NRNP 6635: Psychopathology and Diagnostic Reasoning Practicum

NRNP 6635: Psychopathology and Diagnostic Reasoning Practicum

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation

CC (chief complaint): “I need some Dexedrine for my ADHD.”

HPI:

K.T is a 25-year-old Caucasian male who presents for ADHD evaluation. He states that he has had ADHD since he was around age 5 or 6, and up until a year ago he had been taking Dexedrine. He claims to have been on this medication since being diagnosed. Symptoms he’s experienced since stopping the medication include poor concentration, trouble focusing, getting distracted, forgetting, and hyperactivity. The patient states that on Dexedrine all his symptoms “vanished.” He is a college student and he feels like he is really struggling without medication. He is currently making B’s and C’s and he feels he should have A’s and B’s. The patient was unable to provide information on his doctor or the location of the practice and was unwilling to contact his mother, whom he says would have the information. The patient asked the provider for a “trial” of Dexedrine, in light of not being able to obtain and verify patient records. History of auditory and visual hallucinations only while under the influence of drugs and alcohol. He denies suicidal or homicidal ideation today.

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Past Psychiatric History:

General Statement: The patient states that he started seeing a “shrink” around age 5 or 6 for ADHD

Caregivers: self

Hospitalizations: He did spend some time inpatient at various psychiatric facilities for behavioral issues and outbursts during his adolescent years.

Medication trials: Says he has only taken Dexedrine

Psychotherapy or Previous Psychiatric Diagnosis: ADHD, but unable to obtain records. Claims to have seen the same psychiatrist since age 5, but is unable to recall his name.

Substance Use History: He smokes 1 ppd of cigarettes. He drinks alcohol but will not quantify the amount.

Assessing and Diagnosing Patients with Schizophrenia

Psychiatric Mental Health Nurse Practitioners (PMHNPs) are advanced nurse advanced practice registered nurses prepared to take care of individuals with varying mental disorders. PMHNP is a specialty like no other, the diagnostic tools in their proposal help with proper diagnosis and treatment recommendations that best meet the need of the patient. PMHNP job focuses on the assessment, diagnosis, and treatment of individuals with mental health needs (Jasper). They can provide therapy and prescribe medication as needed for patients with mental health

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation

Templatedisorders and substance abuse problems. The assignment will focus on the assessment and diagnosis of a patient in the video clip presenting with symptoms consistent with schizophrenia.

Training Title 24

Subjective:

CC: “I am having thoughts and hearing things that others couldn’t hear” HPI: JC is a 28 years old Caucasian Caucasian female brought to the clinic for evaluation by her 2 roommates. The roommates are concerned about recent behavior which began 12 days ago after the patient’s younger brother committed suicide in front of her because his girlfriend broke up with him. The patient did not have a good relationship with her parents and her brother was her only close sibling. The patient reports sleep of 1-2 hours and eats only canned. The patient smokes cannabis daily since age 16 and goes out with roommates to have a couple of drinks of beer. The patient was prescribed alprazolam 1mg 2x daily as needed. The patient works as a bartender

Past Psychiatric History:

General Statement: The patient has no history of previous psychiatric hospitalization

Caregivers: No caregiver was mentioned, lives with roommates who brought her for evaluation.

Hospitalizations: No history of previous psychiatric hospitalization.

Medication trials: No history of past medication trials.

Psychotherapy or Previous Psychiatric Diagnosis: No previous psychiatric hospitalization/psychotherapy

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