NRNP 6635 Week 10 Assignment Neurodevelopmental Disorders
The human brain only constitutes approximately 2% of an individual’s total body weight, a percentage that pales in comparison to the brain’s level of importance in human development (Koch, 2016). Although externally protected by layers of membranes as well as the skull, the brain is not very resistant to damage.
Damage to the brain may compromise its functionality, which may, in turn, lead to neurodevelopmental disorders in childhood and adolescence or neurocognitive disorders for any number of reasons across the lifespan. NRNP 6635 Week 10 Assignment: Neurodevelopmental Disorders
This week, you practice assessing and diagnosing neurocognitive and neurodevelopmental disorders across the lifespan.
Reference: Koch, C. (2016, January 1). Does brain size matter? Scientific American. https://www.scientificamerican.com/article/does-brain-size-matter1/
Learning Objectives
Students will:
Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information
Formulate differential diagnoses using DSM-5 criteria for patients with neurocognitive and neurodevelopmental disorders across the lifespan
Neurodevelopmental disorders begin in the developmental period of childhood and may continue through adulthood. They may range from the very specific to a general or global impairment, and often co-occur (APA, 2013). They include specific learning and language disorders, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, and intellectual disabilities.
Neurocognitive disorders, on the other hand, represent a decline in one or more areas of prior mental function that is significant enough to impact independent functioning. They may occur at any time in life and be caused by factors such brain injury; diseases such as Alzheimer’s, Parkinson’s, or Huntington’s; infection; or stroke, among others.
For this Assignment, you will assess a patient in a case study who presents with a neurocognitive or neurodevelopmental disorder.
To Prepare:
Review this week’s Learning Resources and consider the insights they provide. Consider how neurocognitive impairments may have similar presentations to other psychological disorders.
Review the Comprehensive Psychiatric Assessment 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 Assessment 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 10
Complete and submit your Comprehensive Psychiatric Assessment, 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 diagnostic criteria for each differential diagnosis and explain what DSM-5 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.).
CC: “My daughter has poor memory and attention.”
HPI: Sarah Higgins, a 9-year-old African American female accompanied by her mother with filled attention-deficit/hyperactivity disorder questionnaires. The mother complains that Higgins is always inattentive at school and home. She says that Higgins has been inattentive for the last eight or so months.
The mother also reports that Higgins started having poor memory and losing things when she was in kindergarten. Higgins reports during the interview that she does not remember well assignments given by her teachers. She also says that she often forgets a list of assignments prepared for her by her teachers. She fidgets while in class and often sits improperly. He is hardly attentive when during tasks at home or school. She also has trouble organizing her activities or work. She early forgets what she reads.
She is easily distracted and can read things she loves for only five minutes. She lost her bracelet and geography book. She dislikes complicated schoolwork. She easily losses her temper and gets so frustrated when she does the wrong thing. She is always anxious when she does something wrong and can experience uncontrolled restlessness.
She leaves her seat when not needed and has difficulty waiting her turn. She has trouble sitting still, even when eating. She daydreams. The symptoms have prevented her from doing her assignments and playing with other children.
Past Psychiatric History:
General Statement: She has never been treated for mental health problems.
Caregivers (if applicable): Not applicable.
Hospitalizations: No suicidal thoughts or hospitalization. No history of hospitalization for mental health disorders.
Medication trials: No medical trials.
Psychotherapy or Previous Psychiatric Diagnosis: No history of mental health disorder diagnosis or treatment.
Substance Current Use and History: She denies tobacco, drugs, or alcohol use.
Family Psychiatric/Substance Use History: The patient’s father has bipolar disorder. Her mother has no mental health issues. No family history of substance use, suicide events, or alcohol use.
Psychosocial History:
The patient was born and raised in Lakewood, Colorado. She was raised by both her parents. She has three other siblings, two brothers, and a sister. She is the last born child in the family of six. She is in grade four. She is single and does not have any children. Her hobby is going to museums to view the artwork. Another hobby is playing video games.
She can play video games for long hours. No history of trauma or violent events. She denies bullying at school. However, she often gets in trouble when she stands when other students are seated.
