Case study rubric Do case study on DID and cite in apa Please see information below of grading criteria for each case study: INTRODUCTION&CONCLUSION: 10 points Introduction of the case study creates interest, contains detail, and clearly states a good history, with symptoms. Conclusion effectively summarizes issues/topics addressed related to the history, symptoms and management, diagnosis and treatment. MAIN POINTS: 20 points Well-developed main points directly related to history/diagnosis being addressed. Supporting information is concrete and detailed with referencing included within the paper. ORGANIZATION&WRITING STYLE: 20 points Logical progression of ideas. . Writing is clear and sentences have varied structure. Good word choice and proper usage of words MECHANICS: Grammar, punctuation, spelling, and capitalization are generally correct. 20 points Original - pertaining to Chapter readings . 10 points APA Format and referencing. REFERENCE USING APA: American Psychological Association (APA) style of referencing. SEE APA INFORMATION ON COURSE BOARD. 20 points TOTAL POINTS = 100 Example of case study (please make case study similar to this one) Panic disorder S.B is a 18 year old freshman in college. And was brought to the er after experiencing SOB, chest pain, rapid heart rate, and nausea. She came in worried she was having a heart attack. Upon further questioning she stated she was really stressed about classes but has been worse the last week due to finals and that she has multiple episodes of chest pain, nausea, rapid heart rate, and SOB since moving to college. She stated she becomes very worried during episode and that they last about 20 to 30 minutes with the worst of the symptoms being after 5 minutes. She stated she has become more isolated and has a drop in academic performance. She also stated she is constantly worried about having an episode. She said she came in to the er because this episode was more severe. An ekg was done to R/O a heart attack but has a normal sinus rythme. She does not take and medications and declines substance use. TSH, and T3&T4 where unremarkable and she has no evidence of a respiratory condition. pt’s mother had recently passed from a stroke. pt was physically abused by her biological father up until she was 7 years old. Diagnosis Panic attack criteria: A discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes Palpitations, pounding heart, or accelerated heart rate Sweating Trembling or shaking Sensations of shortness of breath or smothering Feeling of choking Chest pain or discomfort Nausea or abdominal distress Feeling dizzy, unsteady, lightheaded, or faint Derealization (feelings of unreality) or depersonalization (being detached from oneself) Fear of losing control or “going crazy” Fear of dying Paresthesias (numbness or tingling sensation) Chills or hot sensations Panic disorder Criteria: Both: Recurrent and unexpected panic attacks (see below) ≥1 attack has been followed by 1 month or more of 1 or both of the following Persistent concern about additional attacks or their consequences A significant maladaptive change in behavior related to the attack The panic attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse or a medication) or a general medical condition The panic attacks are not better accounted for by another mental disorder. (ncbi, n.d.) pt meets criteria for panic attacks due to accelerated heart rate, SOB, nausea, chest pain and a high sense of worry. She also meet criteria peak of her symptoms is about 5 minutes in. Panic attacks and panic disorder. S.B. Meet the criteria for panic disorder due to the frequent panic attacks and her worry about getting one. She also meets criteria because of the drop in academic performance and becoming more isolated. Her disturbance is not better explained by another disturbance. Symptoms are also not caused by any medical conditions such as hyperthyroidism, respiratory conditions, heart conditions, or substance use. The stress of college as well as the move might have contributed to the development of symptoms. Her mother passing and being physically abused as a child. Genetics can play role in the development of panic disorder but she has no known family hx. (Mayo clinic 2018, May 04) Treatment I am sending a referral for psychotherapy as well as cognitive behavioral therapy. I am prescribing 10mg paroxetine to be taken PO and may increase by 10mg not to exceed 50mg for long term treatment and .25mg alprazolam not to exceed 4 doses a day for short term treatment. (Drugs.com, n.d)Prognoses seems good with medication and psychotherapy. Side effects of paroxetine include: * vision changes * weakness, drowsiness, dizziness, tiredness * sweating, anxiety, shaking * sleep problems * loss of appetite, nausea, vomiting, diarrhea, constipation * dry mouth, yawning * infection * headache * decreased sex drive, abnormal ejaculation, or difficulty having an orgasm. Side effects of alprazolam include: * weak or shallow breathing * a light-headed feeling, like you might pass out; * seizures * hallucinations, risk-taking behavior * increased energy, decreased need for sleep * racing thoughts, being agitated or talkative; * double vision * Jaundice Substance Abuse and Mental Health Services Administration. (n.d.). Table 3.10, Panic Disorder and Agoraphobia Criteria Changes from DSM-IV to DSM-5 - Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health - NCBI Bookshelf. