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NRNP 6635: Psychopathology and Diagnostic Reasoning-week 8 assignment

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  • By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
  • Consider what history would be necessary to collect from this patient.
  • Consider what interview questions you would need to ask this patient.
  • Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 8

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.

Incorporate the following into your responses in the template:

  • Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
  • Objective: What observations did you make during the psychiatric assessment?
  • Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

NRNP 6635 Case History Reports

Use these case histories to supplement the information about the patients in the video case
studies.

Category:

Description

NRNP 6635: Psychopathology and Diagnostic Reasoning-week 8 assignment

Assignment: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders

 

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

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

To Prepare:

  • Review this week’s Learning Resources and consider the insights they provide.
  • Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
  • By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
  • Consider what history would be necessary to collect from this patient.
  • Consider what interview questions you would need to ask this patient.
  • Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 8

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.

Incorporate the following into your responses in the template:

  • Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
  • Objective: What observations did you make during the psychiatric assessment?
  • Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

NRNP 6635 Case History Reports

Use these case histories to supplement the information about the patients in the video case
studies.

Table of Contents
Week 3: Mood Disorders………………………………………………………………………………………….. 3
Training Title 2 ……………………………………………………………………………………………………………….3
Training Title 8 ……………………………………………………………………………………………………………….3
Training Title 18 ……………………………………………………………………………………………………………..3
Training Title 28 ……………………………………………………………………………………………………………..4
Training Title 38 ……………………………………………………………………………………………………………..4
Training Title 43 ……………………………………………………………………………………………………………..5
Training Title 150 ……………………………………………………………………………………………………………5
Training Title 118 ……………………………………………………………………………………………………………6
Training Title 144 ……………………………………………………………………………………………………………6
Week 4: Anxiety Disorders, PTSD, and OCD…………………………………………………………………. 7
Training Title 15 ……………………………………………………………………………………………………………..7
Training Title 21 ……………………………………………………………………………………………………………..7
Training Title 37 ……………………………………………………………………………………………………………..8
Training Title 40 ……………………………………………………………………………………………………………..8
Training Title 55 ……………………………………………………………………………………………………………..8
Training Title 85 ……………………………………………………………………………………………………………..9
Training Title 95 ……………………………………………………………………………………………………………..9
Week 7 Schizophrenia and Other Psychotic Disorders; Medication-Induced Movement
Disorders…………………………………………………………………………………………………………….. 10
Training Title 9 ……………………………………………………………………………………………………………..10
Training Title 24 ……………………………………………………………………………………………………………10
Training Title 29 ……………………………………………………………………………………………………………10
Training Title 134 ………………………………………………………………………………………………………….11
Week 8 Substance-Related and Addictive Disorders……………………………………………………. 11
Training Title 82 ……………………………………………………………………………………………………………11

Training Title 114 ………………………………………………………………………………………………………….12
Training Title 151 ………………………………………………………………………………………………………….12
Week 10 Neurocognitive and Neurodevelopmental Disorders………………………………………. 13
Training Title 48 ……………………………………………………………………………………………………………13
Training Title 50 ……………………………………………………………………………………………………………13

Week 3: Mood Disorders

Training Title 2
Name: Ms. Natalie Crew
Gender: female
Age:17 years old
T 97.4 P-82 R-1 20 128/84 Ht 5’2” Wt 192lbs
Background: Recently started an accelerated high school business program in Chicago, Illinois
after growing up and living in New Orleans her whole life. Grew up with both parents and four
brothers. Currently lives in on a specialty high school campus dormitory. Currently a full-time
student and works part time in the local coffee shop. Not married, currently single. She has no
previous psychiatric history; takes no medications. There is history of depression, denied
substance use history for her or family. No legal hx NKDA

Symptom Media. (Producer). (2016). Training title 2 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-2

Training Title 8
Name: Mrs. Abrianna Tilman
Gender: female
Age: 27 years old
T- 98.6 P- 88 R 18 154/92 Ht 5’1 Wt 230lbs
Background: Recently had her first child two months ago. Currently married; stay at home
mother after working in community library for 5 years. Grew up with her mother after her
parents divorced when she was 16; has two sisters in Troy, Alabama. Completed education
through bachelor’s level, majoring in English Literature. No previous suicidal gestures. Brother
committed suicide via GSW. She denied drugs/alcohol; brother was addicted to
methamphetamines. Hx of HTN-prescribed Trandate 100mg twice daily, admits to missing doses
due to forgetting. No legal hx. Allergies: PCN

