NRNP 6635 Week10 Assignment Walden
NRNP 6635 Week10 Assignment Walden
Week 10: Neurocognitive and Neurodevelopmental Disorders
The human brain only constitutes approximately 2% of an individual’s total body weight, a percentage that pales in comparison to the brain’s level of importance in human development (Koch, 2016). Although externally protected by layers of membranes as well as the skull, the brain is not very resistant to damage. Damage to the brain may compromise its functionality, which may, in turn, lead to neurodevelopmental disorders in childhood and adolescence or neurocognitive disorders for any number of reasons across the lifespan. NRNP 6635 Week10 Assignment Walden
This week, you practice assessing and diagnosing neurocognitive and neurodevelopmental disorders across the lifespan.
Reference: Koch, C. (2016, January 1). Does brain size matter? Scientific American. https://www.scientificamerican.com/article/does-brain-size-matter1/
Week 10: Neurocognitive and Neurodevelopmental Disorders Sample Approach
Introduction.
Neurodevelopment disorders are conditions that lead to impaired growth and development of the brain or central nervous system in general. Neurodevelopment disorders commonly impact an individual’s emotions, learning ability, self-control and memory. These conditions are commonly evident during an individual’s growth and development (Stein et al., 2020). Some of the commonly observed neurodevelopment disorders include attention-deficit hyperactivity disorder (ADHD), autism, learning disabilities, cerebral palsy, conduct disorder etc. In this paper, I shall analyse a psychiatric case, come up with the most likely diagnoses and recommend adequate treatment and management.
Subjective Section.
Chief complaint.
Sarah Higgins is a nine-year old female who presented with difficulty in maintaining concentration while at school. Sarah had difficulty remembering the assignments she was given at school. The patient also had difficulty in sitting still for long durations of time and she was constantly fidgeting. She also had difficulty in retaining concentration and had an impaired memory, constantly misplacing her items and forgetting where she placed them.
History of Presenting Illness.
Her mother, who is the informant in this case, says that Sarah’s forgetfulness has been going on for a while to the point where Sarah’s teachers have to leave her a list of the assignments handed out each day. The mother also points out Sarah’s inability to sit still saying that the interview was the longest duration she had ever managed to sit still. Sarah’s mother also points out some dangerous behaviours that Sarah had portrayed when she was younger; jumping into a pool before she could learn how to swim and sticking out her hands into the animal cages every time they went to the zoo.
Past Psychiatric History: Sarah has no previous psychiatric history and is currently not being treated for any psychiatric illness. She has no known history of alcohol, tobacco or drug and substance use.
Development History: She achieved her developmental milestones at the appropriate time and her vaccinations are up to date. She sleeps for the recommended hours each day. She, however, has difficulty sitting down for meals and does not get the recommended nutrition as per the preventive control plan.
Family History: There are no known chronic or psychiatric illnesses among her family members.
Allergies: She has no known drug and food allergies.
ROS: No significant findings were observed on her review of systems.
Objective Section.
Physical Examination.
On examination, Sarah was found to weigh 63 pounds with a height of 4’5. Her temperature was 97.4 with her pulse rate recorded at 62 beats per minute. Her respiratory rate reading was 14 breaths per minute with a blood pressure reading of 95/60. Sarah reports that she sleeps for approximately nine hours each night.
Mental Status Examination.
Sarah is polite and well-behaved for her age. She is willing and co-operative with the interviewer and they easily establish a good rapport with the interviewer. This is shown by the fact that Sarah gives permission for the interviewer to proceed and readily and willingly answers the questions that she is asked.
Sarah is easily distracted and easily loses concentration during the interview. This is observed when she is asked a question by the interviewer on two occasions and she seems distracted. On one occasion, her mother tells her to answer the question that she is asked. On another instance, the interviewer is forced to repeat his question since Sarah was distracted and did not hear the question that she was asked. It is evident that Sarah has a reduced attention span.
