NRNP 6635 Assessing and Diagnosing Patients With Mood Disorders

NRNP 6635 Assessing and Diagnosing Patients With Mood Disorders

Walden University NRNP 6635 Assessing and Diagnosing Patients With Mood Disorders-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NRNP 6635 Assessing and Diagnosing Patients With Mood Disorders 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 Mood Disorders

Whether one passes or fails an academic assignment such as the Walden University NRNP 6635 Assessing and Diagnosing Patients With Mood Disorders 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 Mood Disorders

The introduction for the Walden University NRNP 6635 Assessing and Diagnosing Patients With Mood Disorders 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 Mood Disorders

After the introduction, move into the main part of the NRNP 6635 Assessing and Diagnosing Patients With Mood Disorders 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 Mood Disorders

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 Mood Disorders

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 Mood Disorders

Subjective:

CC (chief complaint): Allegations by the patient’s mother that the patient recurrently gets moody this time of the year every year.

HPI: Ms. Julie Houston is a 19-year-old female who came to the psychiatric clinic for assessment following a recommendation from her mother. The patient presented with allegations by her mother that she recurrently gets moody around this time of the year annually. She reports that she is not feeling great and feels down. She admits to not doing so well, especially with her special business program in school. She reports that she comprehends everything but the classes are boring. She feels the teachers are stressing her with projects such as developing a mock company which she is finding difficult to complete. Two of the projects are already long overdue. The patient reports difficulty concentrating. For instance, she can read newspaper headlines and cannot seem to recall them almost immediately, a similar case with her classes. The patient has recently gained weight approximately ten pounds. She is experiencing excessive daytime sleepiness to an extent of sleeping through five of her classes this month. Initially, the patient was social, and easily made a lot of friends with whom she enjoyed their company. She would attend concerts and shows with them and engage in fun activities. However, lately, she finds them annoying, and dull and avoids their company. She currently prefers staying indoors alone which she partly attributes to the cold weather. She expresses her dislike for fall and winter because she cannot engage in activities such as going to the beach and riding in convertibles which she usually does during summer. She associates winter

with darkness, and misery as opposed to beauty during summer.

Past Psychiatric History:

• General Statement: The patient denies any past psychiatric treatment.
• Caregivers (if applicable): Her parents.
• Hospitalizations: The patient has never had any psychiatric admissions.
• Medication trials: She is not on any medication trials.
• Psychotherapy or Previous Psychiatric Diagnosis: The patient has never been diagnosed with any psychiatric disorder or undergone psychotherapeutic interventions.

Substance Current Use and History: The patient denies any history of or current substance abuse or abuse by any member of her family.

Family Psychiatric/Substance Use History: There is no history of any psychiatric condition in her immediate or extende

d family.

Psychosocial History: The patient grew up in South Carolina and was raised by both her parents. She has three other siblings, two brothers, and one sister. She is currently a full-time student undertaking a business undergraduate program in Boston. She stays with two other female student roommates in off-campus housing. She is unemployed, has never been married, and not dating. She has no history of legal issues or trouble with the authorities.

Medical History: The patient has never been admitted for any medical treatment.

 

• Current Medications: She is not on any prescription medication for any medical condition.
• Allergies: She has no known allergies to drugs or drugs.

• Reproductive Hx: Her menarche was at fourteen years. She experiences a regular menstrual cycle. Her last menstrual period was 20 days ago. She is not currently gravid. She has never used any contraceptives and has no children.

ROS:

• GENERAL: The patient reports no weight loss but a recent weight gain, no fever, and no generalized weakness.
• HEENT: There is no vision loss, hearing loss, dysphagia, sore throat, or nasal congestion.
• SKIN: The patient denies pruritus, skin rash, or abnormal skin changes.
• CARDIOVASCULAR: There are no reported palpitations, easy fatigability, shortness of breath even on exertion, chest pain, or edema.
• RESPIRATORY: There is no difficulty in breathing, no chest pain, and no cough.
• GASTROINTESTINAL: The patient denies experiencing anorexia, abdominal pain, nausea, vomiting, diarrhea, or constipation.
• GENITOURINARY: Patient reports no pain or discomfort on urination, blood in urine, increased frequency, or incontinence.
• NEUROLOGICAL: The patient denies headaches, dizziness, numbness, convulsions, weakness, or paralysis.
• MUSCULOSKELETAL: There are no myalgias, no joint swelling, pain, or stiffness.
• HEMATOLOGIC: The patient denies anemia or excessive bleeding tendency.
• LYMPHATICS: There are no swollen lymph nodes or enlarged spleen.
• ENDOCRINOLOGIC: The patient denies intolerance to heat or cold, polyuria, polydipsia, polyphagia, or excessive sweating.

