Solved: NRNP 6635 week 10 Harold Brown

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NRNP 6635: Harold Brown

Name: Harold Brown
Gender: male
Age:60 years old
T- 98.8 P- 74 R 18 134/70 Ht 5’10 Wt 170lbs
Background:
Has bachelor’s degree in engineering. He dates casually, never married, no children. Has one
younger brother. Sleeps 7 hours, appetite good. Denied legal issues; MOCA 28/30 difficulty with
attention and delayed recall; ASRS-5 21/24; denied hx of drug use; enjoys one scotch drink on
the weekends with a cigar. Allergies Dilaudid; history HTN blood pressure controlled with
Cozaar 100mg daily, angina prescribed ASA 81mg po daily, valsartan 80mg daily.
Hypertriglyceridemia prescribed fenofibrate 160mg daily, has BPH prescribed tamsulosin 0.4mg
po bedtime.

Please note that the video cases may not have all the necessary information needed for your evaluation. Supplementary case histories are provided. Rather than write “not provided” in your evaluations, be sure to use the fact sheets to fill in gaps. For any information still missing, explain what information is needed and why it is important.

Select one of the videos in this weeks’ resources to use for your Assignment this week. Then, access the document “Case History Reports” and review the additional data about the patient in the specific video number you selected.

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis.

For this Assignment, you will assess a patient in a case study who presents with a neurocognitive or neurodevelopmental disorder.

  • 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.
  • 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.).

Solution:

Subjective:

Patient name: Harold Brown (H.B)Gender: Male Age: 60 years.

CC (chief complaint):Difficulty with concentration/attention and delayed recall.

HPI: H.B., a 60-year-old male presents to the clinic with complaints of difficulty with concentration/attention and delayed recall which he attributes to accelerated deadlines and associated pressure. He also reports making silly but possibly costly mistakes at work due to a lack of concentration and attention. He also reports being easily distracted at work, having trouble organizing tasks and activities (he is messy), and forgetfulness (e.g. he forgets his belongings and pays bills, some problems remaining seated and staying focused (which has improved since he was at school).

Past Psychiatric History:

  • General Statement:The patient reports having problems with concentration, attention, forgetfulness, inability to stay seated and focus, and talking out of class since he was young. The current stress and pressure with deadlines have triggered these symptoms.
  • Caregivers (if applicable): None
  • Hospitalizations: None
  • Medication trials: None.
  • Psychotherapy or Previous Psychiatric Diagnosis:None………………………………