From the interview, Sarah answers most of the questions that she is asked with one-word answers. At the start of the interview, her mother urges her to use full words when answering the questions that she is asked. She also seems quite indecisive as she answers the questions asked and is a bit hesitant in responding to some of the issues posed by the interviewer. Sarah also has an impaired memory and is easily distracted.
Diagnostic Features
One of the key diagnostic features in neurodevelopment disorders is a physical examination. It is critical to assess all the systems including the cardiovascular system, respiratory system, gastrointestinal system, genitourinary system and the central nervous system (Myers et al., 2017). This assessment helps in ruling out any underlying medical conditions that may be resulting in the neurodevelopment disorder observed. Physical exam findings reveals that the patient is not in any obvious respiratory distress and does not show any signs of anaemia, clubbing, jaundice, dehydration, cyanosis or oedema.
Clinical observations are another critical component of formulating a diagnosis. Assessing the patient’s level of attention, behaviour, concentration, ability to maintain eye contact and interaction with other individuals is key in coming up with a diagnosis. Other important aspects such as the patient’s speech, articulation, mood and other higher functions are important in diagnosis formulation.
Developmental assessment is also key. A developmental assessment is carried out to establish the child’s level of functioning and reasoning in comparison to his or her peers. Interest is not only taken in what the child does, but how well they are able to perform a specific given task (Saito et al., 2020). Developmental assessments highlight a child’s motor functioning, speech, language and cognitive capabilities. This is critical in the determination of the presence of any neurodevelopment disorders.
Assessment of a child’s growth is also critical in the establishment of any neurodevelopment disorders. Looking at a child’s weight, height and head circumference and comparing to the expected range for that certain age group aids in establishing the presence or absence of most neurodevelopment disorders. Most conditions associated with learning disabilities and developmental delays are commonly associated with abnormalities in the various growth parameters.
I would order a brain imaging test. Brain imaging is an important diagnostic tool in the establishment of neurodevelopment disorders. Cranial ultrasounds, computed tomography scanning and magnetic resonance imaging have proven useful in neurodevelopmental disorders. These tests aid in identifying children with the highest risk of developing neurodevelopment disorders, establishing diagnosis and prognosis of the various conditions and in so doing making it easier to manage neurodevelopment disorders.
Assessment
Differentials.
The differential diagnoses in this case include attention deficit hyperactivity disorder, learning disabilities and autism disorder.
The DSM-5 criteria for attention deficit disorder requires that there be five or more symptoms of inattention or hyperactivity that have been persistent for a duration of more than six months that negatively impact the social and academic functioning of the individual (Kemper et al., 2018). Some of the major symptoms observed include aggression, excitability, fidgeting, impulsivity, persistent repetition of words or actions, difficulty focusing, absent-mindedness, reduced attention span, among others.
DSM-5 criteria for learning disabilities requires the establishment of reduced intellectual ability, a significant decline in social and adaptive functioning and most commonly, childhood onset.
The criteria for autism require that there be an impaired social-emotional reciprocity, difficulty in establishing and maintaining relationships, repetitive motor functions, fixated interests among other symptoms (Dekhil et al., 2018).
Based on the evidence gathered from the interview, the most likely diagnosis is therefore ADHD. The patient clearly has a short attention span and is easily distracted, symptoms that according to Kemper et al. (2018), are key in the diagnosis of ADHD in children. The key pertinent positive findings include being too focused on certain tasks. We also learn that Sarah can play video games for extended durations of time. Other positive pertinent findings include increased energy levels, being spontaneous and being creative and inventive. Pertinent negative findings include self-isolation, increased risk-taking tendencies and behaviours, inability to form and maintain lasting bonds and relationships and self-isolation.
Lessons Learnt.
From the interview, I have learnt that children are easily distracted during interviews, and it is almost impossible to engage them for long durations of time without them being distracted. I would employ the use of more stimulating techniques such as drawing or the use of building blocks to retain the child’s attention, reduce the probability of her being distracted while also assessing her level of performance regarding other children within her age bracket.
Legal/Ethical Considerations.