Objective:

Physical exam:

Vital signs: Temperature 98.1, PR-78, RR-18, BP 119/74 Ht 5’2” Wt 184lbs

General: The patient is in fair general condition, is not in any form of distress, is well nourished and is well-kempt.

HEENT: The head is normocephalic, pupils are equally reactive to light, the oral cavity is of good hygiene and free of inflammatory processes, ear canals are clear, and the nose is not congested.

Neck: The neck is soft with no masses, no cervical lymphadenopathy, no thyroid swelling, and no distended neck veins.

Chest/Lungs: The chest moves with respiration, and expands symmetrically, vesicular breath sounds are heard on auscultation with good bilateral air entry.

Heart/Peripheral Vascular: The precordium has normal cardiac activity, the apex beat is not displaced, and first and second heart sounds were heard with no added sounds or murmurs.

Abdomen: The abdomen is not distended, not tender, with no abnormal masses, hepatomegaly, and no splenomegaly. Bowel sounds are present.

Genital/Rectal: Findings from a digital rectal examination were normal.

Musculoskeletal: There is no limitation in the range of movement in all joints. No swelling, stiffness, deformity, or tenderness was noted.

Neurological: Cranial nerve assessment is normal. Motor examination of bulk, tone, power, and reflexes are normal. Sensory examination is intact.

Skin: The skin has no lesions or abnormal changes.

Diagnostic results:

Complete blood count revealed values of cell counts that were within normal ranges.

A toxicology screen of blood and urine samples was negative for any drug.

No organisms were isolated from blood cultures.

Random blood sugar showed serum glucose levels that were within normal ranges.

Thyroid function tests were within normal values.

Blood urea, nitrogen, and creatinine were within normal levels.

Liver function tests were non-contributory.

A head CT scan detected no cranial pathology.

Assessment:

Mental Status Examination: The patient is a 19-year-old female who looks appropriate to her stated age. She is well-groomed and appropriately dressed. She is alert and fully cooperates with the examiner. There is no evidence of motor agitation. Her orientation to place, person, and time is intact. Her speech is clear, coherent, and of normal tone, rate, and volume. She has a depressed mood which is congruent with her affect. She exhibits no evidence of flight of ideas or looseness of association. She experiences occasional suicidal thoughts but has no intention of harming herself or others. She has no auditory or visual hallucinations, or delusions. Her immediate and recent memory is impaired evidenced by not remembering newspaper headlines five seconds after reading them and not recalling what she learns from her classes. Her remote and long-term memory is intact. Her concentration is poor. She lacks insight into her condition. Her judgment is good.

 

Differential Diagnoses:

1. Bipolar disorder: This is the most likely diagnosis in this patient. This is because the patient exhibits a combination of manic and depressive episodes (Jain et al., 2022). The patient initially experienced a manic episode characterized by elevated mood, increased activity, decreased need for sleep, and increased sociability (Faurholt-Jepsen et al., 2020). During this phase, she could easily make friends and engage in fun activities. The depressive episode that the patient is currently in is characterized by a depressed mood, loss of interest in activities that she initially enjoyed, weight gain, hypersomnia even during classes, reduced concentration, suicidal thoughts, and pessimistic views (Tolentino et al., 2018). The mood disturbance is severe enough to an extent of causing social and functional impairment (Jain et al., 2022). This is evidenced by isolation from her friends whom she initially had cordial relations with. The patient is also having trouble completing her program projects. Bipolar disorder has two incidence peaks of onset the first one being between 15 to 24 years and the second peak occurring between 45 to 54 years (Rowland et al., 2018). The patient is 19 years thus is more predisposed to the first peak. The report by the patient’s mother that the patient gets moody at the same time every year supports the cyclic nature of the condition.
2. Depressive disorder: This is the other probable diagnosis. The symptoms that the patient is currently presenting with are typical of depressive illness. This is supported by the aforementioned symptoms such as depressed mood, reduced energy, suicidal thoughts, and sleep disturbance. The risk factors that predispose to depressive illness that are present in this patient include age, female gender, previous episode based on information from the patient’s mother and stress that probably stems from the program projects (Park et al., 2019). This diagnosis does not, however, explain the experience of manic symptoms.
3. Borderline Personality Disorder: The patient may also be having a borderline personality disorder. This disorder usually presents with pervasive affective instability, impulsiveness, suicidal thoughts, and unstable interpersonal relationships that were evident from the history (Kulacaoglu et al., 2018). This diagnosis does not explain the presence of other depressive symptoms such as hypersomnia and depressed mood.

