NRNP 6635 Week 4 Assignment – Step-by-Step Guide

The first step before starting to write the NRNP 6635 Week 4 Assignment: Assessing and Diagnosing Patients with Anxiety Disorders, PTSD, And OCD, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the NRNP 6635 Week 4 Assignment paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NRNP 6635 Week 4 Assignment

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. 

Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the NRNP 6635 Week 4 Assignment paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NRNP 6635 Week 4 Assignment

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the NRNP 6635 Week 4 Assignment paper.

How to Write the Body for NRNP 6635 Week 4 Assignment

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NRNP 6635 Week 4 Assignment

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the NRNP 6635 Week 4 Assignment paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NRNP 6635 Week 4 Assignment

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NRNP 6635 Week 4 Assignment

The reference helps provide the reader with the complete details of the sources you cited in the NRNP 6635 Week 4 Assignment paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded, in sentence sentence care. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

An Example NRNP 6635 Week 4 Assignment Follows:

WEEK 4 ASSIGNMENT: ASSESSING AND DIAGNOSING PATIENTS WITH ANXIETY DISORDERS, PTSD, AND OCD

Subjective:

CC (chief complaint): “I just really needed to sit and talk. I’m just so… so unsure. I’m tired of being stuck in my house. I don’t like it.”

HPI: Ms. Connie Weidre, a 53-year-old female, presents for evaluation due to her significant distress and limitations caused by fear and anxiety about leaving her house. She reports being able to leave her house only once or twice a week, specifically on Tuesdays and Saturdays, when her husband can accompany her. Her activities outside are limited to short walks around her neighborhood, and she experiences severe anxiety, including shortness of breath and dizziness, when attempting to go further. This fear has restricted her life significantly, leading to isolation and a profound sense of being stuck. The fear of death and safety concerns, such as fast cars, murders, and natural disasters, have been highlighted as contributing factors to her anxiety. Ms. Weidre also expresses distress over not being able to visit her newborn grandson due to her condition. Her symptoms suggest a long-standing issue, with a notable increase in severity over the past fifteen years following her mother’s death.

Past Psychiatric History:

  • General Statement: Ms. Weidre has no reported history of psychiatric treatment before this evaluation.
  • Caregivers (if applicable): Not applicable.
  • Hospitalizations: No history of psychiatric hospitalizations.
  • Medication trials: Ms. Weidre has not been prescribed psychotropic medication in the past.
  • Psychotherapy or Previous Psychiatric Diagnosis: No history of psychotherapy or previous psychiatric diagnoses.

Substance Current Use and History: Ms. Weidre denies the use of tobacco or illicit substances and reports having one glass of red wine with dinner.

Family Psychiatric/Substance Use History: Ms. Weidre was raised by her mother, who had a history of generalized anxiety and was verbally abusive and abused benzodiazepines. There is no reported substance use history for Ms. Weidre herself.

Psychosocial History: She lives with her husband in Memphis, TN, and has one daughter, aged 25. She has never worked outside the home and reports a strained relationship with her mother, who was verbally abusive. Her anxiety and fear severely limit her social activities.

Medical History:

  • Current Medications: She takes over-the-counter (OTC) Tylenol as needed for headaches and OTC Imodium for diarrhea, which occurs 2-3 times weekly. She also continues to consume one glass of red wine with dinner.
  • Allergies: She is allergic to Zofran, which she avoids due to the risk of adverse reactions.
  • Reproductive Hx: Ms. Weidre is the mother of one daughter, aged 25. There are no mentioned complications or significant reproductive health issues.