One of the key legal/ ethical consideration to consider is vulnerability. Vulnerability can be defined as the reduced ability of a human being to anticipate, cope with, resist and overcome the impacts and challenges posed by various situations in life (Haugom, Ruud, & Hynnekleiv, 2019). Taking into consideration that the patient is a nine-year-old child, she is easily predisposed and vulnerable to many challenges posed by her condition.
Other various key legal/ ethical considerations include conflict of interest, exploitation, operational challenges, misconceptions regarding therapeutics among others. Taking into consideration the patient’s age, the parents’ beliefs and socioeconomic status, various treatment and management options may fail to be undertaken in consideration to the various factors identified.
Conclusion.
In conclusion, attention deficit hyperactivity disorder is a common chronic condition that commonly presents with difficulty in maintaining attention, hyperactivity and impulsiveness. The condition is commonly diagnosed during the early stages of life. Medication, therapy and collaborative engagement with other health care professionals is critical in the management of this condition.
NRNP 6635 Week10 Assignment Walden References.
Dekhil, O., Hajjdiab, H., Shalaby, A., Ali, M. T., Ayinde, B., Switala, A., Elshamekh, A., Ghazal, M., Keynton, R., Barnes, G., El-Baz, A. & Hampson, M. (2018). Using resting state functional MRI to build a personalized autism diagnosis system. PLOS ONE, 13(10), e0206351–. doi:10.1371/journal.pone.0206351
Haugom, E. W., Ruud, T., & Hynnekleiv, T. (2019). Ethical challenges of seclusion in psychiatric inpatient wards: a qualitative study of the experiences of Norwegian mental health professionals. BMC Health Services Research, 19(1), 1-12. https://doi.org/10.1186/s12913-019-4727-4
Kemper, A. R., Maslow, G. R., Hill, S., Namdari, B., LaPointe, N. M. A., Goode, A. P., & Sanders, G. D. (2018). Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Jan. (Comparative Effectiveness Reviews, No. 203.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK487761/
Myers, L., Anderlid, B. M., Nordgren, A., Willfors, C., Kuja-Halkola, R., Tammimies, K., & Bölte, S. (2017). Minor physical anomalies in neurodevelopmental disorders: a twin study. Child And Adolescent Psychiatry And Mental Health, 11, 57. https://doi.org/10.1186/s13034-017-0195-y
Saito, M., Hirota, T., Sakamoto, Y., Adachi, M., Takahashi, M., Osato-Kaneda, A., & Nakamura, K. (2020). Prevalence and cumulative incidence of autism spectrum disorders and the patterns of co-occurring neurodevelopmental disorders in a total population sample of 5-year-old children. Molecular Autism, 11, 1-9. https://doi.org/10.1186/s13229-020-00342-5
Stein, D. J., Szatmari, P., Gaebel, W., Berk, M., Vieta, E., Maj, M., de Vries, Y. A., Roest, A. M., de Jonge, P., Maercker, A., Brewin, C. R., Pike, K. M., Grilo, C. M., Fineberg, N. A., Briken, P., Cohen-Kettenis, P. T., & Reed, G. M. (2020). Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies. BMC Medicine, 18(1), 21. https://doi.org/10.1186/s12916-020-1495-2
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Learning Objectives – NRNP 6635 Week10 Assignment Walden
Students will:
- Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information
- Formulate differential diagnoses using DSM-5 criteria for patients with neurocognitive and neurodevelopmental disorders across the lifespan
Learning Resources
Assignment: Assessing and Diagnosing Patients With Neurocognitive and Neurodevelopmental Disorders
Photo Credit: Getty Images
Neurodevelopmental disorders begin in the developmental period of childhood and may continue through adulthood. They may range from the very specific to a general or global impairment, and often co-occur (APA, 2013). They include specific learning and language disorders, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, and intellectual disabilities. Neurocognitive disorders, on the other hand, represent a decline in one or more areas of prior mental function that is significant enough to impact independent functioning. They may occur at any time in life and be caused by factors such brain injury; diseases such as Alzheimer’s, Parkinson’s, or Huntington’s; infection; or stroke, among others. NRNP 6635 Week10 Assignment Walden
For this Assignment, you will assess a patient in a case study who presents with a neurocognitive or neurodevelopmental disorder.