Reflections: The examiner in this case scenario was remarkable in eliciting important information from the patient that guided the formulation of the diagnosis. Involving the patient’s mother provided corroborative information that filled any gaps in the psychiatric assessment. Privacy and confidentiality of the patient were maintained by conducting the assessment in a room with minimal personnel flow. The patient has never been on any psychiatric treatment thus the formulation of the treatment plan will require the provision of adequate information for an informed choice. There should be no coercion in decision-making regarding the treatment approach. The patient is a teenager thus the involvement of the parents in shared decisions may be necessary. Medication trials that will be considered should be beneficial to the patient with minimal risks. The patient lacks insight thus the need for psychoeducation and education on the need for adherence to treatment recommendations. The patient expresses suicidal thoughts thus as an examiner, I would have further explored the suicide risk such as enquiring about previous attempts or intent.

 

 

References

Chapman, J., Jamil, R. T., & Fleisher, C. (2022). Borderline Personality Disorder. In StatPearls. StatPearls Publishing.

Faurholt-Jepsen, M., Christensen, E. M., Frost, M., Bardram, J. E., Vinberg, M., & Kessing, L. V. (2020). Hypomania/Mania by DSM-5 definition based on daily smartphone-based patient-reported assessments. Journal of affective disorders, 264, 272–278. https://doi.org/10.1016/j.jad.2020.01.014

Jain, A., & Mitra, P. (2022). Bipolar Affective Disorder. In StatPearls. StatPearls Publishing.

Kulacaoglu, F., & Kose, S. (2018). Borderline personality disorder (BPD): Amid vulnerability, chaos, and awe. Brain Sciences, 8(11), 201. https://doi.org/10.3390/brainsci8110201

Park, L. T., & Zarate, C. A. (2019). Depression in the primary care setting. New England Journal of Medicine, 380(6), 559–568. https://doi.org/10.1056/nejmcp1712493

Rowland, T. A., & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic Advances in Psychopharmacology, 8(9), 251–269. https://doi.org/10.1177/2045125318769235

Tolentino, J. C., & Schmidt, S. L. (2018). DSM-5 criteria and depression severity: Implications for clinical practice. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00450

Sample Answer 2 for NRNP 6635 Assessing and Diagnosing Patients With Mood Disorders

Subjective:

CC (chief complaint): “My mom says I get moody this time of year, every year.”

HPI:

Natalie Crew is a 17-year-old female client who is on psychiatric assessment after her mother felt that she should see a psychiatrist. Her mother expresses worries about Natalie’s mood changes since she gets moody at this time of year every year. According to Natalie, she does not feel great and feels low. She is having difficulties with the special business school program she enrolled in, where she is required to design a mock company, and is currently running late with two projects. Moreover, the client reports concentration difficulties, sleeping in class, and weight gain. Natalie states that her friends have become annoying and dull and no longer fun like before. She dislikes being outdoors due to the weather. She dislikes fall and winter and loves summer. According to the client, the city is usually dark, grey, and miserable this season but beautiful and sunny during summer.

Past Psychiatric History:

• General Statement: The patient has a history of seasonal mood changes.
• Caregivers (if applicable): None
• Hospitalizations: None
• Medication trials: None
• Psychotherapy or Previous Psychiatric Diagnosis: None

Substance Current Use and History: Denies substance use history.

Family Psychiatric/Substance Use History: No family substance use history.

Psychosocial History: Natalie recently enrolled in an accelerated high school business program in Chicago, Illinois. She grew up and has lived her entire life in New Orleans. She was brought up by her both parents alongside four brothers. She is currently living in a specialty high school campus dormitory. She is a full-time student and has a part-time job in a local coffee shop. She is not married and is currently single. No legal history.

