NRNP 6645 Assignment: Family Assessment

Walden University NRNP 6645 Assignment: Family Assessment-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NRNP 6645 Assignment: Family Assessment 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 6645 Assignment: Family Assessment

Whether one passes or fails an academic assignment such as the Walden University NRNP 6645 Assignment: Family Assessment 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 6645 Assignment: Family Assessment

The introduction for the Walden University NRNP 6645 Assignment: Family Assessment 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 6645 Assignment: Family Assessment

After the introduction, move into the main part of the NRNP 6645 Assignment: Family Assessment 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 6645 Assignment: Family Assessment

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 6645 Assignment: Family Assessment

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 6645 Assignment: Family Assessment

Subjective:

CC (chief complaint): There is chaos in my household.

HPI:

In the video, Patti, a 40-year-old female, is accompanied by her daughter Sharleen, 23-year-old. Patti first presented to the counseling clinic with complaints of chaos in her home. She moved to the United States 12 years ago alongside her four children. However, the family left one daughter, Shirleen- 21 years, back in Iran. Patti obtained a visa for Shirleen two years ago, but since she joined the family in the U.S., there has been constant chaos. The chaos was triggered by Shirleen’s reports that their father abused her physically and sexually and would abandon her in the house. As a result, there have been unending fights, screams, yelling, and cursing in the home. Patti reports that Shirleen constantly blames her mother for leaving her back in Iran, where she faced abuse from her father.

Patti states that the chaos worsened when her daughters tried to detach from her since she still practices Iran traditions. The daughters wish to be independent of their mother and identify their individuality. Patti reports more tension and anxiety in her family since she became disabled from a failed surgery. Her condi

tion left her helpless and hopeless, and she feels that her children are uncontrollable. Patti perceives that she is no longer in control of her family, and her children no longer need her. She has had frequent arguments with her daughters since she wishes to spend more time with them. However, the daughters want to be independent of her, which leaves her feeling depressed. Sharleen and Patti deny having delusions, hallucinations, phobias, obsessive thoughts, or suicidal thoughts or ideations.

Past Psychiatric History:

General Statement: Patti has a history of depression.
Caregivers (if applicable): None
Hospitalizations: None
Medication trials: None
Psychotherapy or Previous Psychiatric Diagnosis: Patti has been referred to a psychiatrist to manage the depressive symptoms. She is currently on psychotherapy.

Substance Current Use and History: Information on substance use is not provided. The information can be

obtained by asking if Patti and Sharleen have a history of smoking, taking alcohol, or using drug substances. The substance use history is important to determine the client’s risk of a substance use disorder, depression, and psychotic disorders.

Family Psychiatric/Substance Use History: The history is not addressed. The information would be obtained by asking Patti and Sharleen if they have any family member who has a history of psychiatric illness or substance use disorder. The history is essential in establishing mental disorders the clients are at risk of from genetic factors such as psychotic, alcohol, and substance abuse disorders.

Psychosocial History:

Patti and her family moved from Iran to the U.S. 12 years ago. Her 3^rd born daughter, Shirleen, immigrated to the U.S. two years ago. Patti has five children, three daughters aged 24, 23, and 21, and two sons aged 18 and 15 years. She lives with her sons since her daughters moved out. Patti was a caregiver before the failed surgery that left her disabled. The 1^st born, Sheela, is working and studying. The 2^nd born, Sharleen, is into promotional jobs and is currently working on having a real estate license. Shirleen, the 3^rd born, is married and is living with her husband. The 4^th born old son is currently in high school. They have a cousin who moved to the U.S. with them, but he now lives in L.A. Patti’s husband remarried twice after he was left Iran.

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Medical History: Patti had two surgeries on her feet. One surgery failed and left her disabled with persistent pain. Sheela had a medical problem during childhood.

Current Medications: No current medications.
Allergies: No history of drug/food allergies

Reproductive Hx: No history of reproductive disorders

Objective:

A physical exam was not performed in this video. However, it would be essential to help identify any abnormalities associated with mental disorders.

Diagnostic results: No diagnostic tests at this point.

Assessment:

Mental Status Examination:

Patti and Sharleen are well-groomed and appropriately dressed. Their speech is clear, but Sharleen’s speech volume and rate vary in the interview. They demonstrate a logical and coherent thought process. The clients exhibited no hallucinations, delusions, or obsessions. They were both oriented to person, place, and time. Patti’s and Sharleen’s short-term and long-term memory were intact.