To Prepare:
- Review this week’s Learning Resources and consider the insights they provide. Consider how neurocognitive impairments may have similar presentations to other psychological disorders.
- 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.
By Day 7 of Week 10
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.).
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK10Assgn+last name+first initial.(extension)” as the name.
- Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Training Title 48 for week 10 Transcript
_____________________________________________________________________________
00:00:00BEGIN transcript:
00:00:00[sil.]
00:00:15OFF CAMERA Well, thank you for bringing in these completed questionnaires on attention deficit hyperactivity disorder.
00:00:25MRS. HIGGINS Yeah, you asked me to have some of her teachers fill out the forms, and so, I had two, and I filled out one.
00:00:35OFF CAMERA Great, great, that’s wonderful, and these look very, yep, very completely filled out. How are you today, Sarah?
00:00:40SARAH Fine, thank you.
00:00:45OFF CAMERA Is it okay if I ask you some of the questions about how well you pay attention in school?
00:00:50SARAH Uh-huh.
00:00:55MRS. HIGGINS Sarah, use full words.
00:00:55SARAH Yes, sir.
00:00:55OFF CAMERA You are very polite. Thank you. Some people your age have difficulty being polite. You are very polite. When teachers tell you assignments in school, how well do you remember what they said your assignments are?
00:01:10SARAH Not very well.
00:01:10OFF CAMERA Mm-hmm.
00:01:10SARAH They have to write her down a list.
00:01:15OFF CAMERA Okay. Does that list help?
00:01:20SARAH Sometimes I lose the list.
00:01:20OFF CAMERA Oh, do you forget where you put the list of assignments?
00:01:25SARAH Uh-huh. I mean, yes, I forget.
00:01:25OFF CAMERA Does that happen every time or sometimes or not very much?
00:01:30SARAH It happens sometimes.
00:01:35MRS. HIGGINS Actually, every day.
00:01:35OFF CAMERA Okay. Do you think maybe your mom is right about that, that you forget your assignment list almost every day? NRNP 6635 Week10 Assignment Walden
00:01:45SARAH Yes.
00:01:45MRS. HIGGINS Yeah, they have to leave me a list on my cell phone.
00:01:50OFF CAMERA Oh, okay. How long has this been a problem?
00:01:55MRS. HIGGINS Pretty much since she started school, kindergarten.
00:02:00OFF CAMERA Uh-huh, let’s see what else is on this list. How well do you sit still in your chair at school?
00:02:10SARAH Not very well.
00:02:10OFF CAMERA Uh-huh, do you fidget?
00:02:10SARAH (chuckles) Yes.
00:02:10OFF CAMERA Do you get in trouble for fidgeting or getting out of your chair?
00:02:15SARAH Sometimes.
00:02:20OFF CAMERA Okay, and if you’re reading from a book or a paper, can you sit still then and read?
00:02:25SARAH Sometimes.
00:02:25OFF CAMERA Mm-hmm.
00:02:25MRS. HIGGINS If she really, really likes it, she’ll last about five minutes or so.
00:02:30OFF CAMERA Do you remember what you read? Sarah, do you remember what you read?
00:02:40MRS. HIGGINS Sarah, he’s talking to you.
00:02:45SARAH Uh.
00:02:45MRS. HIGGINS Answer him. I think this is the longest she’s ever sat still.
00:02:50OFF CAMERA Oh, when you read a book, that’s where I was asking, when you read a book, do you remember what you read?
00:03:00SARAH Not much.
00:03:00OFF CAMERA Mm-hmm. What if the teacher reads the book to you, do you remember what the teacher read?
00:03:05SARAH No, sir.
00:03:05OFF CAMERA Mm-hmm, you are very polite, and thank you for answering my questions. I have a few more. Is that okay if I ask you some more?
00:03:20MRS. HIGGINS Sarah, he’s asking you a question, not me.
00:03:20OFF CAMERA Is that okay if I ask you some more questions?