Medical History:

 

• Current Medications: None
• Allergies: NKDA

• Reproductive Hx: None

ROS:

• GENERAL: Positive for weight gain and increased daytime sleepiness.
• HEENT: No vision changes, blurred/double vision, eye pain, ear pain, hearing loss, nasal congestion, or sore throat.
• SKIN: No rashes, bruises, or itching.
• CARDIOVASCULAR: No chest pain, SOB, palpitations, or edema.
• RESPIRATORY: No sputum, cough, or wheezing.
• GASTROINTESTINAL: No abdominal pain, nausea/vomiting, or bowel changes.
• GENITOURINARY: No urinary symptoms, pelvic pain, or irritation.
• NEUROLOGICAL: No dizziness, headaches, paralysis, or tingling sensations.
• MUSCULOSKELETAL: No muscle pain or joint pain/stiffness.
• HEMATOLOGIC: No bruising or bleeding.
• LYMPHATICS: No lymph node swelling.
• ENDOCRINOLOGIC: No heat/cold intolerance, acute thirst, increased hunger, or polyuria.

Objective:

Physical exam:

Vitals: T 97.4; P-82; R-120; BP-128/84; Ht-5’2”; Wt-192lbs

Diagnostic results: No test results.

Assessment:

Mental Status Examination:

Appearance: Female teenager, appears right age; dull-looking.

Grooming: neat and dressed appropriately.

Eye contact: Limited.

Mood: Low

Affect: Limited

Speech: Goal-directed and volume varies.

Though process- coherent

Thought content- No hallucinations, delusions, obsessions, or suicidal thoughts/plans

Cognition- Oriented to time, person, place, and time.

Memory- Short and long-term memory is intact,

Judgment- Clear judgment

Insight- Present

Differential Diagnoses:

Seasonal Affective Disorder (SAD): This is a syndrome characterized by recurrent, seasonal patterns of depressive episodes (Jupe et al., 2023). The DSM-5 diagnostic criteria for SAD include depression present only at a specific time of year, like in the fall or winter, and full remission occurs at a specific time of the year (Rai et al., 2021). SAD is a differential diagnosis based on the patient’s depressed symptoms during specific times of the year (fall and winter). The patient’s symptoms abate during summer.

Major Depression: The DSM-V diagnostic criterion for Major depression requires at least one of the following symptoms: Depressed mood that manifests with feeling sad, low, empty, or hopeless most of the day, nearly every day, OR shed interest or pleasure in all or almost all activities (Marx et al., 2023). The patient has a depressed mood and reports feeling down and not great, as well as losing interest in her studies and friends. She also presents with other Major depression symptoms like weight gain, hypersomnia, and shed ability to concentrate in her studies.

Bipolar Disorder with Seasonal Pattern: This is characterized by depressive episodes in the fall or winter and mania or hypomania in the spring or summer (Rosenthal et al., 2020). The patient has a history of mood changes, with a depressed mood during fall and winter, but reports enjoying summer. However, this cannot be a primary diagnosis since she has no history of mania or hypomania during summer.

Reflections: In a different situation, I would ask the patient about her mood during summer and spring. I would ask her if she is more motivated to undertake school projects and enjoys hanging out with her friends. Legal and ethical considerations for this patient surround the principles of beneficence and nonmaleficence. The clinician should recommend treatment interventions associated with the best outcomes and no harm to persons with SAD. Health promotion should focus on lifestyle measures the patient can adopt during winter and fall to improve her mood like regular physical exercises and Yoga.

 

References

Jupe, T., Giannopoulos, I., Zenelaj, B., & Myslimi, E. (2023). Treatment of Seasonal Affective Disorder. The efficacy of Light therapy. European Psychiatry, 66(Suppl 1), S604–S605. https://doi.org/10.1192/j.eurpsy.2023.1262

Marx, W., Penninx, B. W. J. H., Solmi, M., Furukawa, T. A., Firth, J., Carvalho, A. F., & Berk, M. (2023). Major depressive disorder. Nature Reviews. Disease Primers, 9(1), 44. https://doi.org/10.1038/s41572-023-00454-1

Rai, B., Gupta, R., & Chakravarty, R. (2021). Major depressive disorder with seasonal pattern or seasonal affective disorder. The Primary Care Companion for CNS Disorders, 23(3). https://doi.org/10.4088/pcc.20l02732