Differential Diagnoses:

Major Depressive Disorder

MDD presents with a depressed/low mood, diminished interest/pleasure, or both. MDD is diagnosed when a patient presents with a depressed mood or diminished pleasure and at least five of the following manifestations: Increased/decreased appetite; Weight loss/gain; Sleep disturbances; fatigue/low energy levels; agitation, guilt; indecisiveness; reduced capacity to think and concentrate; suicidal thoughts or ideations (Tolentino & Schmidt, 2018). MDD is a differential diagnosis based on Patti’s history of depressive symptoms and being referred to a psychiatrist for depression treatment. Patti’s symptoms consistent with MDD include a depressive mood, feelings of tearfulness, sadness, and emptiness for most of the time, feelings of helplessness and worthlessness.

Post-traumatic stress disorder (PTSD)

PTSD occurs after one experience the traumatic event directly, witnesses a traumatic event as it occurs to others, or learns that a traumatic event happened to a loved one (Miao et al., 2018). Based on the video, the family members exhibit symptoms of PTSD. Shirleen’s PTSD symptoms result from directly experiencing physical and sexual abuse and abandonment. For the rest of the family, the symptoms result from finding out the traumatic events that occurred to Shirleen.

PTSD symptoms apparent in Shirleen include irritable behavior, emotional distress, and reckless behavior of eloping with a son to her mother’s friend. Sharleen’s PTSD features include avoiding conversations related to her sister’s traumatic event and a negative emotional state that developed when she learned of Shirleen’s traumatic event (Miao et al., 2018). Patti also exhibits PTSD features such as a negative emotional state and changes in cognition and mood.

Dependent Personality Disorder:

Dependent personality disorder (DPD) manifests with a persistent and exaggerated need to be taken care of, contributing to being submissive and clinging to behaviors. Individuals with DPD do not believe they can take care of themselves (Maccaferri et al., 2020). As a result, they use submissiveness to convince others to care for them. In the video, Patti exhibits a constant and excessive need to be taken care of by her daughters. She believes that her daughters should spend time with her since she is disabled. Her clinging behaviors have exacerbated the chaos in her family (Maccaferri et al., 2020). Besides, the belief that her children must be there for her has resulted in feelings of loneliness, helplessness, and depression.

Reflections:

The family assignment was a bit challenging since the family members presented in the video presented with different complaints. Patti complains of her daughters being out of her control, while her daughter Sharleen complains that Patti is clinging and should let them live independently. However, symptoms of changes in mood, emotional distress, and irritable behavior are common in the family and can be attributed to the traumatic events that occurred to Shirleen. If I were to conduct a session again, I would assess each member for PTSD symptoms.

Case Formulation and Treatment Plan:

Patti presents with features consistent with MDD, PTSD, and Dependent personality disorder. The rest of the family also exhibit features of PTSD, attributed to learning the traumatic events that occurred to Shirleen perpetrated by their father. At this point, Patti will be requested to fill the PHQ-9 questionnaire to help in confirming the MDD diagnosis and assess the degree of her depressive symptoms (Tolentino & Schmidt, 2018). Besides, she will fill the Dependent Personality Questionnaire (DPQ) to help diagnose DPD.

Treatment Plan

MDD: Start Patti on cognitive behavioral therapy (CBT) once a week. CBT centers on helping clients become conscious of how negative automatic thoughts, expectations, attitudes, and beliefs result in sadness and anxiety (Health Quality Ontario, 2017). Individuals then understand how the thinking patterns, which may have developed to cope with difficult or painful experiences, can be identified and modified to reduce distress.
PTSD: Start Patti’s family on Family Trauma-focused cognitive-behavioral therapy (TF-CBT) once a week. TF-CBT focuses on the thoughts, feelings, and memories related to the traumatic event (Watkins et al., 2018). It comprises behavioral techniques, like exposure, and cognitive techniques, like cognitive restructuring.
DPD: Initiate Patti on Clarification-Oriented Psychotherapy (COP). COP is an integrated type of therapy developed for individuals with personality disorders. It centers on tacking the fundamental internal determinants to interaction maneuvers, including emotions, schemes, cognitions, and patterns (Maccaferri et al., 2020).

References

Health Quality Ontario (2017). Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment. Ontario health technology assessment series, 17(15), 1–167.