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t10/ Panic attacks and panic disorder. (2018, May 04). Retrieved from https://www.mayoclinic.org/diseases-conditions/panic-attacks/diagnosis-treatment/drc20376027 Alprazolam: Uses, Dosage, Side Effects. (n.d.). Retrieved from https://www.drugs.com/alprazolam.htm Paroxetine Uses, Dosage & Side Effects. (n.d.). Retrieved from https://www.drugs.com/paroxetine.html Discussion make response 700 words minimum and cite in apa (separate assignment) READ CHAPTER 6 POST RESPONSE BY SUNDAY AND CONTINUE DISCUSSION. Please watch the video and reply to the critical thinking question as well as your peers responses. https://youtu.be/BEHDQeIRTgs Understanding DSM-5 Criteria for PTSD: A Disorder of Extinction https://www.youtube.com/watch?v=I5ixX53GTws https://youtu.be/I5ixX53GTws What are Trauma and Stressor Related Disorders Critical Thinking: 1. What do we know about disorders caused by exposure to specific stressors or traumatic experiences? · Adjustment disorder involves clinically significant emotional distress and significant impairment in life’s activities within 3 months after exposure to a stressor. It persists no longer than 6 months after the end of the stressor or consequences from the stressor. · Acute and post-traumatic stress disorders involve direct or indirect exposure to a lifethreatening or violent event, resulting in intrusive memories of the occurrence, attempts to forget or repress the memories, emotional withdrawal, and increased arousal. · In acute stress disorder (ASD) symptoms last up to 1 month; post-traumatic stress disorder (PTSD) is diagnosed when symptoms continue for more than 1 month after the traumatic event. · Many factors contribute to vulnerability to trauma related disorders. Possible biological factors involve stress hormones and a sensitized autonomic nervous system. Psychological factors include anxiety, depression, and maladaptive cognitions. Maltreatment or inadequate social support during childhood is a risk factor, as are various sociocultural factors, such as experiences with discrimination or racism. · Certain medications are somewhat effective in treating AD, ASD, and PTSD. Prolonged exposure therapy, cognitive-behavioral therapies, and eye movement desensitization and reprocessing (EMDR) are often effective with ASD and PTSD. 2. What role does stress play in our physical health? · External events that place a physical or psychological demand on a person can serve as stressors and can affect physical health. · A psychophysiological disorder is any physical disorder that has a strong psychological component. Psychophysiological disorders can involve actual tissue damage, a disease process, or physiological dysfunction. · Not everyone develops an illness when exposed to the same stressor or traumatic event. Individuals may react to the same stressor in very different ways. · Biological explanations for stress-related physical conditions include chronic activation of the sympathetic nervous system and continual release of stress hormones, as well as genetic influences. · Psychological contributors include characteristics such as helplessness, isolation, cynicism, pessimism, and hostility, as well as feelings of depression or anxiety. · Social contributors include having an inadequate social network; abusive intimate partner interactions; or childhood maltreatment. · Sociocultural factors such as gender, racial, and ethnic background increase risk of some psychophysiological disorders. Stressful environments associated with poverty, prejudice, and racism are associated with increased risk of illness. · Psychophysiological disorders are treated with interventions aimed at reducing stress and physiological reactivity combined with medical treatment for associated physical symptoms. Last discussion 700 words (also a separate assignment please cite in apa) 8. Have a look at the Fairfax Cryobank site (the sperm bank) provided in the optional link. Be sure to look at several sections in order to understand what they do and how they function. Come up with three ethical issues or questions involving sperm donation (they can be in regard to the donors, the clinic, and/or the recipients) and give your reasoning behind them. https://fairfaxcryobank.com/ Selecting the Topic The author should select a topic that is focused, reality based, relevant, and reflects evidence of best practices . The topic can deal with a care scenario from a past nursing/medical experience or one that highlights and emphasizes the scope of current nursing/medical practice. Planning: Write Objectives In the planning stage, it might be helpful to write at least three objectives or outcomes that reflect what can be learned from the case study. Example ( in these examples, the patient diagnosis is schizoaffective disorder) At the conclusion of the case study, it should be possible to: 1. Identify the characteristic behaviors presented in schizoaffective disorder. 2. Identify the components for diagnosing schizoaffective disorder. 3. Identify the common pharmacological approaches to the treatment of schizoaffective disorder including side effects and medical considerations. Developing an Introduction An introduction is one or two opening paragraphs that set the stage for the case study scenario. Within the introduction, the patient, symptoms, and related circumstances of the situation may be described and may also present the history of the patient leading up to the events to be addressed in the scenario. Example J.A., a 35 year old -sanitation worker, was brought to the emergency department by her sister after being found in her home repeating “my neighbors are trying to kill me”. J.A. stated that she often hears voices and sees people who tell her to kill herself. In the emergency department J.A. was assessed and comforted. Her personal hygiene had been deteriorating and her teeth were discolored and falling out. Her sister helped with the exam and stated that J.A. “had not shown up for work and would not answer her phone. I had to break into her house just to get to her. . Additional History/Background (Including: medical and nursing history; family and social history; physical examination findings). By incorporating another paragraph or two (which might be under separate headings), the author can expand on the