Symptom Media. (Producer). (2016). Training title 8 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-8

Training Title 18
Name: Ms. Rosario Campbell
Gender: female
Age:25 years old
T-97.7 P-70 R-18 118/72 Ht 5’3 Wt 123lbs
Background: Currently living off-base in El Paso, Texas, active duty in the Army, MOS 92M
Mortuary Affairs Specialist. Grew up in McAllen TX with both parents and one brother.
Completed education through high school. Currently partnered. No children. Mother history of

depression; brother hx of cannabis use. No medical history. No legal hx; allergy: cipro previous
medication trials: sertraline, fluoxetine both with good effects when taking.

Symptom Media. (Producer). (2017). Training title 18 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-18

Training Title 28
Name: Mrs. Ada Carson
Gender: female
Age: 54 years old
T- 97.6 P- 94 R 22 162/84 Ht 5’5 Wt 144lbs
Background: Currently living in Sioux Falls, South Dakota, working full-time as a contract
negotiator in a financial company. Has an MBA. Lives with her husband and two teenage twin
sons. Born and raised in Trenton, NJ, with her father and two brothers, her mother deceased
when she in MVA when she was 12 years old. Brother has depression; mother has history of
being a “functioning alcoholic”. Recently informed by her PCP she has a “fatty liver.” Allergies:
codeine

Symptom Media. (Producer). (2016). Training title 28 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-28

Training Title 38
Name: Mr. Elijah Loman
Gender: male
Age:18 years old
T- 98.3 P- 93 R 22 118/68 Ht 5’7 Wt 149lbs
Background: Currently lives with his sister and two parents in Durham, NC. Not currently
employed. Completed high school, not currently in school. Hx of treatment for mood disorder
began age 15, previous trials of risperidone, quetiapine off and on, side effects of wt. gain. Has
hx of a six-day hospitalization one year ago after found wandering at night in the mall parking
lot without clothes. He refused medication due to previous experiences. Not currently partnered.
He has been sexually inappropriate with comments to female neighbors; pulled his pants down in
the mall. Denies any recent alcohol or substance use. Father has history of bipolar disorder. No
history of self-harm behaviors, no family suicides. Mother reports he has slept 4-5 hours in past
week, up spending money buying and playing new video games and says he is writing a book on
how others can be a video game master. Appetite is decreased. No medical hx; Hx of vandalism
as a juvenile. Has pending court date for indecent exposure. Allergies: latex

Symptom Media. (Producer). (2016). Training title 38 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-38

Training Title 43
Name: Mr. Elijah Loman
Gender: male
Age:20 years old
T- 97.2 P- 84 R 18 118/68 Ht 5’7 Wt 156lbs
Background: Currently lives with his sister and her husband who are his legal guardians as
parents deceased when he was 15 and he was deemed to need a fiduciary and guardian by the
court system. Not currently employed. Completed high school, not currently in school. Hx of
treatment for mood disorder began age 15, previous trials of Depakote, Quetiapine off and on,
side effects of akathisia. Has hx of a multiple hospitalization, last was 4 months ago when he
exposed his genitals to girls at the mall. . Not currently partnered. He is currently in hospital
admitted one week ago, was initiated on lithium 300mg po three times daily and risperidone 1mg
at bedtime. Denies any recent alcohol or substance use. Paternal uncle has history of bipolar
disorder. No history of self-harm behaviors, no family suicides. Appetite is decreased. No
medical hx; hospital admission labs within normal ranges, UDS negative; Hx of truancy as a
juvenile. Has pending court date for indecent exposure. Allergies NKDA

Symptom Media. (Producer). (2016). Training title 43 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-43