00:03:25SARAH Yes.
00:03:25OFF CAMERA Do you lose things at home like keys or books or pencils? Just anything. Do you lose or misplace things you need?
00:03:35SARAH I lost my geography book yesterday.
00:03:35OFF CAMERA Mm-hmm, did you find it?
00:03:40MRS. HIGGINS I think she left it on the bus. The bus driver is very nice, and we put her name in the book, so we think we’ll get it back.
00:03:45OFF CAMERA Well, that’s good.
00:03:50SARAH I lost my bracelet, too.
00:03:50OFF CAMERA Was that a bracelet you like?
00:03:55SARAH Mimi gave it to me.
00:03:55MRS. HIGGINS My mother.
00:03:55SARAH My grandmother.
00:04:00OFF CAMERA Where do you think you lost it?
00:04:00SARAH On a trip, maybe in the bathroom at the restaurant.
00:04:05MRS. HIGGINS Yeah, we think she took it off to wash her hands.
00:04:05OFF CAMERA Sarah, do you love that bracelet?
00:04:10SARAH Lots.
00:04:10OFF CAMERA Mm-hmm, so then that was sad for you?
00:04:15SARAH Uh-huh, I mean, yes, it was sad.
00:04:15OFF CAMERA Do you ever have problems losing your temper?
00:04:20SARAH Sometimes.
00:04:20OFF CAMERA Mm-hmm, what is something at school that makes you angry?
00:04:25SARAH When the teachers say they asked me to do something, and I didn’t hear them.
00:04:30OFF CAMERA Mm-hmm, do you daydream in school sometimes?
00:04:35SARAH Yes.
00:04:35OFF CAMERA What do you daydream about?
00:04:35SARAH Going home and playing with Conley.
00:04:40MRS. HIGGINS That’s her dog.
00:04:40OFF CAMERA Oh, so you think about good times?
00:04:45SARAH Yes.
00:04:45OFF CAMERA Do you ever think about bad times, too, when you daydream?
00:04:50SARAH Sometimes.
00:04:50OFF CAMERA Mm-hmm, what sorts of bad times?
00:04:50SARAH Missing Mom.
00:04:55MRS. HIGGINS Yeah, we’re separated right now, and we’re split up, but Mom’s working on us being back together real soon.
00:05:05OFF CAMERA Good, any time, Sarah, thinking about anyone, way anyone has hurt you or someone did something bad to you that they wish they didn’t do?
00:05:15SARAH No, May Ann hit me one time at school, though.
00:05:20OFF CAMERA Mm-hmm, do you daydream about her hitting you?
00:05:25SARAH No.
00:05:25OFF CAMERA Oh, when you do your homework or classwork, do you make mistakes?
00:05:30SARAH Lots.
00:05:30OFF CAMERA Mm-hmm, is that pretty frustrating?
00:05:30SARAH Yes, ’cause I try to do it right.
00:05:35OFF CAMERA Mm-hmm, that must not feel good.
00:05:35SARAH It doesn’t feel good.
00:05:40OFF CAMERA What are some of the questions I asked you today?
00:05:40SARAH Uh, about my dog?
00:05:45OFF CAMERA Yeah, okay. Anything else I asked you today?
00:05:50SARAH Uh, I don’t know.
00:05:50OFF CAMERA Mm-hmm, were you just thinking about something else?
00:05:55SARAH I guess so.
00:05:55OFF CAMERA What were you thinking about just then?
00:05:55SARAH Your picture on the wall.
00:06:00OFF CAMERA Ah, do you like that picture?
00:06:00MRS. HIGGINS Sarah loves art, and she loves museums.
00:06:05OFF CAMERA Uh-huh, do you stand and look at the paintings for a long time?
00:06:10MRS. HIGGINS No, she runs from painting to painting, three or four times.
00:06:15OFF CAMERA Oh, let’s see. I see in this form from your teachers that sometimes you have trouble waiting your turn, and yet, you are very polite today.
00:06:25MRS. HIGGINS Yeah, she’s very polite, but in groups, she has a little bit more difficulty.