Maccaferri, G. E., Dunker-Scheuner, D., De Roten, Y., Despland, J. N., Sachse, R., & Kramer, U. (2020). Psychotherapy of dependent personality disorder: the relationship of patient-therapist interactions to outcome. Psychiatry, 83(2), 179-194. https://doi.org/10.1080/00332747.2019.1675376

Miao, X. R., Chen, Q. B., Wei, K., Tao, K. M., & Lu, Z. J. (2018). Post-traumatic stress disorder: from diagnosis to prevention. Military Medical Research, 5(1), 32. https://doi.org/10.1186/s40779-018-0179-0

Tolentino, J. C., & Schmidt, S. L. (2018). DSM-5 criteria and depression severity: implications for clinical practice. Frontiers in psychiatry, 9, 450. https://doi.org/10.3389/fpsyt.2018.00450

Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in behavioral neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258

Sample Answer 2 for NRNP 6645 Assignment: Family Assessment

CC (chief complaint): ” I have a problem as my house is in chaos

HPI: Mrs. P is a forty-year-old female patient who presented to the facility accompanied by one of her daughters. The patient is an immigrant from Iran and has been in the US for the last two decades. She has four children in the US, while one of her children remained in Iran due to immigration issues. She has been working as a caregiver for income, and her eldest daughter has been helping her. Shireen, the daughter who remained in Iran, finally got an opportunity to join her mother in the US; however, the family has been in chaos since she joined them. She reported how her father abused her physically, sexually, and emotionally while she was in Iran and put the blame on her mother, whom she accuses of leaving her behind to suffer in Iran. Mrs P reports that the husband, from whom they are now separated, was an abusive man who brought trauma to their family. The patient is currently obese and disabled after experiencing a failed foot surgery. She is also in pain. While the daughters prefer a contemporary lifestyle, the patient still holds onto the traditional way of living, which brings chaos to their family. As such, she feels hopeless, helpless, and sad as she can’t control her children. The children also accuse her of being controlling, disrespectful, and lacking patience.

Past Psychiatric History:

General Statement: The patient immigrated from Iran and strived to cling to the traditional lifestyle while the children, having been raised in the US, lean towards a contemporary lifestyle, hence a source of conflict in the family, leading to chaos
Caregivers (if applicable): The patient is currently disabled, and she depends on her five children to act as caregivers.
Hospitalizations: The patient reports a failed foot operation, which has left her disabled and in pain. There are no further reports of hospitalizations.
Medication trials: There are no reports of medication trials
Psychotherapy or Previous Psychiatric Diagnosis: The patient and the family have no past history of psychiatric diagnosis or psychotherapy. However, the patient admits to feeling depressed for various reasons, such as loneliness.

Substance Current Use and History: There are no reports of substance use or substance abuse

Family Psychiatric/Substance Use History: Mrs. P and her daughter Shireen indicated that they had been victims of emotional, physical, and sexual abuse, which the husband propagated. There is no history of substance use or abuse.

Psychosocial History: Mrs P and her daughter report no educational background or history. The mother was married, but she is currently separated from her husband. She has a total of five children, three adult daughters and two teenage sons who live with her.The mother is currently not employed as she is disabled due to a failed foot surgery. However, she previously worked as a caregiver. The eldest daughter has a partner, while the other two adult daughters also live independently.

Medical History:

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

Reproductive Hx: The patient is currently separated from her husband. She has five children: three daughters and two younger sons.

ROS:

GENERAL: She is alert, oriented, and well-groomed
HEENT: An assessment should be completed using standard strategies.
SKIN: An assessment should be completed using standard strategies.
CARDIOVASCULAR: An assessment should be completed using standard strategies.
RESPIRATORY: An assessment should be completed using standard strategies.
GASTROINTESTINAL: An assessment should be completed using standard strategies.
GENITOURINARY: An assessment should be completed using standard strategies.
NEUROLOGICAL: An assessment should be completed using standard strategies.
MUSCULOSKELETAL: An assessment should be completed using standard strategies.
HEMATOLOGIC: An assessment should be completed using standard strategies. LYMPHATICS: An assessment should be completed using standard strategies.
ENDOCRINOLOGIC: An assessment should be completed using standard strategies.

Physical exam: if applicable

Diagnostic results:

Assessment

Mental Status Examination: The mother and daughter are both appropriately dressed. The patient is alert and oriented. The mother appears older than her age, possibly due to the stresses of abusive marriage. She appears anxious with a stressed mood. The patient establishes and maintains eye contact. The patient’s speech appears pressured, and she talks at a louder-than-usual volume. She also has goal-oriented thoughts and is irritable. The patient denies suicidal ideation or thoughts, delusions, or hallucinations. The patient’s short-term and long-term memory is intact.

