NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

Walden University NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

Whether one passes or fails an academic assignment such as the Walden University NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

The introduction for the Walden University NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

After the introduction, move into the main part of the NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

Subjective:

CC (chief complaint): “ I Can’t even begin to describe what I am feeling, sadness, fear, I guess.”

HPI: Mr. D.J. is a nineteen-year-old male patient who came to the facility for a psychiatric visit after developing symptoms of fear and sadness after he realized that he is being activated with the Navy Reserves through a stop-loss policy. These symptoms have been there for the last one and half months. He confesses to being discontent with having to listen to gay comments while serving as a soldier since he is gay. However, he fears sharing regarding his sexuality with people since he is not sure how they would react. He fears and is scared that some would be surprised and walk away from him and never come back to his side. The patient also indicates that he fears rejection and feels like he wants to die when he thinks about it. He confesses to having suicidal thoughts before but not in recent times. The patient has had delusions related to the men he works with and hopes that he can move away from such delusions.

Past Psychiatric History:

General Statement: The patient is generally healthy but is of late sad and has fear after realizing he has been activated with the Navy Reserves
Caregivers (if applicable): The patient lives with both parents as the only child
Hospitalizations: no cases of hospitalizations recorded
Medication trials: No cases of medical trials reported
Psychotherapy or Previous Psychiatric Diagnosis: No previous psychiatric history.

Substance Current Use and History: The patient has not used or is not using any substances, alcohol, or cigarette

Family Psychiatric/Substance Use History: There is no substance use or family psychiatric history.

Psychosocial History: D.J is a nineteen-year-old patient who lives with both parents in Minneapolis. The patient has no partner currently and works at Starbucks as a part-timer. The patient’s MOS is an SK1 storekeeper

Medical History:

Current Medications: The patient is currently not using any medications
Allergies: No known allergies

Reproductive Hx: The patient has no partner currently. He confirms that he is gay and has known his sexual identity since the age of eight.

ROS:

GENERAL: The patient is calm and cooperative
HEENT: The head is normal. No eye infection, double vision, double vision, or visual loss. No ear infections or hearing loss. No nose congestion or sneezing. No sore throat
SKIN: no rashes, itchiness, or irritation
CARDIOVASCULAR: No chest discomfort, pressure, or pain was reported
RESPIRATORY: NO congestion, no breathing problems
GASTROINTESTINAL: no eating disorders, no abdominal ailments
GENITOURINARY: no pain passing urine, no urge for frequent urination
NEUROLOGICAL: Reports being sad and having fear. He is also scared and anxious
MUSCULOSKELETAL: No glutes, no muscle or back pain
HEMATOLOGIC: No blood infections were reported
LYMPHATICS: No swelling was noted
ENDOCRINOLOGIC: has no abnormal sweating or excessive thirst

Objective:

Vitals: T- 98.8, P- 89, R 18 110/62 Ht 5’7 Wt 133lbs.

Physical exam: if applicable

Diagnostic results: none was conducted

Assessment:

Mental Status Examination:

D.J is a nineteen-year-old male patient who visited the clinic with the claims of fear and sadness. The patient is well-dressed and groomed. He is keen to participate in the psychiatric examination and assessment. He has normal speech with consistent volume and normal tone. The patient confirms delusional thoughts. He confirms to have had suicidal thoughts sometimes back to not anymore. The patient’s thought process is intact. His short-term and long-term memory are both intact. His mood is sad, and he feels scared to be rejected by people.

Differential Diagnoses:

Social Anxiety Disorder: This is a type of anxiety disorder known to make individuals have symptoms such as excessive self-consciousness and anxiety in a social situation. According to the DSM-5 criteria, the diagnosis of a social anxiety disorder includes fear of anxiety unexplainable through substance abuse, medication use or substance use, and distress or anxiety which impairs daily life, avoidaing of anxiety-prodocing situations (Koyuncu et al.,2019). The other symptom is intense fear or anxiety regarding a particular social situation because of fear of being humiliated, embarrassed, or negatively judged (APA, 2022). The patient has displayed all these symptoms. He fears revealing his sexuality to workmates for fear of being judged; he also seems to avoid going to active duties since it is unpleasant to him hearing people make comments regarding gays. Therefore, this is likely to be the primary diagnosis.
Generalized Anxiety disorder (GAD). This is a condition that may make an individual have extreme worry and fear about various aspects of life. A person may have a constant feeling of being overwhelmed, fearful, and excessive worry regarding various things (Sadock, 2015). The implication is that such individuals usually have problems controlling nervousness or worry (Crocq, 2022). The patient in this case study has displayed these symptoms. The patient has feelings of sadness and worry, which have been triggered by realizing that his active service is being extended. He also feels anxious and scared about revealing his sexuality to his workmates and fears that some may leave him, never to return.

