Requirements

For Week 6 of the course there will not be a case study given to you by the faculty. Instead you will be assigned a mental health disorder commonly seen in primary care and you will create a case study based on that disorder. You may create a case study either from a previous clinical patient experience or if you have not had a patient in clinical that represents your assigned topic you may research your disease using the week’s classroom material and the evidence-based literature in the field. The case should be clear and include all elements of a normal case that might be presented in class (subjective, objective, assessment, and full 5 point plan).  The clinical practicum documentation will be helpful for this process, or notes you have taken in clinical regarding cases.  The case should be clear, organized, and meet the following guidelines:

Week 6 Part One:

This part goes in part one and should begin with subjective and objective data just like we do in your weekly case study discussion.  Do not put diagnosis until your peers respond.

WEEK 6 Part One: The case should lead the class toward the mental health diagnosis assigned to you by your instructor.

WEEK 6 Part One Specific Guidelines:

If this is an actual patient from clinical- Include their actual chief complaint, demographic data, HPI, PMHX, PSHX, medications, allergies, subjective and objective findings without identifying the patient’s name.

If this is a fictitious case you’ve created from the literature/readings you should design an example patient and include chief complaint, demographic data, HPI, PMHX, PSHX, medications and allergies, subjective and objective findings. Be mindful that the background data for the case should bear some relevance to the diagnosis.

The case should not be overly simple. Like your weekly case studies, it should include subjective data that loosely represents the diagnosis you have been given, but includes some elements of the pathophysiology/presentation of the disease.

You must include the following elements in part one: subjective: chief complaint/HPI, demographic data, HPI, PMHX, PSHX, subjective and objective findings.

Solution:

SUBJECTIVE DATA:

CC: “I constantly feel anxious and I have problems with sleep for the past two months”

HPI: P.C a 40 year-old single ex-veteran American male presents complaints of anxiety and lack of sleep for two months. He says that he always feels disturbed and finds it hard to sleep and when he eventually falls asleep, he keeps waking up due to scary nightmares. Patient says that he no longer functions well as he feels fatigued and heavy headed due to lack of sleep.  Patient denies fever, chills, nausea, and vomiting.

Medications: None

Allergies: NKA

Medication Intolerances: No known intolerances

Chronic Illnesses/Major traumas: Left leg Injury back during combat in Afghanistan 1.5 years ago.

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