Training Title 150
Name: Ms. Cheyenne Lisenbe
Gender: female
Age:18 years old
T- 97.4 P- 94 R 22 136/86 Ht 5’2 Wt 121
Background: Currently living with her parents in Locust Grove, Oklahoma along with two
younger sisters and 1 older brother. She is a senior in high school, not currently partnered,
reports she is bisexual, lately hyper-sexual reporting increase of unprotected sex. She has been
stealing money out of her grandmother’s purse to buy clothes, shoes, purses, “and just other
things. She has history of treatment since age 9 for conduct disorder, depression, history of
taking citalopram which worsened her irritability, aggression, impulsivity. She has been in a 90-
day teen residential mental health facility discharged three months ago with lithium 300mg in am
and 600mg at bedtime, aripiprazole 2.5mg in the morning. When discharged, her labs were
within normal ranges and urine toxicology negative. She was positive for cannabis upon
admission. Her parents believe she is hiding her medication as she has made comments “they
slow me down; they make me not think fast” She has hx of domestic violence toward her older
brother with juvenile assault charge. No current legal issues. Her grandmother has hx of bipolar
disorder; her mother and her maternal aunt have anxiety. She is sleeping 2-3hrs/24 hrs. Reports
her appetite “ravishing.” She has no medical issues; has Nexplanon implant; hx of self-harm with
cutting, last engaged in the behavior 6 months ago.

Symptom Media. (Producer). (2018). Training title 150 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-150

Training Title 118
Name: Mr. Connor Walsh
Gender: male
Age: 57 years old
T- 97.2 P- 94 R 20 156/88 Ht 5’8 Wt 163lbs
Background: Born and raised in Peru Indiana Is staying at a shelter after being homeless in
MacArthur Park for 1 year in Los Angeles. He lost his apartment and his job working part-time
at Home Depot. Enjoys playing music. He has long hx of mental health treatment since age 19.
Previous medication trials include lithium (was effective), Depakote (gastric upset), aripiprazole
(akathisia), risperidone (hyperprolactinemia), haloperidol (dystonia), quetiapine (didn’t give a
fair trial), Poor historian. divorced once, reports being gay, no children; estranged from only
living sister, parents deceased. He is not sure of his family mental health or substance use history
but feels like he is most like his aunt, she has history of mental health treatment “but
I’m not sure for what.” States that he got a master’s degree in music theory at Stanford. Admits
to 3-6 drinks of alcohol when “playing music in the clubs”, denied illicit drugs, has history of
intentional drug overdose at age 22, history of 8 inpatient psychiatric hospitalization, most recent
was 8 months ago. hx of one detox admission 15 years ago Allergies: bee stings

Symptom Media. (Producer). (2018). Training title 118 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-118

Training Title 144
Name: Ms. Amy Hartford
Gender: female
Age: 26 years old
T- 98.2 P- 70 R 18 128/76 Ht 5’0 Wt 152lbs
Background: Currently lives in Scottsdale, AZ, divorced with two children a daughter age 8 and
son age 4. Born and raised in Mesa, AZ with her mother and two sisters Works as paralegal, has
an associate degree; no legal hx; allergic to dicyclomine; history of rosacea

Symptom Media. (Producer). (2018). Training title 144 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-144

Week 4: Anxiety Disorders, PTSD, and OCD
Training Title 15
Name: Mr. Ralph Newsome
Gender: male
Age:19 years old
T- 97.0 P- 70 R 18 116/68 Ht 5’9 Wt 175lbs
Background: Lives in Columbus, OH with his dog Chance, only child. Parents live locally.
Works part time in Construction. Not currently partnered. No previous psychiatric history.
Symptoms began in the last 2 months when he discovered he is being activated with the Navy
Reserves. His MOS is CM3 Construction Mechanic; no medical illnesses, no legal hx. Allergies:
NKDA; sleeps 8hrs; appetite good

Symptom Media. (Producer). (2017). Training title 15 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-15