ROS:

  • GENERAL: Reports constant fatigue, significant lack of energy despite sleeping 12-13 hours, and decreased appetite.
  • HEENT (Head, Eyes, Ears, Nose, Throat): Complaints of frequent headaches, managed with over-the-counter Tylenol as needed. No issues with vision, hearing, or sinuses have been mentioned. There are no reports of nasal congestion, sore throat, or changes in hearing or vision.
  • Skin: No specific skin issues, such as rashes or lesions, have been reported. Occasionally experiences skin dryness, but no chronic skin conditions are noted.
  • Cardiovascular: Experiences occasional palpitations, particularly during periods of anxiety or stress. No history of heart disease, chest pain, or hypertension beyond the current reading is mentioned.
  • Respiratory: Describes episodes of shortness of breath, particularly in the context of anxiety attacks. No history of asthma, chronic bronchitis, or other respiratory conditions is provided.
  • Gastrointestinal: Decreased appetite and reports diarrhea 2-3 times weekly, managed with over-the-counter Imodium. No history of chronic gastrointestinal diseases, such as inflammatory bowel disease or gastroesophageal reflux disease, is mentioned.
  • Genitourinary: Has an overactive bladder, which remains untreated. No other urinary complaints or history of kidney disease are noted.
  • Neurological: Episodes of dizziness, especially during anxiety attacks, are reported. No history of seizures, syncope, or neurological disorders is mentioned.
  • Musculoskeletal: No complaints of joint pain, muscle pain, or arthritis are reported. Muscle tension related to anxiety is occasionally experienced.
  • Psychiatric: Significant anxiety and fear related to leaving the house, which severely limits social activities and quality of life. No history of previous psychiatric treatment or diagnosis is provided.
  • Endocrine: No reported history of thyroid disorders, diabetes, or other endocrine issues.

Objective:

Physical exam:

  • General Appearance: Appears well-groomed but fatigued. Her posture and facial expressions may suggest distress or discomfort. She is alert and oriented to time, place, and person during the examination.
  • Vital Signs: Temperature of 99.0, pulse 102, respiration rate 24, blood pressure 156/86. Height is 5’4, and weight is 173 lbs.
  • HEENT (Head, Eyes, Ears, Nose, Throat): Normocephalic and atraumatic. Pupils are equal, round, and reactive to light and accommodation. No scleral icterus or conjunctival pallor. Tympanic membranes are intact, with no signs of infection. Mucosa is moist, and septum is midline. Oropharynx is clear without erythema or exudate.
  • Skin: Exhibits mild dryness, but no rash, lesions, or significant scars are observed. Skin turgor is normal, indicating adequate hydration.
  • Cardiovascular: Heart rhythm is regular, with no murmurs, rubs, or gallops detected upon auscultation. Peripheral pulses are 2+ and symmetrical in both upper and lower extremities.
  • Respiratory: Lungs are clear to auscultation bilaterally, with no wheezes, rales, or rhonchi. The chest wall is non-tender.
  • Gastrointestinal: Abdomen is soft, non-distended, and non-tender upon palpation. No hepatosplenomegaly or masses felt. Bowel sounds are normoactive in all quadrants.
  • Musculoskeletal: Full range of motion in all extremities, with no joint swelling or tenderness. Muscle strength is 5/5 in all major muscle groups.
  • Neurological: Cranial nerves II-XII are intact. Sensation is intact to light touch. Reflexes are 2+ and symmetrical in the biceps, triceps, patellar, and Achilles. Coordination is normal, with no evidence of ataxia.

Assessment:

Mental Status Examination:

The mental status examination reveals a patient who, despite maintaining a well-groomed appearance and demonstrating personal care, exhibits visible signs of fatigue and distress. These signs are subtly manifested in her posture and facial expressions, suggesting an underlying struggle not immediately apparent to an observer. Her behavior during the examination is marked by anxious tendencies, including minimal eye contact and noticeable restlessness, indicating discomfort in the clinical setting. Her speech is coherent and goal-directed, revealing a capacity for clear thought and effective communication. However, the pace of her speech varies, reflecting her fluctuating anxiety levels, which seem to influence her verbal interactions. The mood is congruent with her affect; both are characterized by anxiety. Her facial expressions offer limited variation, reinforcing the dominance of her anxious state.