Medical History: She denies any major medical problems. She gets all the vaccines needed for a person her age.
Current Medications: No medications.
Allergies:No allergies.
Reproductive Hx:She is not sexually active and has not started experiencing a menstrual cycle.
ROS:
GENERAL: Positive for weight loss. Denies fatigue, chills, fever, or weakness.
HEENT: Eyes: Denies blurred vision, eye infections, eye discharge, or double vision. Ears: Denies ear infections, hearing loss, or discharge. Nose: Denies runny nose, congestion, or sneezing. Throat: denies sore throat.
SKIN: No dryness, inflammation, or rash.
CARDIOVASCULAR: No Edema, palpitations, chest pain, pressure, or discomfort.
RESPIRATORY: Denies shortness of breath, difficulty breathing, or cough.
GASTROINTESTINAL: Denies diarrhea, abdominal pain or cramping, nausea, or anorexia.
GENITOURINARY: Denies urgency to urinate, odor urine, or burning on urination.
NEUROLOGICAL: Denies tingling or numbness of the extremities, headaches, paralysis, change in bowel movements, or dizziness.
MUSCULOSKELETAL: Denies muscle and joint swelling, stiffness, or pain.
HEMATOLOGIC: No bruising, anemia, HIV, or bleeding.
LYMPHATICS: No swelling of glands.
ENDOCRINOLOGIC: No reports of heat or cold intolerance.
Objective:
Physical exam:
Vital Signs: Ht. 4’5, Wt. 63lbs, R 14, P 62, T 97, BP 95/60
HEENT: Head: Hair equally distributed. No scars. No deformities on the face. No swelling. Eyes:No glasses, vision intact. Conjunctivae normal. No swelling of the eyelid. Ears: Hearing intact. External ear normal. No hearing aids. Ear canal clear. Nose: External nose normal. Normal nasal mucosa. Normal septum and turbinates. Throat: No sore throat.
Skin: No rash
Cardiovascular: No edema, regular heart rate, and rhythm. No JVD, palpable murmurs on palpation, gallops, or thrill.
Respiratory: Clear to auscultation bilaterally. No distress when breathing. No wheezes. No cracks on the chest walls.
Neurological: Cranial nerves II- XII intact. Normal finger-to-nose. Reflexes are sensitive to all senses.
Diagnostic results:
Behavior Assessment System for Children (BASC-3)– psychologists can use BASC-3 to assess the behaviors of children (Burback, 2020). The authors found in their study that the tool displayed validity when used to assess ADHD. Thus, its results can be used to support ADHD diagnosis. This tool was also selected for screening because it displayed a cross-culture validity in a study done by (Tan et al., 2021).
Assessment:
Mental Status Examination: She looks malnourished but appears the stated age. She is oriented. Her hygiene is appropriate. She is well-groomed. She was polite and engaged during the interview. She contacts her mother during the interview. The self-reported mood is happy and affects consistent with the mood. She sometimes looks confused and losses her alertness during other occasions in the interview.
Her speech is polite. Thought content and process are consistent with the mental development of people her age. She has memory loss and forgets most of the conversations. Insight and judgment and intact and concurrent with her age. She denies suicidal, homicidal, or paranoid thoughts. She also denies delusions, hallucinations, or obsessions.
Differential Diagnoses:
ADHD-Inattentive type
ADHD-Hyperactive and Impulsive type
Anxiety disorder-non specified
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The NRNP 6635 Week 10 Assignment is focused on assessing and diagnosing neurocognitive and neurodevelopmental disorders in patients. Students will use concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information to formulate differential diagnoses using DSM-5 criteria for patients with neurocognitive and neurodevelopmental disorders across the lifespan. The assignment requires students to review the Learning Resources, select a specific video case study, review additional data for the case, and identify at least three possible differential diagnoses for the patient. By Day 7 of Week 10, students are required to complete and submit a Comprehensive Psychiatric Assessment, including their differential diagnosis and critical-thinking process to formulate a primary diagnosis. This will include providing subjective and objective details about the patient’s chief complaint and symptomology, observations during the psychiatric assessment, and a discussion of the patient’s mental status examination results. Additionally, students must compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis.