Training Title 21
Name: Sergeant Berry Sullivan
Gender: male
Age:27 years old
T- 98.8 P- 86 R 18 B/P 122/7 Ht 5’8 Wt 160lbs
Background: He entered the military just after high school and did three long tours of duty in
warzones. He separated from active duty in the Marines (MOS 0800 Field Artillery) six months
ago after eight years of service. He is engaged to be married in 8 months and is using his GI
Education Bill to attend online college for accounting. He said he grew up poor and would not do
much else if he didn’t go into the military. He denies ever using any drugs and avoids alcohol
because his father was “abusive when he was drunk.” Father is still alive, unwell (DM, cirrhosis,
HTN), still drinking. Paternal grandfather was also a veteran and suffered depression at times
though he never told anyone except the patient because of their combat connection. He has one
younger brother and one older sister. He lives in a different state, approximately five hours from
his parents and siblings. After the military, he and his fiancé moved because she got a much
better opportunity. They want kids someday. Has service-connected asthma, seasonal allergies;
no hx of psychiatric or substance use treatment.

Symptom Media. (Producer). (2016). Training title 21 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-21

Training Title 37
Name: Mr. Luca Esposito
Gender: male
Age:21 years old
T- 97.4 P- 112 R 22 122/68 Ht 6’1Wt 198lbs
Background: Lives alone in Orlando, FL raised by parents in Buffalo, NY, only child. He is a
full- time student obtaining a degree for graphic design. works part-time as Uber driver. Has a
girlfriend from high school. No previous psychiatric history. No medical illnesses; no history of
psychiatric treatment; denied drugs or alcohol; Allergies: NKDA; sleeps 6 hrs.; appetite eats 3
meals/day, likes to keep a routine schedule.

Symptom Media. (Producer). (2016). Training title 37 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-37

Training Title 40
Name: Ms. Connie Weidre
Gender: female
Age: 53 years old
T- 99.0 P- 102 R 24 156/86 Ht 5’4 Wt 1lbs73
Background: Lives with her husband in Memphis, TN, has one daughter age 25. She has never
worked. Raised by mother, she never knew her father. Mother with hx of generalized anxiety and
was verbally abusive, abused benzodiazepines; no substance hx for patient. No previous
psychiatric treatment. Has one glass red wine with dinner. Sleeps 12-13 hrs.; appetite decreased.
Has overactive bladder, untreated. Allergic to Zofran; complains of headaches, takes prn
Tylenol, has diarrhea 2-3 times weekly, takes OTC Imodium.

Symptom Media. (Producer). (2016). Training title 40 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-40

Training Title 55
Name: Matilda Johnson
Gender: female
Age: 8 years old
T-98.0 P 70 R 24 B/P 110/68
Ht 45 inches Wt 57lbs
Vaccinations are up to date, on target with developmental milestones. Appetite, she is a picky
eater per mom. NKDA

Symptom Media. (Producer). (2017). Training title 55 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-55

Training Title 85
Name: Mrs. Isla Flanagan
Gender: female
Age: 47 years old
T- 98.0 P- 82 R 18 136/62 Ht 5’0 Wt 123lbs
Background: Born and raised in Northern Ireland, parents brought her and her one sister to U.S.
when she was 15 to go to U.S. university where she met her husband. They live in Charleston,
SC. She obtained her master’s degree in education; no history of mental health or substance use
treatment, no family history. Her husband reported a recent school shooting nearby 3 weeks ago
“flipped a switch” in her. She is watching the news 24/7, barely sleeping, and even when she
does, it is only a few hours, Appetite is decreased. Hx of hysterectomy, NKDA, no legal hx.

Symptom Media. (Producer). (2017). Training title 85 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-85

Training Title 95
Name: Ms. Serenity Jackson
Gender: female
Age: 24years old
T- 97.5 P- 80 R 18 118/74 Ht 5’2 Wt 136lbs
Background: Born and raised in Gainesville, FL with her mother and 4 older brothers; her
mother has hx of panic disorder, 2 brothers hx of cannabis; father abandoned the family when
she was 3 years old. One brother is in prison for burglary. no previous mental health treatment,
no medications; NKDA; no legal hx; sleeping 9 hrs.; Appetite is good. She has an associate of
arts degree and works for Leaders furniture warehouse. She has DX of diabetes since age 8. She
recalls having great difficulty with her medical condition (uncontrolled blood sugar, fighting
with mother over needle sticks, “kids want candy, and I was so different because of my diet”).
She recalls having a difficult relationship with her mother who was a nurse and really worked
hard to control her daughter’s diabetes. She is not in a relationship, identifies as lesbian but has
not come out to the family. Only her closest co-workers know She stated, “I don’t see why I
would, they wouldn’t understand, and this is not important right now.”

