across the Lifespan Practicum - Chamberlain
NR 547 Week 1
1. differential diagnosis: The provider's initial hypothesis
-a working list of potential problems that can be associated with the initial or chief
complaint
-Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)
• provides guidance for identifying psychiatric diagnoses
2. Psychiatric assessment: History taking: -History of Present Illness
-How long have you been feeling this way?
-Did something happen in your life that may have triggered these emotions?
-How is this current situation impacting your life?
The Psychiatric History
-Have you ever been hospitalized for any mental health issues?
-Have you ever had counseling or psychotherapy?
-Have you ever taken medications for your mental health in the past?
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-Are you currently on any medications for mental health or sleep?
Medical History/Screening for General Medical Conditions
-Do you have a primary care provider?
-Do you have any medical illnesses?
-Are you currently taking any medications or herbal supplements?
-Do you have any allergies to medications?
, -Have you ever been hospitalized for any reason?
-Have you ever had surgery?
Family Psychiatric History
-Has any relative of yours ever been hospitalized for a mental health issue?
-Has any blood relative of yours ever been diagnosed with a mental health issue?
-Has any blood relative of yours had a history of seizures or dementia/Alzheimer's?
Social and Developmental History
-Tell me a little bit about your childhood and how you grew up.
-How was your experience in school when you were younger? Did you enjoy school?
-How do you support yourself with your finances?
-Do you have a good support system? Are you currently in a relationship? Where
do you live? Who do you live with?
-What do you do in your free time? What activities do you enjoy?
3. Screening and Psychiatric Rating Scales: Evidence-based screening tools and
psychiatric rating scales
-can help the provider identify symptoms and assess their severity and can assist
with the evaluation of response to treatment
4. A 52-year-old client presents to the emergency department following a car
accident. The emergency department (ED) physician is concerned that the
client may have intentionally crashed her car and requests a stat PMHNP con-
sult. In speaking with the PMHNP, the client describes persistent feelings of
sadness and hopelessness. She states that she often wonders if her husband
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would be happier if she wasn't around anymore since she's never happy and
sometimes thinks about what it would be like to just take a handful of sleeping
pills and go to sleep forever. The client reports a previous suicide attempt
when she was 16 but denies that she is considering killing herself right now.
Based on the client's ASQ score, what is the most appropriate response?
No action is necessary as the client is not currently considering suicide.