NRNP 6675 Week 3: Focused SOAP Note and Patient Case Presentation
NRNP 6675 Week 3: Focused SOAP Note and Patient Case Presentation College of Nursing-PMHNP, Walden University NRNP 6675: PMHNP Care Across the Lifespan 2 Practicum September 19, 2021 Introduction Each mental intervention is based on the evidence gathered during the initial interview with the patient; each patient's therapy begins with a thorough medical and mental health evaluation, the incorporation of trust, and a dialogue of past mental health history, substance misuse history, family mental health history, and so forth. The evaluation of the patient in this case was documented, and a diagnostic impression was formed based on the information obtained from the patient during the evaluation. A therapy strategy was devised when the case was developed. The patient is a 7-year-old Caucasian boy who was scheduled for an initial screening for a mood disorder after her pediatrician recommended that she consult a psychiatrist. At this time, the patient is not taking any medications. DDAVP PO was given to the patient, but it was stopped since it was ineffective. Patient Initial: R.C Age: 7 Gender: Male Subjective Data: CC: "My mother said you will be able to help me with my mood problem" HPI: R.C a 7-year-old White male who was referred to a psychiatrist for evaluation after several treatments and efforts by his teacher to help him with his mood. According to patient's mother during the interview, the mother said that the pediatrician placed patient on DDAVP which did not help patient. Mother did not list dose of medication or frequency. During the interview, patient states that he feels worried most time. Patient said " I am worried about everything". Patient admits to bad dreams and that he dreams a lot that he can't find his brother and mom. When asked if patient feels lost. Patient responding saying " I worry about my mom and brother when I am alone". Patient went further to state "People in school don't like me. They call me smelly and calls me names". Patient said that his mom said his school mates calls him those names because patient does not take her baths. Patient expressed that he is sad about it. Patient said sometimes he will have accidents at night. Patient also states that his school mates his school mates don't know how it feels when your father can't come back home and that he worried what if his mom does not come home. Patient states that his teacher also picks on him in class. His teacher was telling him to sit down and focus. Patients admit to harming other by saying" I have thrown book at Billy". Denies
Escuela, estudio y materia
- Institución
- NRNP 6675
- Grado
- NRNP 6675
Información del documento
- Subido en
- 29 de diciembre de 2022
- Número de páginas
- 12
- Escrito en
- 2022/2023
- Tipo
- Examen
- Contiene
- Preguntas y respuestas
Temas
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nrnp 6675
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nrnp 6675 week 3 focused soap note and patient case presentation
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week 3 focused soap note and patient case presentation
