiences other problems like loss of appetite, change in sleep patterns and problems with sleep, and lack of concentration. The patient also has experienced pain in the back for the last three days and a slight headache.

O: The patient is smartly dressed and groomed. She is well-oriented and alert. The patient’s speech is normal and audible with no pressure. Her memory is intact, with a coherent thought process. The patient has trouble concentrating and seems restless thought out the examination. The patient confirms suicidal thoughts or ideation but has not attempted to act on the thoughts. She denies delusions and hallucinations.

A: The patient has symptoms indicating that she has a generalized anxiety disorder, an indication that she needs an appropriate intervention to help in managing the symptoms.

P: The patient needs to start psychotherapy sessions, such as cognitive behavioral therapy sessions, every week before coming for review in four weeks’ time. The patient also needs to modify her bedroom to eliminate anything that can disturb her sleep and wake her up. The patient also needs to adopt relaxation techniques at home to help her cope better.

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Insomnia

Name: A.R

Age: 54 years old

Gender: Female

Diagnosis: Insomnia

A.R is a fifty-four-year-old female patient who came to the clinic, indicating that for the last few weeks, she has been experiencing a lot of fatigue during the day. Therefore, she can not attend to her daily tasks appropriately. She associates the feelings of fatigue with a lack of enough sleep at night. The symptoms started appearing over a month ago, and she hoped they would go away as before, but unfortunately, they have persisted. The patient gets it difficult to fall asleep and also finds it hard to remain asleep. She is easily distracted, and when she wakes up, even in the middle of the night, she finds it challenging to fall asleep again. The patient is not using any substance and has not been diagnosed with any other medical illness.

O: the patient is appropriately dressed for the prevailing weather. She is alert and oriented. She actively participates in the interview but starts dosing off at the tail end of the interview. She has clear and normal speech with no pressure. She denies suicidal thoughts, hallucinations, delusions, or illusions. The patient’s thought process is intact. The long-term and short-term memory are both intact.

A: The patient experiences fatigue and tiredness during the day, mainly due to insomnia at night. She lacks sufficient sleep due to incidences of sleep disruptions.

P: The patient needs to start DBT sessions to help talk with her on various strategies to use to realign her thoughts and help her with the symptoms.

Major Depressive Disorder

Name: B.C

Age: 18 years old

Gender: Female

Diagnosis: Major depressive disorder

B.C is an eighteen-year-old white female patient who visited the facility with a major complaint of sleeping difficulties and more frequent crying spells. The patient had been diagnosed with depression and has been using medication. However, she recently stopped using the medication after joining college, indicating that her friends and classmates would judge her. The patient also indicated that she has been having other symptoms, such as decreased energy levels, social phobia, loss of interest in activities, reduced concentration levels, and lower appetite. The patient also indicated that sometimes she feels extremely sad and wants to be alone.

O: The patient is well-dressed and groomed. She is also oriented. The patient appropriately responds to questions and is impressively cooperative. The patient’s speech is normal, and she also speaks fluently. The patient’s thought process and judgment are intact. The long and short-term memory are both intact. The patient’s mood is sad, and she finds it difficult to concentrate even during the interview. The patient reports that, in most cases, she wants to be alone and doesn’t want to leave her house. The patient denies suicidal thoughts, ideation, or actions. She also denies delusions, hallucinations, or nightmares.

A: The patient’s symptoms are an indication of a major depressive disorder. According to the DSM-V criteria, the patient’s symptoms, such as loss of interest in activities and lower energy levels, are a strong indication of the condition.

P: The patient needs to start attending cognitive behavioral therapy to help deal with the symptoms.

Substance-Induced Psychotic Disorder

Name: F.H

Age: 28 years old

Gender: Female

Diagnosis: Substance-Induced Psychotic Disorder

F.H is a twenty-eight-year-old male patient who visited the facility with his older brother. The brother indicates that the patient has been showing some strange behavior in the last few weeks. The patient has a history of using Marijuana from his early twenties. Some one year back, he caused a disturbance at a public place and escaped after a police chase. He came back home a few months ago and had since been living with the elder brother since he doesn’t have a house or a partner. The brother indicates that the patient has been seeing things like an army passing over his head and hearing non-existing things. He claims that someone keeps on telling him that they should go skiing together. However, the brother disputes this as he has never seen an army in his compound, nor has he ever heard anyone talking to the patient about skiing. The patient also has nightmares and hallucinations.

