Abnormal Psychomotor Movements Case Essay
I will attach the Practicum Experience Plan. And at the bottom I will briefly describe the 3 most challenging patients. I doubt anyone will even read this thoroughly because it’s the last assignment of the quarter. I don’t even care if it’s 2 pages. The sooner its done the sooner I can be done. Thanks for all of your help you are the absolute best
In 450–500 words, address the following:
Learning From Experiences
Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
Reflect on the 3 most challenging patients you encountered during the practicum experience. What was most challenging about each?
What did you learn from this experience?
What resources were available?
What evidence-based practice did you use for the patients?
What would you do differently?
How are you managing patient flow and volume? How can you apply your growing skillset to be a social change agent within your community?
Communicating and Feedback
Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
Answer these questions: How am I doing? What is missing?
Reflect on the formal and informal feedback you received from your Preceptor.
Data: 14-year-old patient who identifies as male. Both parents are present. Previous diagnoses of Bulimia, GAD, PTSD, Borderline Personality Disorder. History of physical and emotional abuse by parents. Child services stepped in 2 years ago and the abuse has since stopped. Pt’s mood swings are “almost constant”, his depression is “gradually worsening”, meltdowns occur “almost weekly”. Pt has always been schooled online. He is gender-fluid, trans female to male, bisexual, non-binary. Uses pronouns he/they. Pt is not sexually active.
Assessment: Pt is well-groomed. Calm yet disinterested. Poor eye contact. No abnormal psychomotor movements. Writer had difficult time engaging with patient. Patient answered questions after encouragement from parents. Pt first experienced thoughts to harm himself 2 weeks ago. Singular episode. No current thoughts of self-harm. Denies SI/HI/AVH. Energy and concentration are both “decent”. Appetite is “so-so”. Pt has Bulimia but has not purged in over 2 years. Sleep is “good”.
Plan: NP will address pt’s diagnoses in steps. First step initial labs: CBC, CMP, TSH, HgB, Liver function. Pt will also begin Lexapro 10mg QD and Buspar 5mg TID. Follow up in one week
(you can write about this patient was tough because “he” is gender fluid. Sometimes he identifies as a male sometimes as a female)
Data: This is a 15 yr old female with history of GAD and MDD. Pt has been having significant struggles for the past year. Pt has had to quarantine for the Covid-19 pandemic and this has negative effects on her social life and her academics. Pt has been a cheerleader since age 6 and quit the sport in July. Pt had to attend summer school because she could not concentrate with online classes and failed two. Pt states that she has been interested in taking medications, but her parents “do not believe in them.”
Assessment: Pt is well-groomed. Calm, sullen, cooperative. Poor eye contact. No abnormal psychotmotor movements. Speech is mumbled, slow rate. Rates depression 6/10. Anxiety 7/10. Denies SI/HI/AVH. Energy and motivation “low”. Able to get up, shower, “I don’t want to but I do”. Sleep is good. Appetite according to mother “has never been good”.
Plan: Pt has not been taking any medication in 3 years. Before Covid, pt’s mother reported that her daughter was “doing just fine without medications”. NP spoke with mother in private after appointment. Mother agreed to allow patient to take medications “if it actually will help.” Start Lexapro 10mg QD. Order for labs: CMP, CBC, TSH, HgB. Follow up in 1 week.
(you can write that this patient was tough because her mom wasn’t eager to let her use medications)
Data: 77-year-old female previously diagnosed with Bipolar Disorder Type II, GAD, And Alcohol Abuse Disorder. NP canceled last appointment because pt showed up intoxicated and was verbally abusive towards staff. Pt states “I don’t know what happened last time but I am sorry. I haven’t had a sip of alcohol since that day.” NP accepted apology but acknowledged the fact that it has happened before this last incident.
Assessment: Pt is disheveled. Anxious, visibly upset. AAO x 3. Poor eye contact, mumbled speech. Denies SI/HI/AVH/paranoia. She reports depression 7/10 and anxiety 8/10. Energy and concentration are both “terrible”. Sleep and appetite are both “good enough”.
Plan: Pt signed a behavioral contract saying that if she ever shows up intoxicated, she will be banned from any treatment at PPC. Pt agreed and signed. NP wants to see if the current medications work now that she has ceased using alcohol. Follow up in 1 week
(you can write that she is an active alcoholic which is detriment to her mental health)