Symptom Media. (Producer). (2018). Training title 95 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-95

Week 7 Schizophrenia and Other Psychotic Disorders; Medication-
Induced Movement Disorders

Training Title 9
Name: Ms. Fatima Branning
Gender: female
Age: 28 years old
T- 98.4 P- 82 R 18 124/74 Ht 5’0 Wt 118lbs
Background: Raised by parents, lives alone in Coronado, CA. Only child. Works as an
administrative assistance in car sales, has a bachelor’s in hospitality. Has medical history of
scoliosis, currently treated with chiropractic care. Guarded and declined to discuss past
psychiatric history. Denied family mental health issues, declined to allow you to speak to parents
for collaborative information. Allergies: latex; menses regular, no birth control

Symptom Media. (Producer). (2016). Training title 9 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-9

Training Title 24
Name: Ms. Jess Davies
Gender: female
Age: 30 years old
T- 98.6 P- 86 R 20 120/70 Ht 5’2 Wt 126lbs
Background: Jess is brought for evaluation by her 2 roommates who are concerned with
behaviors. She had some issues with depression after aunt died but worsened in the 12 days after
she witnessed her brother killed via GSW in a gas station burglary. She is estranged from her
parents and her brother was her only sibling. She is only sleeping 2 hours/24hrs; she will only eat
canned foods. She smokes cannabis daily since she was 17 and goes out on weekdays couple
times with her roommates and has couple drinks of beer. She was prescribed alprazolam 1mg
twice daily as needed by her PCP for 15 days. She works in a bakery. Allergies: medical tape

Symptom Media. (Producer). (2016). Training title 24 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-24

Training Title 29
Name: Mr. Harold Feldman
Gender: male
Age:20 years old
T- 98.4 P- 76 R 18 116/74 Ht 5’6 Wt 120lbs

Background: European-American male. He has two younger sisters, one with history of ADHD,
the other with history of separation anxiety. His mother has depression; his father has paranoia
schizophrenia. He is home for spring break. He has no previous medical problems.
Developmental milestones met as child. Appetite is inconsistent and it seems he has lost 18lbs
since first going back to school in the fall. He had a short trial of risperidone in the last six
months of high school for mild paranoia. He stopped the medication after graduation as he could
not tolerate due to side effects of over-sedation. Harold has HS several friends but has not kept in
touch with them since being back home. He has not been showering. Sleeping 14 hrs./ he admits
to episodic cannabis use weekly. Allergies shellfish

Symptom Media. (Producer). (2016). Training title 29 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-29

Training Title 134
Name: Mrs. Patricia Warren
Gender: female
Age: 42 years old
Background: Patricia was brought in under a emergency evaluation order after her best friend,
Felicia, after the police for Patricia locking herself in a closet and screaming loudly for over an
hour. EMS was able to calm her with a small dose of Ativan enroute to the emergency
department. This is Patricia’s third presentation to the emergency room in 2 weeks. She had one
psychiatric hospitalization around this same last year. No self-harm behaviors but has assaulted
other in the past. No hx of TBI. Sleeps 1–2-hour increments for total of 6 hrs. daily, refuses to
sleep at night. Refused vitals, wt., refuses labs, not cooperative. She obtains SSDI. She lives in
Cameron, Montana. She denies ever using any drugs and drinks one glass wine weekly. She has
a sister who is five years older, both parents deceased in the last three years. She has no children,
her husband is out of town, truck driver. Family history includes that her father had two previous
inpatient psychiatric hospitalizations for paranoia Mother had history of bipolar depression.
Paternal grandmother had “shock therapy”. Denies history of trauma experience, but her friend
reports parents death was extremely difficulty for Patricia. no current legal charges. dropped out
of high school in 11th grade, was pregnant and had abortion. allergies: Clozaril

Symptom Media. (Producer). (2018). Training title 134 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-134