Differential Diagnoses:

Post-traumatic stress disorder (PTSD): This is a mental health illness that is known to develop when a person witnesses or experiences a traumatic event. The events may include terrorist attacks, childhood abuse, accidents, natural disasters, sexual or physical assault, and military combat, among other things (Bryant, 2019). The mother reported abuse by her partner, which could have led to some of these symptoms. In addition, the patient also reports low energy levels and depressed mood. This information makes PTSD a differential diagnosis.
Depression: The mother and the daughter confess to experiencing chaos in their family, which has led to a depressed mood. The mother also indicates that she becomes distressed due to loneliness as her daughters don’t want to visit her anymore. A patient with depression may present with various symptoms, such as irritability, lower energy levels, and challenges with concentration (Li et al.,2019). The patient exhibited some of these symptoms, making this a potential diagnosis.
Persistent depressive disorder: This is a condition sometimes known as dysthymia. The condition is chronic depression, with the patients having it known to present with various symptoms such as persistent and long-term low mood. The patient seems to have had a prolonged duration of depressive symptoms such as hopelessness, sadness, and lack of interest in activities, making this a potential diagnosis.

Case Formulation and Treatment Plan: This family, especially the mother, has been experiencing unpleasant depressive symptoms, likely associated with events such as separation from abuse, stress, and abuse, and the family is in chaos. Therefore, the family should continue with the family psychotherapy sessions. It is important to combine both family therapy and individual therapy to help the mother adjust to the new life and accept that she can not control her children anymore (Esposito‐Smythers et al.,2019). Individual therapy can also help the mother and her children to be more accommodating to each other. As part of the treatment plan, the patient’s mother should combine psychotherapy with medications such as 20 mg Prozac. For excellent attendance of psychotherapy sessions, the patient should be offered transport means to improve her mobility as she is currently disabled. Besides, there is a need to commence an initiative or program that may help lower the patient’s weight as she is currently obese.

Reflections:

This case presents a situation showing that, even though the mother and daughter are of Iran origin and culture, they have completely different and contrasting cultures, which are always in conflict, hence impacting their relationships and mental health outcomes. Therefore, there are various learning opportunities. One of the learning opportunities is that family relationships have a significant impact on mental health outcomes. It is clear from the case that the relationships significantly affected the outcomes, especially for the mother. The patient is separated from her husband, and she is also not getting along well with her children due to conflict between contemporary and traditional beliefs. One aspect that needs to be explored is the family’s psychiatric history back in Iran before they came to the USA. One of the SDOHs that may impact the patient’s outcome is access to care (Jester & Pender, 2022). The patient is currently disabled and hence can be having a challenge honoring psychiatric visits. Therefore, there is a need to offer transport to this patient to enable access to appropriate care. As part of the patient education, the family needs to be educated on the choice of foods to help their mother deal with obesity, as well as strategies that they need to live harmoniously.

References

Bryant, R. A. (2019). Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges. World Psychiatry, 18(3), 259-269. https://doi.org/10.1002/wps.20656

Esposito‐Smythers, C., Wolff, J. C., Liu, R. T., Hunt, J. I., Adams, L., Kim, K., … & Spirito, A. (2019). Family‐focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co‐occurring risk factors: A randomized trial. Journal of Child Psychology and Psychiatry, 60(10), 1133-1141. https://doi.org/10.1111/jcpp.13095

Jeste, D. V., & Pender, V. B. (2022). Social determinants of mental health: recommendations for research, training, practice, and policy. JAMA Psychiatry, 79(4), 283-284. Doi: 10.1001/jamapsychiatry.2021.4385

Li, Z., Ruan, M., Chen, J., & Fang, Y. (2021). Major depressive disorder: advances in neuroscience research and translational applications. Neuroscience Bulletin, 37, 863-880. Doi: 10.1007/s12264-021-00638-3

Schramm, E., Klein, D. N., Elsaesser, M., Furukawa, T. A., & Domschke, K. (2020). Review of dysthymia and persistent depressive disorder: history, correlates, and clinical implications. The Lancet Psychiatry, 7(9), 801-812. https://doi.org/10.1016/S2215-0366(20)30099-7