NRNP 6635 WEEK 8 Assignment Sample Solution

NRNP 6635 WEEK 8 Assignment: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorder

An important consideration when working with patients is their cultural background.  Understanding an individual\’s culture and personal experiences provides insight into who the person is and where he or she may progress in the future.  Culture helps establish a sense of identity and set values, behaviors, and purposes for individuals within a society.  Culture may also contribute to a divide between specific interpretations of cultural behavior and societal norms.  What one culture may deem as appropriate, another culture may find inappropriate.  As a result, advanced practice nurses must remain aware of cultural considerations and interpretations of behavior for diagnosis, especially concerning substance-related disorders.  At the same time, PMHNPs must balance their professional and legal responsibilities for assessment and diagnosis with such cultural considerations and interpretations. For this Assignment, you will practice assessing and diagnosing a patient in a case study who is experiencing a substance-related or addictive disorder.  Remember to consider the patient’s cultural background in this and all cases.

To Prepare: Review this week’s Learning Resources and consider the insights they provide. Review the Comprehensive Psychiatric Evaluation template you will use to complete this Assignment.

By Day 1 of this week, select a specific video case study for this Assignment from the Video Case Selections choices in the Learning Resources.  View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation 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 8

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a 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, from highest priority to lowest priority.  

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

NRNP 6635 WEEK 8 Assignment Sample Solution

NRNP 6635 Week 8: Assessing and Diagnosing Patients with Substance-Related and Addictive Disorders

Subjective: Name: Ally Dean

Gender: Female

Age: 48 years old

CC (chief complaint): The client’s supervisor, “Ms. Ally’s alcohol consumption is getting out of hand.  I suspect a potential substance use.”

HPI: Ally is a 48-year-old female undergoing psychiatric assessment after a referral from the school EAP counselor due to her substance abuse probability.  The client has been late for classes for 22 days due to excessive alcohol consumption and was referred to facilitate getting her help and retaining her at the school.  The patient reports being late to work on the interview day since she attended a party the previous evening and drank too much.  She initially denies that she got intoxicated and passed out but later admits it.  The client reports that she drinks too much every night.  She states that she mostly drinks alone but occasionally goes to a bar with her friends or drinks at school functions, where the alcohol supply is liberal.  She also reports taking 5-6 glasses of wine and several mixed drinks when her students give her a rough time. The client attributes the excessive drinking to the stress she experiences at school due to students’ indiscipline.  She admits to taking too much alcohol but states it affects her differently.  She admits to passing out severally when drunk.  Students and parents have complained that Ally has severally gotten to class to teach while drunk, but she denies the claims.  According to her students, she goes to class drunk and orders them to read from their textbook or copy notes from the board while sleeping with her head on the desk.  Her drinking behavior risks losing her teaching job, and the Board of Education may dismiss her if she does not cooperate during the psychiatric evaluation. Past Psychiatric History:

  • General Statement: No psychiatric history.
  • Caregivers: None
  • Hospitalizations: No history of psychiatric hospitalization.
  • Medication trials: None
  • Psychotherapy or Previous Psychiatric Diagnosis: None

Substance Current Use and History: She has had a history of alcohol consumption since she was a teenager.  Alcohol consumption has increased over the years.  She reveals taking on average 5 wine glasses alongside some mixed drinks to get high.  She takes 5-6 glasses of wine and a handful of mixed drinks to get intoxicated.

Family Psychiatric/Substance Use History: The client’s father was an alcoholic.  He got into Alcohol Anonymous and quit alcohol. Psychosocial History: Ally was born alone, and her parents raised her in the San Francisco area of California.  She possesses a PhD in Biology, and a master’s in high school education.  Her current employment is in high school.  Ally reports being currently in a relationship. Medical History:

  • Current Medications: None
  • Allergies: No food or drug allergies.
  • Reproductive Hx: Para 0+0; No history of gynecologic disorders.  LMP-3 weeks ago.

ROS:

  • GENERAL: Lacks chills, fever, fatigue, or weight changes.
  • HEENT: Denies traumatic head injury, eye pain, blurred vision, ear discharge, hearing loss, sneezing, nasal discharge, sore throat, or hoarse voice.
  • SKIN: Negative for skin rashes, itching, bruises, or lesions.
  • CARDIOVASCULAR: Denies palpitations, chest pain, SOB on exertion, orthopnea, or edema
  • RESPIRATORY: Does not have a cough, sputum production, dyspnea, or chest pain.
  • GASTROINTESTINAL: Denies rectal bleeding, vomiting, nausea, constipation, abdominal discomfort, or diarrhea.
  • GENITOURINARY: Negative for pelvic pain, excessive or malodorous vaginal discharge, dysuria, or urine color changes.
  • NEUROLOGICAL: Negative for headache, fatigue, drowsiness, LOC, or burning sensations.
  • MUSCULOSKELETAL: Denies muscle pain, joint pain/stiffness, or joint enlargement.
  • HEMATOLOGIC: Denies bruising or history of blood transfusion.
  • LYMPHATICS: Does not have a history of lymph node enlargement.
  • ENDOCRINOLOGIC: Rejects excessive hunger, polyuria, thirst, or excessive sweating.