Major Depressive Disorder: This is a type of depression where an individual displays intense depressive symptoms for more than a fortnight, hence interfering with normal functionality or everyday life (Mullen, 2018). The feelings may include hopelessness, being anxious, and feeling sad. According to the DSM-V criteria, an individual is diagnosed with a major depressive disorder when the individual displays symptoms such as feelings of worthlessness, low or sad most of the time for at least a fortnight, change in appetite, loss of interest in activities and sleep problems (Zimmerman et al.,2019). Even though the patient has shown symptoms such as anxiety and sadness, he sleeps well, eats well since he has a good appetite, and has not reported losing interest in activities. Therefore, this condition looks less likely, though it is considered a differential diagnosis.

Reflections:

This case study presented an opportunity to learn more about mental health conditions. This patient presented with fear and sadness resulting largely from his sexual identity. He finds it difficult to go back for active duties, which he has associated with unpleasant comments regarding being gay as he is also gay. The anxiety and fear regarding his sexual identity extend to the other workplace, where he is skeptical about telling others about his sexual identity for fear of being judged or left by others. If I was in the same position as the healthcare professional, there are various things I would have done differently. For example, I would have inquired more about his daily life and how he feels regarding his functionality. This would have led to a better insight into the physical impacts of the condition. The patient is so sensitive about his secrets being shared with other people; as such, I will endeavor to keep the information confidential (Sussman, N., & DeJong, 2018). One of the social determinants of health that is applicable in this case is social support. The patient is sad and has a fear of the extended active duty, as well as worries and fear concerning how to reveal his sexual identity. Therefore, the patient needs adequate social support to help him through the difficulties he is facing (Wang et al.,2018).

References

American Psychiatric Association. (2022). Trauma- and stressor-related disorders. In the Diagnostic and statistical manual of mental disorders

Crocq, M. A. (2022). The history of generalized anxiety disorder as a diagnostic category. Dialogues in Clinical Neuroscience. https://doi.org/10.31887/DCNS.2017.19.2/macrocq

Koyuncu, A., İnce, E., Ertekin, E., & Tükel, R. (2019). Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs In Context, 8. https://doi.org/10.7573%2Fdic.212573

Mullen, S. (2018). Major depressive disorder in children and adolescents. Mental Health Clinician, 8(6), 275–283. https://doi.org/10.9740/mhc.2018.11.275

Sadock, B. J. (2015). Sadock’s synopsis of psychiatry: behavioral sciences. Rezaee F.(Persian translator). 11th ed. Tehran: Arjmand pub, 399-410.

Sussman, N., & DeJong, S. M. (2018). Ethical considerations for mental health clinicians working with adolescents in the digital age. Current Psychiatry Reports, 20(12), 1-8. https://doi.org/10.1007/s11920-018-0974-z

Wang, J., Mann, F., Lloyd-Evans, B., Ma, R., & Johnson, S. (2018). Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry, 18(1), 1–16. https://doi.org/10.1186/s12888-018-1736-5

Zimmerman, M., Martin, J., McGonigal, P., Harris, L., Kerr, S., Balling, C., … & Dalrymple, K. (2019). Validity of the DSM‐5 anxious distress specifier for major depressive disorder. Depression and Anxiety, 36(1), 31–38. https://doi.org/10.1002/da.22837

Sample Answer 2 for NRNP 6635 Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

This soap note centers around a 27-year-old Sergeant who enlisted in the military immediately after completing high school and served in war zones. After serving eight years in the military, he has recently become engaged. This paper explores a patient’s psychiatric assessment, differential diagnoses, and the critical thinking process involved. The paper also provides a comprehensive analysis of the patient’s symptoms, DSM-5 criteria, and potential areas for improvement. Finally, the paper also discusses possible future sessions and addresses ethical considerations.

Subjective:

CC (chief complaint): “My fiancé suggested, well, demanded that I make an appointment.”

HPI: B.S., a 27-year-old white male, sought psychiatric evaluation due to experiencing anxiety disorders following a distressing incident at a county fair in the company of his sister and husband. The fair was disrupted by significant aerial explosions, of which B.S. was unaware. He fled, apprehensive of law enforcement officers attempting to restrain him. After loudly proclaiming his status as a combat veteran, his companions quickly retreated, realizing that the sound of fireworks resembled the gunfire he had experienced in combat. The explosions transported B.S. back in time, reminding him of his military service. The patient has not received any previous psychiatric or substance use treatment and has plans to enter into marriage and start a family. The patient has recurring memories of the event, which manifest as nightmares, heightened startle responses, and a sense of being trapped between two vehicles. He talks of intense events during his military career, and any unpleasant disruption might make him feel queasy and cause his stomach muscles to tense.