Rosenthal, S. J., Josephs, T., Kovtun, O., & McCarty, R. (2020). Seasonal effects on bipolar disorder: A closer look. Neuroscience & Biobehavioral Reviews, pp. 115, 199–219. https://doi.org/10.1016/j.neubiorev.2020.05.017

Sample Answer 3 for NRNP 6635 Assessing and Diagnosing Patients With Mood Disorders

Subjective:

CC (chief complaint): “I am wound up. I lost my temper”

HPI: A 49-year-old female patient reports to the clinic complaining of losing her temper. She claims to be moody most of the time, especially this time of the year, every year. She has been having sleeping problems and gained weight recently. Her concentration has greatly reduced, and she gets bored most of the time. She gets bored with her friends which makes it hard for her to keep them.

Past Psychiatric History:

• General Statement: The psychiatric history of the patient is unremarkable.
• Caregivers (if applicable): The patient was raised by her mother, who is a functioning alcoholic with a fatty liver.
• Hospitalizations: No history of hospitalization
• Medication trials: No medication prescribed for a psychiatric condition
• Psychotherapy or Previous Psychiatric Diagnosis: No history of psychotherapy for any psychiatric condition.

Substance Current Use and History: The patient denies tobacco or alcohol use. She has no history of substance abuse.

Family Psychiatric/Substance Use History: The patient is married with 3 children who are all teenage boys. She denies drinking alcohol or smoking cigarettes among other illicit drugs.

Psychosocial History: The patient currently lives in Indianapolis, IN. She has an MBA and works full-time as a logistics buyer in a medical facility. she has three children, all boys, who she lives with together with her husband.

Medical History: The patient

 

• Current Medications: The patient is currently taking no medication for her symptoms.
• Allergies: Latex

• Reproductive Hx: The patient is married and sexually active with three children. She has no history of STIs.

Family History: The patient was born and raised in Indianapolis, IN, with two sisters and her mother. Her father died in MVA when she was only 2 years old. Her sister has been diagnosed with depression, while her mother has a history of being a “functioning alcoholic.” She has a “fatty liver.”

ROS:

• GENERAL: The patient complains of losing her temper and getting bored most of the time. She claims to have sleeping problems. She has gained weight.
• HEENT: Eyes: No vision changes or double or blurry vision. The sclera has no abnormal discoloration. No hearing loss, congestions, or sneezing. No sore or scratchy throat, or cough.
• SKIN: No itchiness or rashes.
• CARDIOVASCULAR: No chest pressure, pain, or any other discomfort. No edema or palpitations.
• RESPIRATORY: No respiratory challenges or congestion.
• GASTROINTESTINAL: No nausea or vomiting, anorexia, or diarrhea. No abdominal pain.
• GENITOURINARY: No polyuria or pain passing urine.
• NEUROLOGICAL: No headache, with no syncope, dizziness, ataxia, paralysis, tingling or numbness, in the extremities. No change in bladder control or bowel movement.
• MUSCULOSKELETAL: No muscle, back pain, joint pain, or stiffness
• HEMATOLOGIC: No bruises, anemia, or bleeding
• LYMPHATICS: No history of splenectomy. No swollen lymph nodes.
• ENDOCRINOLOGIC: No excessive sweat or thirst.

Objective:

Physical exam:

Vital Signs: T- 98.8 P- 99 R 20 150/88 Ht 5’5 Wt. 135lbs

HEENT: Head is atraumatic and normocephalic. Pupils are round, equal, and reactive to light. No erythema or effusion on the tympanic membrane. No discharge or swelling was noted in ear canals. The neck is supple with anterior cervical lymphadenopathy. The throat is clear with no swelling and exudates. Tonsils are not swollen.

Chest/lungs: Breathing sounds clear to auscultation

Heart: Regular heart rate and rhythm with no murmur or gallop.

Abdomen: Soft, non-distended, non-tender abdomen, with bowel sounds present in all four quadrants.

Diagnostic results: Several screening tools are applied for appropriate diagnosis to be made. Such tools include the Child Behavior Checklist (CBCL) and Mood-Disorder Questionnaire (MDQ).

