Nursing Homework help

History of Present Illness (HPI): Video notes

The patient presents with a longstanding history of difficulty sustaining attention, distractibility, forgetfulness, and hyperactive behaviors, as reported by her mother. According to the mother, these symptoms have been present since kindergarten and have persisted throughout the patient's academic years.

The patient demonstrates significant difficulty maintaining focus during classroom activities and frequently becomes distracted by environmental stimuli. She exhibits limited eye contact during interactions and is often observed looking around the room rather than maintaining attention on the individual speaking.

The mother reports that teachers frequently provide written instructions and assignment checklists to help the patient remain organized and complete academic tasks. However, the patient often misplaces these lists and forgets assignments or daily responsibilities.

Additionally, the patient has difficulty remaining seated for extended periods and frequently demonstrates restlessness while sitting in her chair. According to her mother, when attempting to read independently, the patient can sustain attention for approximately five minutes before becoming distracted or disengaged.

These symptoms have reportedly been present since early childhood and continue to interfere with her academic performance, organizational abilities, and completion of daily school-related responsibilities.

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.).

Name: Sarah Higgins

Gender: female

Age: 11 years old

T- 97.4 P- 58 R 14 98/62 Ht 4’5 Wt 65lbs

Background: no history of treatment, developmental milestones met on time, vaccinations up to

date. Sleeps 9-10hrs/night, meals are difficult as she has hard time sitting for meals, she does get

proper nutrition per PCP. she has a younger brother. lives with her parents in Washington,

D.C. No hx of head trauma.

References

Symptom Media. (Producer). (2017). Training title 48 [Video].

https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/wa

tch/training-title-48

· American Psychiatric Association. (2022). Neurocognitive disorders. In Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url= https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.x17_Neurocognitive_Disorders

· American Psychiatric Association. (2022). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url= https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.x01_Neurodevelopmental_Disorders

· Boland, R. & Verduin, M. L. & Ruiz, P. (2022).  Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.

· Chapter 3, “Neurocognitive Disorders”

· Chapter 2- sections 2.1 “Intellectual Disability”, 2.2 “Communication Disorders”, 2.3 Autism Spectrum Disorder, 2.4 Attention-Deficit Disorder, 2.5 “Specific Learning Disorder”, 2.6 “Motor Disorders”

· Chapter 26 “Level of Care”

· Chapter 29 “End-of-Life Issues and Palliative Care