Objective: Physical exam: BP: 122/76; HR- 84; RR-20; Temp- 98.24 Ht- 5’4; Wt- 138 lbs.

Diagnostic results: No labs or imaging tests were ordered.

Assessment: Mental Status Examination: The client is neat and dressed appropriately for the weather and function.  She is alert but appears confused and anxious and maintains limited eye contact.  Her speech is clear at a normal rate, but the volume increases when she gets provoked.  She demonstrates a congruent thought process.  No hallucinations, delusions, obsessions, homicidal, or suicidal ideations were noted.  She is oriented to time, person, and place and also manifests good judgment.  Memory is intact.  Insight is present.

Differential Diagnoses: Alcohol Use Disorder Alcohol use disorder (AUD) is defined as a maladaptive pattern associated with substance use that leads to an individual’s clinical impairment or distress.  According to the DSM-V, specific symptomatology such as extended alcohol use in large amounts, inability to reduce alcohol intake, expending time on alcohol-related activities, and craving for alcohol indicate the condition (APA, 2013).  Moreover, using alcohol recurrently, thus impairing social and economic functions, and the usage of alcohol despite its social detriments also lend to the presence of alcohol use disorder (Yang et al., 2018).  Besides, fundamental occupational, social, or recreational activities are given up or reduced due to imbibing alcohol.  Lastly, obsession with alcohol does not reduce despite its exacerbation of physical or psychological manifestations. AUD is a differential diagnosis based on the client’s history of taking large amounts of alcohol; Spending lots of time taking alcohol; recurrent alcohol use failing to carry out her teaching obligations, and continuing to take alcohol despite it causing problems in her relationships.

Generalized Anxiety Disorder The client could have GAD based on her report of stress due to student indiscipline at school.  The alcohol intake could result from GAD since she reports taking alcohol when her students take the edge off the day (McHugh & Weiss, 2019).  Besides, the client appears anxious and is inattentive during the interview, which is consistent with GAD.

Major Depressive Disorder Major depressive disorder (MDD) is a differential diagnosis based on the client’s history of losing interest in her job.  The client’s alcohol problem could be secondary to depression (McHugh & Weiss, 2019).  However, she does not demonstrate other symptoms of MDD.

Reflections: If I were to conduct the session again, I would assess the client’s history of using other drugs and substances to rule out the presence of a substance abuse disorder.  I would also order a urine test to evaluate if the client has been using other illicit drugs (Kranzler & Soyka, 2018).  Legal and ethical considerations for this client include autonomy, beneficence, nonmaleficence, and confidentiality.  The PMHNP should respect the client’s decision regarding her care to uphold autonomy.  Beneficence and nonmaleficence should be upheld by choosing treatment interventions to promote the best possible health outcomes and not harm the client.  In addition, the PMHNP should ensure that the client’s information is not shared with other persons without the client’s consent.  The client’s health promotion strategies should reduce alcohol consumption and help her return to normal functioning.

References

American Psychiatric Association.  (2013). Diagnostic and statistical manual of mental disorders (DSM-5®).  American Psychiatric Pub. Kranzler, H. R., & Soyka, M. (2018).  Diagnosis and Pharmacotherapy of Alcohol Use Disorder: A Review. JAMA320(8), 815–824.  https://doi.org/10.1001/jama.2018.11406 McHugh, R. K., & Weiss, R. D. (2019).  Alcohol Use Disorder and Depressive Disorders. Alcohol research: current reviews40(1), arcr.v40.1.01.  https://doi.org/10.35946/arcr.v40.1.01 Yang, P., Tao, R., He, C., Liu, S., Wang, Y., & Zhang, X. (2018).  The Risk Factors of the Alcohol Use Disorders-Through Review of Its Comorbidities. Frontiers in neuroscience12, 303.  https://doi.org/10.3389/fnins.2018.00303

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Who We Are 

We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.

Do you handle any type of coursework?

Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.

Is it hard to Place an Order?

  • 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
  • 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
  • 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
  • 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
  • 5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS: ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT-NRNP 6635 WEEK 8 Assignment: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorder

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

  • Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

  • Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

  • APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

  • Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

  • LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

  • Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

  • Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

  • GuaranteeNRNP 6635 WEEK 8 Assignment: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorder
  • Zero Plagiarism
  • On-time delivery
  • A-Grade Papers
  • Free Revision
  • 24/7 Support
  • 100% Confidentiality
  • Professional Writers
  • Services Offered
  • Custom paper writing
  • Question and answers
  • Essay paper writing
  • Editing and proofreading
  • Plagiarism removal services
  • Multiple answer questions

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS: ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper

NEED HELP WITH YOUR NURSING ASSIGNMENTS ?

We are dedicated to delivering high quality nursing papers that adhere to the provided instructions, are adequately referenced with the latest scholarly knowledge,

Timely Delivery

Respecting your time and needs, we complete and deliver your orders within the specified timeframe.

Highly skilled writers

We employ experienced and qualified PhD and MD writers able to deal with any types of academic papers

100% unique content

Thorough research and the best academic writing practices ensure complete originality and high quality of every paper we deliver.

Order Now
Online Nursing Owl