Week 8 Substance-Related and Addictive Disorders
Training Title 82
Name: Lisa Tremblay
Gender: female
Age: 33 years old
T- 100.0 P- 108 R 20 180/110 Ht 5’6 Wt 146lbs

Background: Lisa is in a Naples, FL detox facility thinking about long term rehab. She is
considering treatment for her Hep C+ but needs to get clean first. She has been abusing opiates,
approximately $100 daily. She admits to cannabis 1–2 times weekly (“I have a medical card”),
and 1/2 gallon of vodka daily. She has past drug paraphernalia possession arrest. Her admission
labs. abnormal for ALT 168 AST 200 ALK 250; bilirubin 2.5, albumin 3.0; her GGT is 59; UDS
positive for opiates, THC. Positive for alcohol or other drugs. BAL .308; other labs within
normal ranges. She reports sexual abuse as child ages 6-9 perpetrator being her father who went
to prison for the abuse and drug charges. She is estranged from him. Mother lives in Maine, hx
of agoraphobia and benzodiazepine abuse. Older brother has not contact with family in last 10
years, hx of opioid use. Sleeps 5-6 hrs., appetite decreased, prefers to get high instead of eating.
Allergies: azithromycin

Symptom Media. (Producer). (2017). Training title 82 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-82

Training Title 114
Name: Ally Chen
Gender: female
Age: 44 years old
Background: Only child, raised by parents in Philadelphia, PA. Has PhD in biology and master’s
degree in high school education (8–12). Her supervisor has asked the school EAP counselor to
intervene with concerns regarding potential substance use in effort to facilitate getting her help
and be able to retain her. She is divorced, has a 4-year-old son who lives with his father. Appetite
healthy, sleeping 9 hours/24 hrs., wakes 2-3 times during the night. Denied drug use. had DUI
when she was age 21.

Symptom Media. (Producer). (2018). Training title 114-2 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-114-2

Training Title 151
Name: Daniela Petrov
Gender: female
Age:47 years old
T- 98.8 P- 84 R 20 B/P 132/90 Ht 5’8 Wt 128lbs
Background: Moved to Everett, Washington from Russia with her parents when she was 16 years
old. Currently lives in Boise, Idaho. She has younger 1 brother, 3 older sisters. Denied family
mental health or substance use issues. No history of inpatient detox or rehab denied self-harm hx;
Menses regular. uses condoms for birth control Has fibromyalgia. She works part time cashier at
Save A Lot Grocery Store. Dropped out of high school in 10th grade. Sleeps 5-6 hours on
average, appetite good.

Symptom Media. (Producer). (2018). Training title 151 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-151

Week 10 Neurocognitive and Neurodevelopmental Disorders
Training Title 48
Name: Sarah Higgins
Gender: female
Age: 11 years old
T- 97.4 P- 58 R 14 98/62 Ht 4’5 Wt 65lbs
Background: no history of treatment, developmental milestones met on time, vaccinations up to
date. Sleeps 9-10hrs/night, meals are difficult as she has hard time sitting for meals, she does get
proper nutrition per PCP. she has a younger brother. lives with her parents in Washington,
D.C. No hx of head trauma.

Symptom Media. (Producer). (2017). Training title 48 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-48

Training Title 50
Name: Harold Brown
Gender: male
Age:60 years old
T- 98.8 P- 74 R 18 134/70 Ht 5’10 Wt 170lbs
Background:
Has bachelor’s degree in engineering. He dates casually, never married, no children. Has one
younger brother. Sleeps 7 hours, appetite good. Denied legal issues; MOCA 28/30 difficulty with
attention and delayed recall; ASRS-5 21/24; denied hx of drug use; enjoys one scotch drink on
the weekends with a cigar. Allergies Dilaudid; history HTN blood pressure controlled with
Cozaar 100mg daily, angina prescribed ASA 81mg po daily, valsartan 80mg daily.
Hypertriglyceridemia prescribed fenofibrate 160mg daily, has BPH prescribed tamsulosin 0.4mg
po bedtime.

Symptom Media. (Producer). (2017). Training title 50 [Video]. https://video-alexanderstreet-
com.ezp.waldenulibrary.org/watch/training-title-50

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