The thought process is logical and goal-oriented, with a notable preoccupation with personal safety and health concerns. This focus aligns with the symptoms commonly associated with anxiety disorders. There is no evidence of delusions or hallucinations, indicating her perceptual experiences remain grounded in reality despite her heightened state of fear. Cognitive functions appear intact. She is oriented to time, place, and person and demonstrates no signs of disorientation. Neurological assessments, including reflexes and coordination, do not reveal any abnormalities, suggesting her cognitive and neurological functions are preserved.

Despite this, she reports difficulty concentrating, particularly in situations that exacerbate her anxiety. Insight into her condition seems limited. While she recognizes her difficulties, there appears to be an underestimation of their severity and a hesitancy to pursue treatment. This suggests a gap in her understanding of her condition and its implications. Judgment, while not explicitly assessed through complex decision-making scenarios, may be inferred to be impacted by her anxiety, potentially influencing her choices and behaviors in ways that further contribute to her isolation and distress.

Differential Diagnoses:

  1. Agoraphobia:

The patient exhibits significant anxiety related to leaving her home, avoids places or situations that might cause her to panic or feel trapped, and demonstrates a dependency on a companion (e.g., her husband) for venturing outside. These symptoms closely align with the DSM-5-TR criteria for Agoraphobia, which include marked fear or anxiety about two (or more) specific situations (e.g., using public transportation, being in open or enclosed spaces, standing in line or being in a crowd, being outside of the home alone), where escape might be difficult, or help might not be available in the event of developing panic-like symptoms (Preti et al., 2021).

Pertinent Positives: Limited outings to specific, perceived safe routes; severe anxiety preventing further exploration; reliance on her husband for support when leaving the house.

Pertinent Negatives: No reported panic attacks in various scenarios required for diagnosis; her fear is not better explained by another mental disorder.

  1. Generalized Anxiety Disorder (GAD):

The patient’s pervasive worry about a range of topics, difficulty controlling worry, and physical symptoms such as restlessness and fatigue suggest GAD. DSM-5-TR criteria for GAD include excessive anxiety and worry occurring more days than not for at least six months, about a number of events or activities, and the individual finds it difficult to control the worry (Watts et al., 2020).

Pertinent Positives: Reports of constant fatigue, significant lack of energy, and episodes of dizziness, all of which could be exacerbated by chronic worry.

Pertinent Negatives: The focus of her anxiety is more specific (fear of leaving the home) than the broad anxieties typically seen in GAD.

  1. Panic Disorder:

The patient’s episodes of palpitations, shortness of breath, and dizziness could suggest panic attacks. DSM-5-TR criteria for Panic Disorder include recurrent unexpected panic attacks and at least one of the attacks has been followed by one month (or more) of one or both of the following: persistent concern or worry about additional panic attacks or their consequences, a significant maladaptive change in behavior related to the attacks (Javelot & Weiner, 2021).

Pertinent Positives: Experiences physical symptoms that could be interpreted as panic attacks.

Pertinent Negatives: There is no clear indication that she has experienced the abrupt onset of intense fear or discomfort that reaches a peak within minutes, along with a combination of physical and cognitive symptoms that are characteristic of panic attacks.

Critical-Thinking Process:

The primary diagnosis of Agoraphobia is reached by carefully considering the specific nature of the patient’s fears and avoidance behaviors. Her anxiety is primarily triggered by the thought of leaving home and being in situations from which escape might be difficult or where help might not be available, rather than by generalized worries or the panic attacks themselves (Preti et al., 2021). The absence of broad, generalized anxiety about multiple aspects of life makes Generalized Anxiety Disorder a less fitting diagnosis.

Similarly, although she experiences symptoms that could be part of panic attacks, the absence of sudden, intense panic attacks that occur unexpectedly and the preoccupation with specific types of situations point away from Panic Disorder as the primary diagnosis. The critical analysis of her symptoms, in conjunction with the DSM-5-TR criteria, underscores Agoraphobia as the most accurate diagnosis, supported by both the pertinent positives of her behavior and the pertinent negatives that rule out other disorders.