Past Psychiatric History:

General Statement: The patient has been untreated for mental health difficulties for the past twelve months.
Caregivers (if applicable): His fiancé.
Hospitalizations: No prior hospitalizations.
Medication trials: Has never used any psychotropic medications.
Psychotherapy or Previous Psychiatric Diagnosis: No previous treatment or psychiatric diagnosis

Substance Current Use and History: The patient reported no use of illegal drugs or tobacco. The father exhibited signs of neglect and struggled with alcoholism.

Family Psychiatric/Substance Use History: His father exhibited harsh behavior when intoxicated. The father is still alive but in bad health, with cirrhosis, diabetes mellitus, hypertension, and alcoholism. His paternal grandfather had depressive episodes while serving in the military.

Psychosocial History: The patient moved with his fiancée because of her work opportunity, and they presently reside five hours away from their family. He has an elder sister and a younger sibling. He completed high school and is pursuing an online degree in accounting. His pastimes include reading and viewing television. However, he eschews music because of its capacity to induce uneasiness. He had just concluded his eight-year Marine tenure, during which he undertook three extended deployments in combat zones.

Medical History:

Current Medications: The patient uses medication to control his asthma.
Allergies: No food or drug allergies are known. Verifies the existence of seasonal allergies.

Reproductive Hx: Engaged in a sexual relationship with plans to marry within the following two years.

ROS:

GENERAL: The patient reports no fever, weight fluctuations, weariness, or physical weakness.
HEENT: No evidence of head trauma, pain, or changes in hair distribution or inner structures. The auricular area lacks exudate, itching, pain, tinnitus, or auditory deficits. Eyes: No glasses, impaired vision, or tears are necessary. Nose: No sinus pain, congestion, or prior history of epistaxis. Throat and Mouth: No dental discomfort, hemorrhaging gums, sore throat, or dysphagia.
SKIN: Free of rashes, itching, hives, or eczema.
CARDIOVASCULAR: Denies cyanosis, heart palpitations, chest constriction, or dyspnea.
RESPIRATORY: Denies coughing, dyspnea, wheezing, or sneezing.
GASTROINTESTINAL: Denies hernia, altered bowel movements, or reflux present. Nausea and strained stomach muscles were reported.
GENITOURINARY: denies burning during urination, dysuria, nocturia, and any variations in the frequency of urination.
NEUROLOGICAL: Denies headache, lightheadedness, dizziness, or blurred vision.
MUSCULOSKELETAL: Denies stiffness or discomfort in the joints and muscles.
HAEMATOLOGIC: Denies a history of hemorrhage, protracted ecchymosis resolution, or anemia.
In the lack of lymphadenopathy
ENDOCRINOLOGIC: Denies excessive thirst, polyuria, polydipsia, or hair changes.

Objective:

Physical exam:

Vital signs: Temperature – 98.8°F, Pulse – 86 bpm, Respiration – 18 breaths/min, Blood Pressure – 122/70 mmHg, Height – 5’8″, Weight – 160 pounds

Diagnostic results: No laboratory testing was requested. The Clinician-Administered PTSD Scale (CAPS) is the definitive instrument for diagnosing PTSD, evaluating 17 questions based on DSM-IV criteria (Hunt et al., 2022).

Assessment:

Mental Status Examination: The patient is a 27-year-old Caucasian male who is alert, well-groomed, and actively participating in the interview. He seems composed and agreeable, although he sometimes exhibits defensiveness and apprehension. His discourse is lucid and cohesive but sometimes emotive. He acknowledges the need for coping mechanisms and expresses apprehension over flashbacks from his duty. No motor impairments were seen, and he exhibits sound judgment and understanding. He refutes the presence of suicidal thoughts, homicidal ideation, and auditory or visual hallucinations.

