PRAC 6635 Week 9 Assignment – Step-by-Step Guide

The first step before starting to write the PRAC 6635 Week 9 Assignment Comprehensive Psychiatric Evaluation and Patient Case Presentation, 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 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 PRAC 6635 Week 7 Assignment 2

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 paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for PRAC 6635 Week 9 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 paper.

How to Write the Body for PRAC 6635 Week 9 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 PRAC 6635 Week 9 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 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 PRAC 6635 Week 9 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 PRAC 6635 Week 9 Assignment

The reference helps provide the reader with the complete details of the sources you cited in the 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 PRAC 6635 Week 9 Assignment Follows:

Week 9 Assignment: Comprehensive Psychiatric Evaluation And Patient Case Presentation

Patient information

Name: AS

Age: 56 years

Sex: male

Race: white

Subjective:

CC (chief complaint): “My weight and this gut have bothered me a lot recently.”

HPI: A.E., a 52-year-old white male, has presented himself for a psychiatric evaluation primarily due to an escalation in argumentative behavior, an obsessive need for answers, and a decrease in the amount of time spent at a friend’s house, resulting in more free time. A.E. has a history of schizophrenia, with the initial episode characterized by a feeling of detachment from himself. Despite lacking insight into his illness, he acknowledges the positive effects of his medication regimen. During his recent month-long trip to South America, he experienced nightmares, which he attributes to inadequate sleep. Since returning, he denies any changes in sleep quality but reports an increase in argumentative behavior. 

A.E. is actively engaged in various activities such as odd jobs, house-sitting, and working at a garage. He expresses concern about his weight and has requested a consultation with an endocrinologist. Currently, he is prescribed a combination of medications, including Klonopin, Gabapentin, Clozapine, Fluphenazine, and Benztropine. In addition to these psychiatric medications, he also takes enalapril/Vasote, aspirin, benztropine 2 mg q 6 pm, atorvastatin, omeprazole, glyburide, JANUVIA, Victoza, Lantus, ferrous sulfate amlodipine, Symbicort, and ibuprofen for his medical conditions.

Past Psychiatric History:

  • General Statement: AS has been on treatment for schizophrenia for 20 years now
  • Caregivers (if applicable): The patient cannot recall
  • Hospitalizations: One hospitalization 20 years ago for schizophrenia
  • Medication trials: Fluphenazine
  • Psychotherapy or Previous Psychiatric Diagnosis: Was diagnosed with schizophrenia 20 years ago and has been compliant with his treatment.

Substance Current Use and History: denies use of alcohol, tobacco, or illicit substances of abuse

Family Psychiatric/Substance Use History: The father had bipolar disorder, but unfortunately, he is no longer alive. The mother, on the other hand, is a survivor of a stroke and currently resides in South America. The patient has five older siblings who are alive and well. No psychiatric or substance use history of ASe’s siblings, as well as any extended family members. No history of family suicides

Psychosocial History: He is the youngest among his five siblings and currently lives in temporary housing. He is unmarried and does not have any children. He completed high school and has also attended three trade schools to further his education. He is involved in various small jobs for his friends and works as a driver. There is no record of any legal issues or involvement in any criminal activities. AS’s interests include dog-sitting, watching movies, listening to music, ballroom dancing, and telling jokes.

Medical History: AS has a medical history of type 2 diabetes mellitus, hypercholesterolemia, and sleep apnea. He has also had a vasectomy. There are no reported seizures or head injuries.

  • Current Medications: AS is currently prescribed a medication regimen that includes Klonopin 0.5 mg as needed every 8 hours, Gabapentin 300 mg at 5 pm and 8 pm, Clozapine 500 mg at 8 pm, Fluphenazine 10 mg at 6 pm, Enalapril/Vasotex, Aspirin, Benztropine 2 mg at 6 pm, Atorvastatin, Omeprazole, Glyburide, Januvia, Victoza, Lantus, Ferrous Sulfate, Amlodipine, Symbicort, and Ibuprofen.
  • Allergies: he is allergic to hornets, poison ivy, and penicillin
  • Reproductive Hx: had a vasectomy at age 30

ROS:

  • GENERAL: No recent weight changes, no fever, no night sweats
  • HEENT: No headache, double vision, or hearing loss
  • SKIN: No skin rashes or color changes
  • CARDIOVASCULAR: No unilateral chest pain, leg swelling, easy fatigue, or fainting
  • RESPIRATORY: No shortness of breath or cough
  • GASTROINTESTINAL: No abdominal pain, no change in bowel movements, no appetite changes
  • GENITOURINARY: No genital itchiness, pain, or discharge, and no change in urine color or frequency.
  • NEUROLOGICAL: No numbness, paralysis, or tingling in the limbs
  • MUSCULOSKELETAL: No weakness or pain in the joints or muscles
  • HEMATOLOGIC: No anemia or recurrent infections
  • LYMPHATICS: No leg swelling
  • ENDOCRINOLOGIC: No neck swelling, flank pain, polyuria, or polydipsia

Objective:

Physical exam:

BP: 135/86, T: 97.50F, P: 85 bpm, Ht: 71.5″, Wt: 255, BMI 34

Neuro: Normal cranial nerve exam, normal sensory system exam, normal motor exam, cerebellar function intact

Diagnostic results: The Absolute Neutrophil Count levels recorded on different dates indicate decreasing values over the past six months, with the last value normal at 4300/microliter, the last clozapine level was six months ago was slightly high at 771 (normal 350-600). The last norclozapine + clozapine levels were typically below 450

Assessment:

Mental Status Examination: AS is a 56-year-old Caucasian male who appears to be his stated age. He presents himself with a well-groomed appearance that is consistent with his age. He is alert, cooperative, and open to the examiner. His focus and concentration were deemed to be satisfactory, and his memory appeared to be functioning normally. He maintains eye contact. His subjective mood is “great” and objectively euthymic, with mood congruent affect that is reactive. 

