An important consideration when working with patients is their cultural background. Understanding an individual’s culture and personal experiences provides insight into who the person is and where he or she may progress in the future. Culture helps to establish a sense of identity, as well as to set values, behaviors, and purpose for individuals within a society. Culture may also contribute to a divide between specific interpretations of cultural behavior and societal norms. What one culture may deem as appropriate another culture may find inappropriate. As a result, it is important for advanced practice nurses to remain aware of cultural considerations and interpretations of behavior for diagnosis, especially with reference to substance-related disorders. At the same time, PMHNPs must balance their professional and legal responsibilities for assessment and diagnosis with such cultural considerations and interpretations.

For this Assignment, you will practice assessing and diagnosing a patient in a case study who is experiencing a substance-related or addictive disorder. With this and all cases, remember to consider the patient’s cultural background.

TO PREPARE:

• Review this week’s Learning Resources and consider the insights they provide.
• Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
• 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.

BY DAY 7 OF WEEK 8:

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:

Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders

Subjective:

CC (chief complaint):The patient shows up because her boss has expressed worries about possible substance abuse.

HPI: Ally Chen, an Asian American woman of 44, comes in for assessment at the request of her supervisor. Because she is worried about possible substance abuse, she seeks help to keep her work. Ally reports that her appetite is healthy and that she sleeps for around nine hours every day, with two to three nighttime awakenings. She admits to having a DUI when she was 21 but denies using drugs at the time. According to Ally, there are no indications of mental health issues such as anxiety or sadness at the moment.

Previous Psychiatric History:

• General Statement: The patient is not currently on any drugs and denies having ever received a psychiatric diagnosis for any disease. She said that she occasionally takes over-the-counter drugs to treat hangover headaches.
• Caregivers: N/A, if applicable
• Hospitalizations: According to the patient, they have never been admitted for any illness.
• Medication trials: According to the patient, they have never taken any trial drugs.

 • Previous psychiatric diagnosis or psychotherapy: The patient admits to having a DUI conviction under their belt when they were 21 years old, but they deny using drugs or alcohol at this time. No longer does a single glass of wine or mixed drink enough to “pass out,” whether one is socializing with friends or on one’s alone. No more information on drug use has been provided. Substance abuse and mental illness in the family:……………….KINDLY CLICK ON THE PURCHASE ICON BELOW TO ACCESS THE ENTIRE SOLUTION FOR $15