O: The patient came to the clinic looking shaggy and inappropriately dressed. He finds it difficult to maintain eye contact. He looks sad and angry. The patient’s speech is tremulous. He confirms feelings of low self-esteem, helplessness, and hopelessness. He has a distorted thought process. The patient is positive for hallucinations and self-harm activities. However, he denies suicidal thoughts

A: The patient’s symptoms point to psychosis. Since the patient has been using Marijuana for at least eight years, he can be diagnosed with a substance-induced psychotic disorder

P: The patient should start a cognitive behavioral therapy session. These sessions will help the patient remodify and redirect behavioral patterns and thoughts.

Attention-Deficit/ Hyperactivity Disorder (ADHD)

Name: S.E

Age: 7 years old

Gender: Male

Diagnosis: ADHD

S.E. is a seven-year-old white male patient who was brought to the facility by his mother, who was keen on an evaluation. She indicates that the son has been showing unusual behavior, which has been a source of frustration and worry for her. In the last few weeks, the child has found it difficult to complete any task assigned to him at home or in school. He has continually been disruptive at home and doesn’t want to sit in one place. As reported by his teachers, the boy likes disrupting other children in school. The positive part is that the boy takes in instructions and tones down whenever reprimanded.

O: The patient is appropriately dressed by the mother and looks healthy. The patient is alert and oriented. The boy is willing to answer questions but answers them in haste. The boy also fidgets and is restless. He moves up and down in the examination room and doesn’t like sitting in one place. He finds it hard to concentrate too. The patient denies suicidal thoughts, actions, or ideations. He also denies hallucinations or delusions

A: The primary diagnosis for this patient is ADHD according to the DSM-V diagnostic criteria since the boy is positive for impulsivity, hyperactivity, and inattention.

P: The patient should start a psychotherapy session as family therapy to help with the behavior.

Schizophrenia Spectrum and Other Psychotic Disorders

Name: F.R

Age: 57 years old

Gender: Female

Diagnosis: Schizophrenia Spectrum and Other Psychotic Disorders

F.R is a fifty-seven-year-old female patient who was brought to the clinic by the eldest son. The patient lives in her son’s family house after her husband passed on some years earlier. The son reports that his mother has been exhibiting abnormal behavior of hearing non-existing things and seeing non-existing people. Just two days prior, she claimed to have heard some people saying that they would come to the house and take her son away and that she frequently sees one of them peeping at them through the window. The patient also fears going outside and prefers staying indoors. She insists that she is well, and were it not for her son insisting, she couldn’t have come to the facility. The son has also indicated that the patient has continually shown anger and has also lost interest in activities. The patient has been using medication after being diagnosed with psychosis sometimes back, but she is no longer using them.

O: The patient is well-dressed, well-groomed, and oriented. The patient’s speech is incoherent and rapid. The patient shows a stressed mood. Her thoughts are delusional. The memory is still intact. She denies suicidal thoughts, mind, or actions. She also denies any nightmares or self-injurious behavior.

A: Based on the patient’s history and the current symptoms, the patient’s current condition is schizophrenia spectrum and other psychotic disorders.

P: She should start cognitive behavioral therapy sessions. These sessions should help improve the functionality and overall life.

Bipolar Disorder

Name: G.A

Age: 36 years old

Gender: Female

Diagnosis: Bipolar disorder

G.A is a thirty-six-year-old white female patient who came to the facility for a psychiatric evaluation. She indicates that she has been experiencing remarkable and extreme mood swings. She also indicates that she has symptoms such as delusions, periods of excitement and sadness, and overactivity. The patient also reports that there are periods when she experiences depression hence interfering with her normal functionality. During the depressive periods, the patient exhibits additional symptoms such as the inability to appropriately make decisions, problems with concentration, extreme need to sleep, and lower energy levels. The result is impaired functionality which disturbs her normal life.

O: The patient is appropriately dressed and oriented.  She has a sad mood, and her thought process is slow. Her speech is pressured. she finds it hard to concentrate. The patient denies suicidal thoughts or mind. She also denies hallucinations and delusions.

A: From the patient’s symptoms and history, the patient has bipolar disorder, especially as shown by the manic symptoms.

P: psychotherapy sessions are also key to a patient’s recovery and better outcomes. Weekly cognitive behavioral therapy will be administered for weeks

Panic Attack Disorder

Name: H.S

Age: 38 years old

Gender: Male

Diagnosis: Panic Attack Disorder

H.S is a thirty years old male patient who visited the facility complaining of chest pain. The chest pain has been bothering him, and he thinks it may one day lead to a heart attack. The fact that the pain has been worsening over the last few days has been a source of worry hence the urgency in need of help. When the chest pains, he also feels other undesirable symptoms such as shortness of breath, sweating, feeling faint, and a racing heartbeat. The feelings leave him anxious about what could happen next.