introduction of the case scenario. Additional information may be included to add richness, clarify the case, or expand on the background information given in the introduction. For example, It is very important to include laboratory or diagnostic results, physical assessment findings, and additional information about the patient’s history and illness, may be discussed, which provides supplementary information that provides a clearer perception of the problem. Example J.A. has a history of schizoaffective disorder. She discontinued her medications three weeks ago. According to a study performed in 2002, encouraging medication adherence early in the course of schizoaffective disorder will actually help the patient to continue to take the medication long term (Robinson, et al. 2002). Schizoaffective disorder is characterized by an uninterrupted period of illness in which two major criteria are present: Delusions – False beliefs and disturbances in thinking; firm convictions and thoughts about the world that are not based in reality. When challenged about the unlikely hood of their beliefs, clients preserver relentlessly. Hallucinations – Problems with sensory perception that seem to reflect reality. The individual is convinced that he or she can hear, see or smell something that is not perceived by others. Catatonia – A state of psychologically induced immobilization at times interrupted by episodes of extreme agitation. Negative symptoms – Refers to the functional deficits observed in schizophrenia. They include flat affect, lack of motivation, social withdrawal, poor attention, and alogia (Glod, 1998, Ed.) When compared with schizophrenic patients, schizoaffective patients have consistently better outcomes. However, when compared with typical affective disorder patients, schizoaffective patients have a poorer outcome. Family and social history Provide pertinent details. Example J.A.’s mother was diagnosed with depression when she was forty years old and committed suicide ten years after. Physical examination/Assessment findings Example J.A. was very apprehensive to let the medical person get near her. Her sister helped with the examination. She appeared to have poor hygiene as evidenced by her unwashed hair and yellow/ black teeth. She was guarded and defensive, reported not sleeping well and a poor appetite. J.A. had little direct eye contact and was hard to keep occupied. She confirmed that she had been having hallucinations and delusions but denies that she might want to commit suicide. Her sister states that J.A. has been on numerous antipsychotic medications in the past and she cannot tolerate the side effects so she stops taking them. DIAGNOSIS: Please state info about the diagnosis - how it is diagnosed - what criteria is used anything pertinent like - how does one acquire this disorder, is it genetic, or is it from child rearing, environment, etc. What percentage of people get it - is it rare? Course of Care: Planning/Treatment/Evaluation Outline the course of care, treatments of choice and evaluate planned outcomes: Example J.A was put on an antipsychotic medication, 25mg 1 time daily initially, increasing to 50 mg per day after two weeks with a target dose of 400mg per day. Review of existing studies of pharmacological agents in the treatment of schizoaffective disorder suggests that use of an antipsychotic agent is necessary (McElroy, Keck and Strakowski, 1999). Although there are many different types of treatments available, many with positive outcomes, antipsychotics are the mainstay of treatment for schizoaffective disorder(Glod, 1998). Clozapine, and antipsychotic medication, is commonly used as a last resort in patients with schizoaffective disorder. Some common side effects of Clozapine are: sedation; dizziness; hypertension; tachycardia and constipation. Nursing/Medical implications for clozapine (clozaril) include the monitoring of: mental status; blood pressure; onset of tardive dyskinesia; frequency and constancy of bowel movements; transient fever and WBC with platelets. The Manisses Community group (1999) note that Olanzapine (Zxprexa) has also been used to treat schizoaffective disorder. Some side effects of this drug are: dry mouth; constipation; weight gain; insominia; orthostatic hypotension; tachycardia and fever. Some nursing /medical implications for Olanzapine include monitoring of: blood pressure; mental status; onset of extrapyramidal symptons; tardive dyskinesia and the onset of neuroleptic malignant syndrome. Treatment of patients with schizophrenia or schizoaffective disorder may improve when olanzapine doses are increased above 20mg daily, and that the higher doses seem to be well tolerated (Manisses Community Group,1999). Risperidone, also known as Risperdal, is also used in the treatment of schizoaffective disorder. It is an antipsychotic agent that works by antagonising dopamine and serotonin (NewsRX, 2002). Some common side effects of risperidone include: aggressive behavior; headache; constipation; dry mouth; weight gain; visual disturbances and sedation. (Lacey, 1996, p.127) When caring for patients who are prescribed risperidone, nurses/medical personel should monitor mental status and mood changes; blood pressure; extapyramidal symptons; tardive dyskinesia and neuroleptic malignant syndrome. J.A. was immediately transferred to a psychiatric unit where her medications could be monitored until she was stable and able to return to her home. She was given community group therapy information. Five days after her admission to the psychiatric unit she was discharged back into the community. Her medications were overseen by a home health care nurse and Behavior Management Systems. She attends a group session on Tuesday evenings for people with schizoaffective disorder. References A reference list should follow in APA format.
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