NRNP 6635 WEEK 8 ASSIGNMENT: ASSESSING AND DIAGNOSING PATIENTS WITH SUBSTANCE-RELATED AND ADDICTIVE DISORDERS

NRNP 6635 WEEK 8 ASSIGNMENT: ASSESSING AND DIAGNOSING PATIENTS WITH SUBSTANCE-RELATED AND ADDICTIVE DISORDERS

NRNP 6635 WEEK 8 ASSIGNMENT: ASSESSING AND DIAGNOSING PATIENTS WITH SUBSTANCE-RELATED AND ADDICTIVE DISORDERS

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 to establish a sense of identity, as well as to set values, behaviors, and purpose 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, it is important for advanced practice nurses to remain aware of cultural considerations and interpretations of behavior for diagnosis, especially with reference to 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.

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For this Assignment, you will practice assessing and diagnosing a patient in a case study who is experiencing a substance-related or addictive disorder. With this and all cases, remember to consider the patient’s cultural background.

LEARNING RESOURCES

Required Readings

• American Psychiatric Association. (2022). Substance related and addictive 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.x16_Substance_Related_Disorders
• Boland, R. & Verduin, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry(12th ed.). Wolters Kluwer.
  • Chapter 4, “Substance Use and Addictive Disorders”
  • Chapter 2 only section 2.17, “Adolescent Substance Abuse”
  • Chapter 27 “Ethics and Professionalism”
  • Chapter 28 “Forensic and Legal Issues”

Required Media

• Classroom Productions. (Producer). (2016). Addictive disordersLinks to an external site.[Video]. Walden University.
• Complex Care Consulting. (2018, April 4). Addiction neuroscience 101Links to an external site.[Video]. YouTube. https://www.youtube.com/watch?v=bwZcPwlRRcc

TO PREPARE:

• Review this week’s Learning Resources and consider the insights they provide.
• Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
• By Day 1 of this week, select a specific video case study to use 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.

PLEASE USE VIDEO TRAINING TITLE 151 FOR THIS ASSIGNMENT.

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.).

PLEASE USE VIDEO TRAINING TITLE 151 FOR THIS ASSIGNMENT.

PLEASE FOLLOW THE INSTRUCTIONS AND THE RUBRICS. USE THE TEMPLATE. USE 7^TH EDITION APA FORMAT AND BOOKS NOT MORE THAN FIVE YEAR YEARS.

Subjective:

CC (chief complaint):

HPI:

Past Psychiatric History:

• General Statement:
• Caregivers (if applicable):
• Hospitalizations:
• Medication trials:
• Psychotherapy or Previous Psychiatric Diagnosis:

Substance Current Use and History:

Family Psychiatric/Substance Use History:

Psychosocial History:

Medical History:

• Current Medications:
• Allergies:

• Reproductive Hx:

ROS:

• GENERAL:
• HEENT:
• SKIN:
• CARDIOVASCULAR:
• RESPIRATORY:
• GASTROINTESTINAL:
• GENITOURINARY:
• NEUROLOGICAL:
• MUSCULOSKELETAL:
• HEMATOLOGIC:
• LYMPHATICS:
• ENDOCRINOLOGIC:

Objective:

Physical exam: if applicable

Diagnostic results:

Assessment:

Mental Status Examination:

Differential Diagnoses:

Reflections:

References

NRNP_6635_Week8_Assignment_Rubric
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeCreate documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected. In the Subjective section, provide: • Chief complaint• History of present illness (HPI)• Past psychiatric history• Medication trials and current medications• Psychotherapy or previous psychiatric diagnosis• Pertinent substance use, family psychiatric/substance use, social, and medical history• Allergies• ROS	20 to >17.0 pts Excellent The response throughly and accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. 17 to >15.0 pts Good The response accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. 15 to >13.0 pts Fair The response describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis, but is somewhat vague or contains minor innacuracies. 13 to >0 pts Poor The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. Or, subjective documentation is missing.	20 pts
This criterion is linked to a Learning OutcomeIn the Objective section, provide:• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.	20 to >17.0 pts Excellent The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented. 17 to >15.0 pts Good The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are accurately documented. 15 to >13.0 pts Fair Documentation of the patient’s physical exam is somewhat vague or contains minor innacuracies. Diagnostic tests and their results are documented but contain minor innacuracies. 13 to >0 pts Poor The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or, objective documentation is missing.	20 pts
This criterion is linked to a Learning OutcomeIn the Assessment section, provide:• Results of the mental status examination, presented in paragraph form.• At least three differentials with supporting evidence. List them from top priority to least 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.	25 to >22.0 pts Excellent The response thoroughly and accurately documents the results of the mental status exam…. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides a thorough, accurate, and detailed justification for each of the disorders selected. 22 to >19.0 pts Good The response accurately documents the results of the mental status exam…. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides an accurate justification for each of the disorders selected. 19 to >17.0 pts Fair The response documents the results of the mental status exam with some vagueness or innacuracy…. Response lists at least three different possible disorders for a differential diagnosis of the patient and provides a justification for each, but may contain some vaguess or innacuracy. 17 to >0 pts Poor The response provides an incomplete or inaccurate description of the results of the mental status exam and explanation of the differential diagnoses. Or, assessment documentation is missing.	25 pts
This criterion is linked to a Learning OutcomeReflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, 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.).	10 to >8.0 pts Excellent Reflections are thorough, thoughtful, and demonstrate critical thinking. 8 to >7.0 pts Good Reflections demonstrate critical thinking. 7 to >6.0 pts Fair Reflections are somewhat general or do not demonstrate critical thinking. 6 to >0 pts Poor Reflections are incomplete, inaccurate, or missing.	10 pts
This criterion is linked to a Learning OutcomeProvide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).	15 to >13.0 pts Excellent The response provides at least three current, evidence-based resources from the literature to support the assessment and diagnosis of the patient in the assigned case study. The resources reflect the latest clinical guidelines and provide strong justification for decision making. 13 to >11.0 pts Good The response provides at least three current, evidence-based resources from the literature that appropriately support the assessment and diagnosis of the patient in the assigned case study. 11 to >10.0 pts Fair Three evidence-based resources are provided to support assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification. 10 to >0 pts Poor Two or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence based.	15 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph development and organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.	5 to >4.0 pts Excellent A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. …Paragraphs and sentences follow writing standards for flow, continuity, and clarity. 4 to >3.5 pts Good Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. …Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. 3.5 to >3.0 pts Fair Purpose, introduction, and conclusion of the assignment is vague or off topic. … Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%-79% of the time. 3 to >0 pts Poor No purpose statement, introduction, or conclusion were provided. … Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.	5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English writing standards: Correct grammar, mechanics, and punctuation	5 to >4.0 pts Excellent Uses correct grammar, spelling, and punctuation with no errors 4 to >3.0 pts Good Contains a few (one or two) grammar, spelling, and punctuation errors 3 to >2.0 pts Fair Contains several (three or four) grammar, spelling, and punctuation errors 2 to >0 pts Poor Contains many (≥ five) grammar, spelling, and punctuation errors that interfere with the reader’s understanding	5 pts
Total Points: 100

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