00:06:30OFF CAMERA Uh-huh, is it difficult to sit still?
00:06:35MRS. HIGGINS Answer his question.
00:06:40OFF CAMERA Mm-hmm, we’ve been sitting still a pretty long time.
00:06:40MRS. HIGGINS Yeah, this is the longest that I’ve seen her sit still.
00:06:45OFF CAMERA Uh-huh, do you play video games?
00:06:45MRS. HIGGINS Yeah, she likes her video games. She can stay on those for long periods.
00:06:50OFF CAMERA Uh-huh, is that right, Sarah? Is that right, Sarah?
00:06:55SARAH Is what right?
00:07:00OFF CAMERA That you can play a video game for a long time. Do you get injured much?
00:07:05SARAH Sometimes.
00:07:05OFF CAMERA Mm-hmm.
00:07:10MRS. HIGGINS Not so much now. When she was younger. We couldn’t even take her to the zoo. She used to stick her hand inside of the bars where the animals could bite her.
00:07:20OFF CAMERA Oh.
00:07:20MRS. HIGGINS And she was this little thing, and she would jump up on the walls, and she even jumped in a pool before she learned how to swim, and that, that really scared us.
00:07:30OFF CAMERA Is that something that doesn’t happen so much now?
00:07:35MRS. HIGGINS No, thank God.
00:07:35OFF CAMERA So, Sarah, from what your mom told me, and what these teachers listed on these forms, it sounds like everyone is in agreement that you have some kind of trouble paying attention and with remembering things and about losing things and some other problems. Do you think you’d like help with all of that?
00:07:55SARAH I guess so.
00:08:00MRS. HIGGINS Yes, we would.
00:08:05[sil.]
00:08:05END transcript
Rubric Detail – NRNP 6635 Week10 Assignment Walden
Select Grid View or List View to change the rubric’s layout.
| Excellent | Good | Fair | Poor | |
|---|---|---|---|---|
| Create documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected.
In the Subjective section, provide: |
18 (18%) – 20 (20%)
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.
|
16 (16%) – 17 (17%)
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.
|
14 (14%) – 15 (15%)
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. NRNP 6635 Week10 Assignment Walden
|
0 (0%) – 13 (13%)
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.
|
| In 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. |
18 (18%) – 20 (20%)
The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.
|
16 (16%) – 17 (17%)
The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are accurately documented.
|
14 (14%) – 15 (15%)
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.
|
0 (0%) – 13 (13%)
The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or, objective documentation is missing.
|
| In 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 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. |
23 (23%) – 25 (25%)
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. |
20 (20%) – 22 (22%)
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. |
18 (18%) – 19 (19%)
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. |
0 (0%) – 17 (17%)
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.
|
| Reflect 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!), 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.). |
9 (9%) – 10 (10%)
Reflections are thorough, thoughtful, and demonstrate critical thinking.
|
8 (8%) – 8 (8%)
Reflections demonstrate critical thinking.
|
7 (7%) – 7 (7%)
Reflections are somewhat general or do not demonstrate critical thinking.
|
0 (0%) – 6 (6%)
Reflections are incomplete, inaccurate, or missing.
|
| Provide 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). |
14 (14%) – 15 (15%)
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.
|
12 (12%) – 13 (13%)
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. NRNP 6635 Week10 Assignment Walden
|
11 (11%) – 11 (11%)
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.
|
0 (0%) – 10 (10%)
Two or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence based.
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| Written 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 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. |
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. |
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. |
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. No purpose statement, introduction, or conclusion were provided. |
| Written Expression and Formatting—English writing standards: Correct grammar, mechanics, and punctuation |
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors. NRNP 6635 Week10 Assignment Walden
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4 (4%) – 4 (4%)
Contains a few (one or two) grammar, spelling, and punctuation errors
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3 (3%) – 3 (3%)
Contains several (three or four) grammar, spelling, and punctuation errors
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0 (0%) – 2 (2%)
Contains many (≥ five) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
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| Total Points: 100 |
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