NRNP 6635: Psychopathology and Diagnostic Reasoning Practicum

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation

CC (chief complaint): “I need some Dexedrine for my ADHD.”

HPI:

K.T is a 25-year-old Caucasian male who presents for ADHD evaluation. He states that he has had ADHD since he was around age 5 or 6, and up until a year ago he had been taking Dexedrine. He claims to have been on this medication since being diagnosed. Symptoms he’s experienced since stopping the medication include poor concentration, trouble focusing, getting distracted, forgetting, and hyperactivity. Patient states that on Dexedrine all his symptoms “vanished.” He is a college student and he feel like he is really struggling without medication. He is currently making B’s and C’s and he feels he should have A’s and B’s. Patient was unable to provide information on his doctor or the location of the practice, and unwilling to contact his mother, whom he says would have the information. Patient asked the provider for a “trial” of Dexedrine, I light of not being able to obtain and verify patient records. History of auditory and visual hallucinations only while under the influence of drugs and alcohol. He denies suicidal or homicidal ideation today.

Past Psychiatric History:

General Statement: Patient states that he started seeing a “shrink” around age 5 or 6 for ADHD

Caregivers: self

Hospitalizations: He did spend some time inpatient at various psychiatric facilities for behavioral issues and outbursts during his adolescent years.

Medication trials: Says he has only taken Dexedrine

Psychotherapy or Previous Psychiatric Diagnosis: ADHD, but unable to obtain records. Claims to have seen the same psychiatrist since age 5, but unable to recall his name.

Substance Use History: He smokes 1 ppd of cigarettes. He drinks alcohol but will not quantify the amount.

 

Assssing and Diognosing Patients with Scizophrenia

Psychiatric Mental Health Nurse Practitioners (PMHNPs) are advanced nurse advanced practice registered nurses prepared to take care of individuals with varying mental disorders. PMHNP is a specialty like no other, the diagnostic tools at their proposal help with proper diagnosis and treatment recommedations that best meet the need of the patient. PMHNP job focuses on assessment, diagnosis and trestment of individuals with mental health needs (Jasper). They can provide therapy and prescribe medication as needed for patient with mental health

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation

Templatedisorders and substance abuse problems. The assignment will focus on the assessment and diagnosis of a patient in the video clip presenting with symptoms consistent with schizophrenia.

Training Title 24

Subjective:

CC: “I am having thoughts and hearing things that others couldn’t hear” HPI: JC is a 28 years old Caucasian Caucasian female brought to the clinic for evaluation by her 2 roomates. The roomates are concerned about recent behavior by which began 12 days ago after patient’s younger brother brother commited suicide in front of her because his girlfriend broke up with him. Patient was did not have good relationship with her parents and her brother was her only closed siblings. Patient reports sleep of 1-2 hours, eats only canned. Patient smokes cannabis daily since age 16, goes out with roomates to has couple drinks of beer. Patient prescribed alprazolam 1mg 2x daily as needed. Pateint works as a bartender

Past Psychiatric History:

General Statement: The patient has no history of previous psychiatric hospitalization

Caregivers: No caregiver mentioned, lives with roomates who brought her for evaluation.

Hospitalizations: No history of previous psychiatric hospitalization.

Medication trials: No history of past medication trials.

Psychotherapy or Previous Psychiatric Diagnosis: No previous psychistric hospitalization/psychotherapy

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