Differential Diagnoses:

Posttraumatic Stress Disorder (PTSD): PTSD is a severe psychiatric disorder that is often disregarded. The DSM-5 describes it as being exposed to traumatic experiences, specific manifestations, avoidance of stimuli, and adverse alterations in mood, arousal, reactivity, and cognition. It is a significant consequence of trauma exposure (Blais et al., 2021). The patient’s recurrent exposure to traumatic events is indicated by the patient’s experiences with PTSD, which include flashbacks, anxiety, and terror.
Panic Disorder: PD is a debilitating anxiety illness that impairs functioning in social, vocational, and daily activities. Approximately one in three persons have agoraphobia, leading them to evade panic episodes and seek assistance. The Anxiety Sensitivity Index and the Pain Disorder Severity Scale evaluate anxiety symptoms. Panic attacks, according to the DSM-5, are abrupt occurrences of profound dread or distress (Barrett et al., 2020). The patient reports feeling ensnared in traffic and exhibiting chilly perspiration.
Agoraphobia: Agoraphobia is an anxiety condition defined by the dread of settings from where escape may be intricate or where assistance may be unavailable during panic episodes. It is prevalent in public transit, open areas, densely populated environments, and isolation. The DSM-V classifies it as panic disorder with agoraphobia and panic disorder without agoraphobia (Gros et al., 2023). Symptoms include aversion to crowds and confinement inside a vehicle’s interior. Adverse psychological and physical outcomes are more common among service members who have agoraphobia.

Reflections: Should I have the chance to conduct the session with this patient again, I would prioritize enquiring more comprehensively about his coping techniques and support system while also examining any regrets he may have over his anxiousness. I would underscore the need for secrecy and probe for any considerations of self-harm or damage to others, acknowledging that his experiences from active duty may engender complicated feelings such as remorse. Comprehending the impact of these emotions on his health is crucial, particularly since PTSD may arise from traumatic events and is linked to several medical complications (Neilson et al., 2020). I would concentrate on recognizing alterable elements to guide therapy and enhance his autonomy in health management. To improve the session, I would use a systematic, trauma-informed methodology encompassing client-centered communication, informed consent, cultural competency, and well-defined professional limits (Benedict et al., 2020). I would also provide psychoeducation on PTSD, support networks, and stress management skills, customizing treatments to his specific history and circumstances while ensuring frequent follow-ups to assess progress and modify treatment plans as needed.

Conclusion

The patient requested a psychiatric examination for anxiety disorders after a distressing incident at a fair and subsequent flashback related to his military experience. He has no prior history of mental or drug use therapy and intends to marry and procreate. His familial background comprises an alcoholic father and a grandpa afflicted by depression. Treatment must include a systematic, trauma-informed methodology, psychoeducation, support networks, and stress management strategies.

References

Barrett, A. J., Taylor, S. L., Kopak, A. M., & Hoffmann, N. G. (2020). PTSD, panic disorder, and alcohol use disorder as a triple threat for violence among male jail detainees. Journal of Criminal Psychology, 11(1), 21–29. https://doi.org/10.1108/jcp-07-2020-0029

Benedict, T. M., Keenan, P. G., Nitz, A. J., & Moeller-Bertram, T. (2020). Post-traumatic stress disorder symptoms contribute to worse pain and health outcomes in veterans with PTSD compared to those without. A Systematic Review with Meta-Analysis. Military Medicine, 185(9–10), e1481–e1491. https://doi.org/10.1093/milmed/usaa052

Blais, R. K., Tirone, V., Orlowska, D., Lofgreen, A., Klassen, B., Held, P., Stevens, N., & Zalta, A. K. (2021). Self-reported PTSD symptoms and social support in U.S. military service members and veterans: a meta-analysis. European Journal of Psychotraumatology, 12(1). https://doi.org/10.1080/20008198.2020.1851078

Gros, D. F., Pavlacic, J. M., Wray, J. M., & Szafranski, D. D. (2023). Investigating Relations Between the Symptoms of Panic, Agoraphobia, and Suicidal Ideation: The Significance of Comorbid Depressive Symptoms in Veterans with Panic Disorder. Journal of Psychopathology and Behavioral Assessment, 45(4), 1154–1162. https://doi.org/10.1007/s10862-023-10082-4

Hunt, C., Krauss, A., Hiatt, E., & Teng, E. J. (2022). Predictors of symptom reduction following intensive weekend treatment for panic disorder: An exploratory study of veterans. Journal of Affective Disorders, 308, 298–304. https://doi.org/10.1016/j.jad.2022.04.053

Neilson, E. C., Singh, R. S., Harper, K. L., & Teng, E. J. (2020). Traditional masculinity ideology, posttraumatic stress disorder (PTSD) symptom severity, and treatment in service members and veterans: A systematic review. Psychology of Men & Masculinity, 21(4), 578–592. https://doi.org/10.1037/men0000257

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Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
Student paper example
Citing Sources
The Writing Center is a great resource