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Diagnosis of Schizophrenia Spectrum and Other Psychotic Disorders

Assignment: Diagnosis of Schizophrenia Spectrum and Other Psychotic Disorders

This week, you have focused on key symptoms related to schizophrenia spectrum and other psychotic disorders. Now, in this Assignment, you practice diagnosing in this area.

This is your fifth practice in diagnosing mental disorders. When reviewing the case study, remember that social workers keep a wide focus on several potential syndromes, analyzing patterns of symptoms, risks, and environmental factors. Narrowing down from that wider focus happens naturally as you match the individual symptoms, behaviors, and risk factors against criteria and other information in the  DSM-5-TR.

Here are a few tips or reminders:

· Catatonia is a specifier, although it does have a code. It even appears on a line of its own and may look like a code. However, it cannot be used as a diagnosis on its own.

· Remember to include all of the words that go with the diagnostic code.

Note: Remember that symptoms can occur in many disorders. As a result, all disorders in the  DSM-5-TR covered up until this point may factor into your diagnosis (for example, as a possible additional disorder you diagnose).

To Prepare

· Review the case study for this week.

· Start by familiarizing yourself with the disorders from the  DSM-5-TR found in the Learning Resources this Week.

· Look within the noted sections for symptoms, behaviors, or other features the client presents within the case study.

· If some of the symptoms in the case study cause you to suspect an  additional disorder,  then research any of the previous disorders covered so far in the course. 

· This mirrors real social work practice where you follow the symptoms. 

· Review the correct format for how to write the diagnosis noted below. Be sure to use this format.

· Remember: When using Z codes, stay focused on the psychosocial and environmental impact on the client within the last 12 months.

By Day 7

Submit your diagnosis for the client in the case. Follow the guidelines below.

· The diagnosis should appear on one line in the following order.  Note: Do not include the plus sign in your diagnosis. Instead, write the indicated items next to each other.

Code + Name + Specifier (appears on its own first line) Z code (appears on its own line next with its name written next to the code)

Then, in 1–2 pages, respond to the following:

· Explain how you support the diagnosis by specifically identifying the criteria from the case study.

· Describe in detail how the client’s symptoms match up with the specific diagnostic criteria for the disorder (or all the disorders) that you finally selected for the client. You do not need to repeat the diagnostic code in the explanation.

· Identify the differential diagnosis you considered.

· Explain why you excluded this diagnosis/diagnoses. 

· Explain the specific factors of culture that are or may be relevant to the case and the diagnosis, which may include the cultural concepts of distress.

· Explain why you chose the Z codes you have for this client.

· Remember: When using Z codes, stay focused on the psychosocial and environmental impact on the client within the last 12 months

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Symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

  • Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.

Scenario: A 58-year-old obese white male presents to ED with chief complaint of fever, chills, pain, and swelling in the right great toe. He states the symptoms came on very suddenly and he cannot put any weight on his foot. Physical exam reveals exquisite pain on any attempt to assess the right first metatarsophalangeal (MTP) joint. Past medical history positive for hypertension and Type II diabetes mellitus. Current medications include hydrochlorothiazide 50 mg po q am, and metformin 500 mg po bid. CBC normal except for elevated sedimentation rate (ESR) of 33 mm/hr and C-reactive protein (CRP) 24 mg/L. Metabolic panel normal. Uric acid level 6.7 mg/dl.

All papers submitted must include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting

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Why is the sequence of pain (location and type of pain) significant in the diagnosis of acute appendicitis? Describe the rational for each type of pain.

Ms. F, 48 years old, has been admitted to the hospital with severe abdominal pain. Earlier that day she had generalized abdominal pain, followed by a severe pain in the lower right quadrant of her abdomen, accompanied by nausea and vomiting. That evening she was feeling slightly improved and the pain seemed to subside somewhat. Later that night, severe, steady abdominal pain developed, with vomiting. A friend took her to the hospital, where examination demonstrated lower right quadrant tenderness and mild abdominal rigidity. Fever and leukocytosis indicated infection. A diagnosis of acute appendicitis, with possible perforation, was indicated, with immediate surgery.

Discussion Questions

  1. Why is the sequence of pain (location and type of pain) significant in the diagnosis of acute appendicitis? Describe the rational for each type of pain. Does this sequence confirm the diagnosis?
  2. Using the pathophysiology, describe the reason for:
    1. the pain subsiding and then recurring.
    2. leukocytosis and fever.
    3. abdominal rigidity.

Ms. T, age 28 years, has noticed urgency, frequency, and dysuria recently, as well as an unusual odor to the urine. Urinalysis indicated a heavy concentration of Escherichia coli in the urine, some pus, and WBCs. Ms. T was prescribed antibiotics, which she took for the first few days. This seemed to give her relief, but she then stopped taking the medication. Within a few days, the symptoms returned, but she decided to “just live with it.”

Discussion Questions

  1. Explain why women are predisposed to cystitis.
  2. What preventive measures are important in reducing recurrence?
  3. Discuss other signs and symptoms that may indicate cystitis.
  4. What potential problems may she experience if she does not adhere to the treatment prescribed?

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Sometimes a coder might need to query the physician if they see a medication and no diagnosis that corresponds to the usual use of the medication

It is important for coders to be familiar with medications. Sometimes a coder might need to query the physician if they see a medication and no diagnosis that corresponds to the usual use of the medication. For your initial post, select a body body system (ex. circulatory, reproductive, respiratory, etc) and research FIVE common medications utilized for diseases of that body system. Indicate the name of the drug (if generic is available list generic and other brand names), and common diagnosis that the medication would be utilized for. MAKE SURE YOU CITE YOUR SOURCES AND USE RELIABLE SOURCES! For your follow up posts, select two of your classmates and code the diagnoses they list for THREE of the medications they selected. 

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Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder

The Assignment: 5 pages

Examine Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder (https://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_04/index.html) You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

References

Ostacher, M. J., & Hsin, H. (2016). The use of antiepileptic drugs in psychiatry. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 93–98). Elsevier.

Perlis, R. H., & Ostacher, M. J. (2016a). Bipolar disorder. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 48–60). Elsevier.

Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20–26). Elsevier

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