O: The patient is appropriately dressed and groomed. He is also alert and oriented. The patient is cooperative throughout the assessment. He looks anxious and worried. He also responds to questions appropriately with audible speech. The patient’s thought process is coherent. His short and long-term memory is intact. He denies delusions, hallucinations, or suicidal thoughts or mind.

A: the conducted examination revealed a racing heart, and combined with other symptoms, the patient is experiencing panic attacks and hence can be diagnosed with panic attack disorder.

P: the first line of treatment will be cognitive behavioral therapy which will be key to helping the patient learn through experience how to manage the symptoms which come with a panic attack

Intermittent Explosive Disorder

Name: D.T

Age: 45 years old

Gender: Female

Diagnosis: Intermittent explosive Disorder

D.T is a forty-five-year-old white female patient who visited the clinic, reporting that she has a problem with her temper. She has so far failed to appropriately control her temper. The lack of temper control has consistently come at the same time every year for the last three years. She has also observed that she finds it difficult to concentrate and gets bored easily by friends. In addition, the patient reports that it is challenging to make and keep friends and easily gets bored with them when they do their own activities. The patient indicates that she has insomnia and that she recently gained substantial weight, which bothers her a lot.

O: The patient came into the facility appropriately dressed and groomed. She satisfactorily maintains eye contact. She has fluent but rushed speech. The patient looks sad and irritable. She is positive for delusional thoughts. The patient denies self-harm or harm to others’ intentions, suicidal thoughts, or ideation. The patient also shows indications of depression and frustration.

The patient also finds it difficult to concentrate and easily gets distracted.

A: Based on the patient’s symptoms of inability to control anger and aggression and consistent outbursts, and according to DSM-V criteria, the patient has Intermittent explosive disorder.

P:  cognitive behavioral therapy should be used as the first line of treatment. The patient will be monitored after every four weeks to check at the progress.

Enuresis Disorder

Name: F.C

Age: 10 years old

Gender: male

Diagnosis: Enuresis Disorder

F.C is a ten-year-old male patient who was brought by his mother to the clinic. The mother indicates that the boy has developed a tendency to bed wetting at night. However, the boy manages to stay dry during the day. To help solve the problem, the mother has forced the patient to use pull-ups at night, which the patient finds uncomfortable. The condition makes the boy feel embarrassed, and consequently, he avoids going to sleepovers for fear of being embarrassed at his friend’s house. The boy is also sad because he feels lonely as he fears playing with other friends because they would laugh at him.

O: The patient is appropriately dressed and well-groomed. He is also alert and oriented. He has a sad mood and looks worried because of his current condition. The physical examination did not reveal the potential cause of the problem; hence a basic management approach should be undertaken.

A: Since the boy is only bed wetting at night, the diagnosis is Enuresis disorder

P: DBT will be used to help the patient with the thinking and behavior patterns.

Clinical Hour and Patient Logs

Clinical Hour Log

For this course, all practicum activity hours are logged within the Meditrek system. Hours completed must be logged in Meditrek within 48 hours of completion to earn the points associated with this assignment. You may only log hours with Preceptors that are approved in Meditrek.

Students must complete a minimum of 160 practicum hours.

You may not complete your hours sooner than 8 weeks. You will enter your approved preceptor and clinical faculty as part of each time and patient encounter you log.

Your clinical hour log must include the following:

  • Dates
  • Course
  • Clinical Faculty
  • Approved Preceptor
  • Total Time (for the day)
  • Notes/Comments

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 

WEEKLY RESOURCE

Patient Log

Throughout this course, you will also keep a log of patient encounters using Meditrek. You must record at least 80 patients by the end of this practicum. You must record at least 80 patients by the end of this practicum. You must see at least 5 pediatric/adolescent patients and 5 adult/older adult patients.

The patient log must include the following:

  • Date
  • Course
  • Clinical Faculty
  • Approved Preceptor
  • Patient Number
  • Client Information
  • Visit Information
  • Practice Management
  • Diagnosis
  • Student Notes—Students must include a brief summary/synopsis of the patient visit—this does not need to be a SOAP note; however, the note needs to be sufficient to remember your patient encounter

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