Assessment:

Mental Status Examination: Appearance: well-groomed, neat, upright posture and maintains eye contact. Speech: Fluent and a little bit pressured at some point. Motor activity: agitated and uneasy. Affect and Mood: sad and angry at the time, irritable. Thought and perception: Ideas flow in sequence. Her thoughts are however delusional. Attitude and Insight: the patient is cooperative, and seems to understand her present mental health status (MacQueen, & Memedovich, 2017). The threat of Harm to Self or Others: The patient denies any suicidal attempts or thoughts, or harm to self or others. Examiner’s Reaction to Patient: The patient seems frustrated and depressed. Cognitive Abilities: the patient was easily distracted during the examination.

Differential Diagnoses:

1. Intermittent explosive disorder (IED): According to DSM-5, this disorder is associated with recurrent behavioral outbursts showing the inability of controlling aggressive impulses. This condition is very common among youth and young adults. The patient was raised by an alcoholic mother, hence might have gone through some kind of traumatic experience (MacQueen, & Memedovich, 2017). She also claims to have lost her temper which is a great sign of IED.
2. Major depressive disorder (MDD): This a mental disorder characterized by low mood and anhedonia among other symptoms. According to DSM-5 diagnostic criteria, the patient displayed 5 of the listed symptoms such as depressed mood, diminished interest in routine activities, weight gain, difficulties in sleeping, agitation, and lack of concentration (MacQueen, & Memedovich, 2017). This makes MDD a considerable differential diagnosis for the given case study.
3. Cyclothymic disorder (CD): This is a personality disorder that involves numerous periods of depression symptoms and those of elevated mood. According to DSM-5, this disorder has been classified as a subtype of bipolar disorder (Hørlyck et al., 2021). As such, patients are expected to display the following symptoms, periods of elevated mood and depression symptoms for at least two years in adults, periods of stable mood for at least two months, significant problems in the patient’s life, symptoms that meet the diagnosis of bipolar and lastly, they symptoms must not be caused by a medical condition or substance use. The patient meets most of these symptoms.

Diagnostic result: Intermittent explosive disorder (IED)

Treatment Plan:

• Psychotherapy: Group or individual therapy that is focused on helpful building skills. Enhance cognitive behavioral therapy to help identify the behavior or situation that may trigger the aggressive response and learn how to manage and control the anger through relaxation training, application of communication and problem-solving skills, and thinking differently about situations (MacQueen, & Memedovich, 2017).
• Medication: The FDA approves the use of central antidepressants such as selective serotonin reuptake inhibitors (SSRIs) in addition to anticonvulsant mood stabilizers among other drugs if needed. Fluoxetine 20mg orally for 12 weeks has proven to be effective in reducing impulsive aggressive behavior compared to other medications (Amare, Schubert, Baune, & SpringerLink, 2017).

Reflections: The patient in the case study suffers from a mood disorder, most precisely Intermittent explosive disorder (IED). Taking care of such patients with mental disorders, who come from a family background of substance abuse parents is quite challenging. Nurses are thus encouraged to observe all the legal and ethical considerations required when taking care of such a patient. For instance, in as much as the patient has a right to confidentiality, the clinician is allowed to report to the relevant authorities if the patient has shown potential harm to self or others (Malhi et al., 2018). Consequently, the patient must be informed on the available treatment options, in addition to both their positive and negative outcome. the patient generally plays a significant role in ensuring that positive care outcome is achieved.

References

Amare, A. T., Schubert, K. O., Baune, B. T., & SpringerLink (Online service). (2017). Pharmacogenomics in the treatment of mood disorders: Strategies and Opportunities for personalized psychiatry. EPMA Journal 8, 211–227. https://doi.org/10.1007/s13167-017-0112-8

MacQueen, G. M., & Memedovich, K. A. (January 01, 2017). Cognitive dysfunction in major depression and bipolar disorder: Assessment and treatment options. Psychiatry and Clinical Neurosciences, 71, 1, 18-27. https://doi.org/10.1111/pcn.12463

Hørlyck, L. D., Obenhausen, K., Jansari, A., Ullum, H., & Miskowiak, K. W. (February 01, 2021). Virtual reality assessment of daily life executive functions in mood disorders: associations with neuropsychological and functional measures. Journal of Affective Disorders: Part A, 280, 478-487. https://doi.org/10.1016/j.jad.2020.11.084

Malhi, G. S., Irwin, L., Hamilton, A., Morris, G., Boyce, P., Mulder, R., & Porter, R. J. (January 01, 2018). Modelling mood disorders: An ACE solution?. Bipolar Disorders, 20, 4-16. https://doi.org/10.1111/bdi.12700

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Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

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