He exhibits no noticeable abnormalities in his gross motor activity. AS displayed a calm demeanor and a normal gait, with no apparent tremors, tics, or abnormal movements in the oral/perioral region. His thought processes were logical, linear, and goal-directed, and his speech was normal in rhythm and articulation. AS denied any current thoughts of suicide or homicide, demonstrated appropriate insight and judgment, and denied experiencing any hallucinations, dissociative episodes, or self-harm thoughts.

Differential Diagnoses:

1. F20.9 Schizophrenia, Multiple episodes, currently in partial remission: The patient has been a known schizophrenia patient for a significant part of his life. He has been on various medication trials and is currently on fluphenazine and clozapine, which have seemed to control his psychotic symptoms despite the current escalation of argumentative behavior. The assumption is that he met the DSM criteria for diagnosis of schizophrenia at the time of diagnosis and is currently on maintenance treatment (American Psychiatric Association, 2022). This patient’s psychotic symptoms have improved, thus justifying the diagnosis of partial remission

2.    Treatment-resistant schizophrenia: The patient was added clozapine to his fluphenazine after failing typical antipsychotics and could not improve his psychotic symptoms adequately. Per current guidelines, clozapine is reserved for treatment-resistant schizophrenia (Pandey & Kalita, 2022; Peitl et al., 2023; Chakrabarti, 2021). In addition to fluphenazine, this patient is on benztropine to counter the anticholinergic side effects of typical antipsychotics. Therefore, despite showing marked symptomatic improvement with the current regimen, the diagnosis of treatment-resistant schizophrenia is still valid

3.    F20.81 Schizophreniform disorder: Past psychotic symptoms could qualify this diagnosis in this patient. The patient’s change in behavior, along with their good social and occupational functioning and lack of flat affect, are positive signs for their prognosis. (American Psychiatric Association, 2022). Because he met the diagnostic criteria for schizophrenia, the current episodes last less than a month, thus making the schizophreniform disorder less likely.

4.    301.22 (F21) Schizotypal personality disorder: It is possible that this patient may have schizotypal personality disorder due to their significant discomfort with close relationships, distorted thinking and perceptions, and recent unusual behavior patterns (Xi et al., 2020). The current lack of psychotic symptoms supports this diagnosis, but normal affect and mood make it less likely.

Reflections: 

In a similar patient assessment, it would be essential to prioritize gathering a more comprehensive history of substance use, as the clinical note provided lacked specific information about Alfred Seifert’s consumption of caffeine, nicotine, illicit substances, and alcohol. Substance use plays a crucial role in mental health, and conducting a thorough evaluation could significantly contribute to a more comprehensive understanding of the patient’s overall well-being. When considering social determinants of health, one significant aspect highlighted by Healthy People 2030 is “Social and Community Context.” 

In AS’s case, it would be valuable to delve deeper into his housing situation and explore the potential impact of transitional housing on his mental health, as this could provide valuable insights. Individuals with mental illness are at a higher risk of experiencing housing instability, which in turn may lead to decreased adherence to treatment. Those who live in unstable housing arrangements are more prone to experiencing symptoms and requiring readmission to a treatment facility compared to those who live in stable housing situations (Gowda & Isaac, 2022). 

As a future advanced healthcare provider, a health promotion initiative could involve collaborating with community resources to improve access to stable housing for individuals like Alfred, addressing a critical social determinant that influences mental health outcomes. Patient education efforts could focus on raising awareness and promoting understanding of mental health issues within communities, aiming to reduce stigma and foster a more supportive environment for individuals with psychiatric illnesses. By doing so, this approach would contribute to improved health equity within the field of psychiatry.

PRAC 6635 Week 9 Assignment References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders, Fifth Edition, Text Revision [Review of Diagnostic and Statistical Manual of mental disorders, Fifth Edition, Text Revision]. American Psychiatric Association.

Chakrabarti, S. (2021). Clozapine resistant schizophrenia: Newer avenues of management. World Journal of Psychiatry, 11(8), 429–448. https://doi.org/10.5498/wjp.v11.i8.429

Gowda, G. S., & Isaac, M. K. (2022). Models of care of schizophrenia in the community—an international perspective. Current Psychiatry Reports, 24(3), 195–202. https://doi.org/10.1007/s11920-022-01329-0

Pandey, A., & Kalita, K. N. (2022). Treatment-resistant schizophrenia: How far have we traveled? Frontiers in Psychiatry, 13, 994425. https://doi.org/10.3389/fpsyt.2022.994425

Peitl, V., Puljić, A., Škrobo, M., Nadalin, S., Fumić Dunkić, L., & Karlović, D. (2023). Clozapine in treatment-resistant schizophrenia and its augmentation with electroconvulsive therapy in ultra-treatment-resistant schizophrenia. Biomedicines, 11(4), 1072. https://doi.org/10.3390/biomedicines11041072

Xi, C., Cai, Y., Peng, S., Lian, J., & Tu, D. (2020). A diagnostic classification version of the Schizotypal Personality Questionnaire using diagnostic classification models. International Journal of Methods in Psychiatric Research, 29(1), e1807. https://doi.org/10.1002/mpr.1807

Congratulations for the progress made so far. You are almost there. I hope your patient logs are up to date. Another week of writing is coming up next in NRNP 6635 week 11 assignment, which offers another case presentation, for which you will prepare a comprehensive psychiatric evaluation.

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.

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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.