6635.NonWk4

Jane, just watch the video of the patient interview. Some extra info is written about him as well. Let me know that the video works ok. Thanks!

· By Day 1 of this week, you will be assigned to a specific video case study for this Assignment. View your assigned video case, keeping the requirements of the documentation template in mind.

· Consider what history would be necessary to collect from this patient.

· Consider what interview questions you would need to ask this patient.

· Identify at least three possible differential diagnoses for the patient.

By Day 7 of Week 4

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 diagnostic criteria for each differential diagnosis and explain what DSM-5 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.).

Patient Info:

You are working as a  PMHNP at a VAMC.  The medical clinic called you to request that you come to see a patient who is currently in for a medical evaluation.   The FNP said that he has “raw wounds” and appears to be a high-risk case.  The FNP was worried if he left with an appointment for the mental health clinic, he may not show up.   She asked that you come connect with him today to help increase his chances of engaging in long term psychiatric care. 

 

During the physical, the patient seemed extremely nervous, stated his fiancé made his appointment telling him he needs to be connected to the VAMC and get the proper care he needs.

 

The patient is 27 years old and has no identified medical problems and his tests today included CBC, Comprehensive Metabolic Panel, and EKG- all  are normal.  He c/o “feeling off”,  having some memory & concentration problems, dizzy/lightheaded spells, and feels exhausted even when he first wakes up from sleeping. 

 

He entered the military just after high school and did three long tours of duty in warzones.  Michael (“everyone calls me “Sergeant”)  separated from active duty in the Army less than a year ago after eight years of service. 

 

He is engaged to be married (no date set) and is currently working as an EMT while studying (last year of BSN).  He said he grew up poor and would not do much else if he didn’t go into the military.  He denies ever using any drugs and avoids alcohol because his father was “an abusive drunk.”   He had two older sisters, no bothers.  Siblings are married with kids; one suffers from drug addiction and is in and out of rehab.  Father is still alive, unwell (DM, liver disease, HTN), still drinking.  Paternal grandfather was also a veteran and suffered depression at times though he never told anyone except Michael because of their combat connection.   Mother is alive and well, still “caring for dad.”   He lives in a different state, approximately five hours from his parents and siblings. After the military, he and his fiancé moved because she got a much better opportunity.  They want kids someday and hope to marry in a year or two.

 

Video Link

https://video-alexanderstreet-com.ezp.waldenulibrary.org/watch/training-title-21