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Clinical Case Presentation Paper

Due Oct 7 by 11:59pm Points 15 Submitting a file upload

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Case Presentation Paper (CO: 1-9): Students are required to complete a case presentation paper guided by a Nursing Theorist or Psychodynamic Theory to inform clinical care. The paper must adhere to APA 7th edition format and will be evaluated for correct grammar, spelling, and overall scholarly writing. A minimum of three current references, published within the past five years, must be used to support clinical reasoning and decision-making. All identifying data should be limited to the individual's initials to protect confidentiality. The paper must include the following components: identifying data, chief complaint, history of present illness, psychiatric history, personal and social history, mental status examination, suicide/homicide risk assessment, medical history, allergies, current medications, review of systems, history of abuse or trauma, DSM-5-TR diagnosis, application of a nursing theory or psychodynamic approach, treatment plan and goals, education and referrals, conclusions and summary, and a reference list. Emphasis will be placed on the integration of evidence-based data throughout the assessment.

CASE PRESENTATION REQUIREMENTS

1. Please use APA 7th edition format. The paper will be reviewed for correct grammar and spelling. 2. Use a Nursing Theorist or Psychodynamic Theory to guide your care. 3. Must have three current references from the past 5 years. 4. Must include the following elements:

Use of APA 7th edition format and grammar

Identifying data, but only use the individual's initials

Chief Complaint (CC)

History of Present Illness (HPI)

Psychiatric History and Substance Use History

Personal and Social History

Mental Status Examination

Written Case Presentation

Criteria Ratings Pts

Chief Complaint

5 pts

History of Present Illness 5 pts

Psychiatric History 5 pts

Suicide and Homicide Assessment

Medical History

Allergies

Current Medications

Review of Systems

History of Abuse, Neglect, and Trauma

Mental Status Examination

Assessment i.e. DSM 5-TR Diagnosis

Nursing Theory/Psychodynamic Approach

Treatment Plan and Goals

Education and Referrals

Conclusions and Summary

References page including evidenced-based data

Note: TurnItIn will be linked with this assignment

Grading: Each of the above items will be worth 5 points. Total 100%. See Expanded Rubric in Course Syllabus.

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

Personal and Social History 5 pts

Mental Status Examination 10 pts

Suicide/Homicide assessment 5 pts

Medical History 5 pts

Allergies 5 pts

Current Medications 5 pts

Review of Systems 5 pts

History of abuse/trauma 5 pts

Assessment i.e. DSM DX 5 pts

Nursing Theory/Psychodynamic Approach 5 pts

Treatment Plan/Goals 5 pts

Education and Referrals 5 pts

5 pts Full Marks

0 pts No Marks

10 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

Conclusions and Summary 5 pts

References including evidenced based data 5 pts

Use of APA Style and Grammar 5 pts

Identifying data but only use the individuals initials 5 pts

Total Points: 100

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks

5 pts Full Marks

0 pts No Marks