Reflections:

Reflecting on the conducted session with this client, I recognize opportunities for a more nuanced approach that could further enrich the therapeutic engagement and outcomes. Specifically, a deeper exploration into the client’s psychosocial context could unveil additional layers influencing her anxiety, such as her cultural background, beliefs about mental health, and the dynamics within her family. Understanding these factors is pivotal, as they can significantly affect her perception of and openness to mental health treatment.

In revisiting the session, legal and ethical considerations extend beyond the foundational aspects of confidentiality and consent. The concepts of autonomy and the patient’s capacity to make informed decisions, especially under the duress of anxiety, warrant careful navigation. Additionally, a therapist must be vigilant about the ethical duty to protect, which may sometimes necessitate mandatory reporting if there is a risk of harm. Ensuring the client is aware of these parameters from the outset is crucial for maintaining trust and transparency.

Addressing health promotion and disease prevention tailored to the client’s specific needs could also enhance her well-being. Suggestions for manageable physical activities and discussions on nutrition and sleep hygiene could serve as accessible entry points for improving her quality of life. Furthermore, considering her age, discussing the potential impact of hormonal changes on her mental health could offer valuable insights and empowerment. Incorporating patient factors such as socioeconomic status, cultural background, and possible stigma associated with mental health within her community is essential. These considerations could inform more accessible and culturally sensitive treatment plans, potentially increasing her engagement and the efficacy of interventions.

NRNP 6635 Week 4 Assignment References

Javelot, H., & Weiner, L. (2021). Panic and pandemic: Narrative review of the literature on the links and risks of panic disorder as a consequence of the SARS-CoV-2 pandemic. L’encephale, 47(1), 38-42. https://doi.org/10.1016/j.encep.2020.08.001

Preti, A., Piras, M., Cossu, G., Pintus, E., Pintus, M., Kalcev, G., & Carta, M. G. (2021). The burden of agoraphobia in worsening quality of life in a community survey in Italy. Psychiatry Investigation, 18(4), 277. https://doi.org/10.30773%2Fpi.2020.0342

Watts, S., Marchand, A., Bouchard, S., Gosselin, P., Langlois, F., Belleville, G., & Dugas, M. J. (2020). Telepsychotherapy for generalized anxiety disorder: Impact on the working alliance. Journal of Psychotherapy Integration, 30(2), 208. https://psycnet.apa.org/doi/10.1037/int0000223

That was marvelous. We are approaching midway the class, which only means one thing, the NRNP 6635 Midterm Exam is coming up soon. To prepare, review everything covered from week 1 to week 6. Stay ready.

Frequently Asked Questions (FAQs)

When approaching a 500-word essay, it’s essential to understand the nuances of this compact form of writing. These frequently asked questions will guide you through the process of crafting a concise and impactful essay.

How many pages is a 500-word essay typically?

A 500-word essay usually spans about one page if single-spaced or two pages when double-spaced, with standard margins and a 12-point font size.

Can you provide examples of a well-structured 500-word essay?

Certainly, to see the structure and flow of a well-written essay, you might want to take a look at a student’s writing guide that provides insights and examples.

Are there specific formatting guidelines for a 500-word essay?

Formatting guidelines typically involve using a legible font like Times New Roman or Arial, size 12, with double-spacing and one-inch margins on all sides. Check any specific requirements your instructor might have provided.

What are some effective strategies for writing a personal essay of 500 words?

For a personal essay, focus on a singular event or characteristic, ensuring your ideas are clear and you reflect on the significance of the subject matter. Use concise language and powerful imagery to maximize impact.

What topics are suitable for a concise 500-word essay?

Choose topics you can thoroughly address within the word limit, such as a personal anecdote, a critical analysis of a poem, or a focused argument on a singular point or issue.

How much time should you allocate to write a 500-word essay effectively?

Depending on your familiarity with the topic and writing proficiency, allocate anywhere from one to several hours for planning, drafting, and revising to ensure a well-presented essay.