NRNP-6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment

NRNP-6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment

NRNP/PRAC 6645 Comprehensive Psychiatric

Evaluation Note Template

CC (chief complaint): Mother: dependent on kids, depression, abuse from marriage and pain issues from past surgeries. The daughter Wants independence from her mom and thinks the mom needs to adapt and let her kids live their lives.

HPI: 40-year-old Iranian mother and her 23-year-old daughter present for therapy consultation. There is a conflict with the expectation of the mother-daughter relationship. The mother wants her kids to be around because she gets lonely and depressed when alone. On the other hand, her daughter and kids feel too smothered by the mom and want their independence from her. The daughter feels she is at the age to grow and find herself, while the mom is heavily influenced by her Iranian culture.

Past Psychiatric History: The mother admits to depression but is not specific if diagnosed by a psychiatrist.

General Statement: Mother complains of loneliness and depression and seek more time with her adult kids. Adult kids seeking independence from mom.

• Caregivers (if applicable): None both adults and lives independently
• Hospitalizations: Mother noted past surgeries. No known past psychiatric hospitalizations
• Medication trials: None
• Psychotherapy or Previous Psychiatric Diagnosis: None stated.

Substance Current Use and History: No stated substance use or history from both mom and daughter

Family Psychiatric/Substance Use History: No stated substance use or history in the family

Psychosocial History: Patients are a 40 year old Iranian female with no educational history and her 23 year old daughter. The mother get married at the age of 16 and her husband was chosen for her by her family. Patient stated that her husband was verbally and physically abusive to her. She has 5 children with her husband. The two youngest children currently live with her at home. Mom complains of depression but unknown if ever officially diagnosed. Abusive husband who tries to control her even though they don’t live together .

Medical History:

 

• Current Medications: Did not report medication during therapy
• Allergies: No known allergies reported

• Reproductive Hx: Mom has 5 children. Three Daugthers 24, 23, and 21 Two sons ages 18 and 15.

ROS: No systems assessment done in video.

• GENERAL: Mom appeared overweight and looks older for her age. Daughther looks to be in good health. No personal health information provided
• HEENT: N/A
• SKIN: N/A
• CARDIOVASCULAR: N/A
• RESPIRATORY: N/A
• GASTROINTESTINAL: N/A
• GENITOURINARY: N/A
• NEUROLOGICAL: N/A
• MUSCULOSKELETAL: N/A
• HEMATOLOGIC: N/A
• LYMPHATICS: N/A
• ENDOCRINOLOGIC: N/A

Physical exam: No physical examination performed in video

Diagnostic results: No lab results discussed during the session.

Assessment

Mental Status Examination: Both mother and daughter were alert and oriented to self, place and time. Mom was overweight and appeared older than her stated age. Daugther look to be in good physical health. Both appeared stressed about the current mother daughter relationship .

Differential Diagnoses:

The three differential Diagnoses I came up with for this patient case are:

Post-Traumatic Stress Disorder

Persistent depressive disorder (PDD)

Dissociative disorders

 

Post-Traumatic Stress Disorder (PTSD)  is my first potential diagnosis for this patient. PTSD occurs following a traumatic incident. The patient experienced both physical and verbal abuse during her merrage and living with her husband. According to DSM-V, PTSD is characterized by physical symptoms, including fatigue or sleep disturbances (Rumball et al., 2020). People with this disorder also experience stress reactions such as irritability. The patient is experiencing all these symptoms, increasing the likelihood of a PTSD diagnosis. The patient did complain of fatigue and depression. The daughter reported that her mom is sometimes very irritable. After reviewing PTSD, the client qualifies to be diagnosed with this condition. 

 Persistent depressive disorder (PDD), also known as dysthymia, is the second differential diagnosis I chose for this patient. PDD is a long-lasting but milder form of depression. This mood disorder is characterized by a mild form of various depression symptoms, including hopelessness, low self-esteem, an overall feeling of inadequacy, anger, sadness, general discontent, irritability, excess sleepiness or insomnia, slow activity, or indecisiveness (Ogundele, 2018). According to Miller (2019), depression can also occur after a traumatic event or events. The data collected in the video shows that the patient can be diagnosed with this condition.

Dissociative disorders are also a possible differential diagnosis for this patient. This condition presents symptoms similar to PTSD, and the causes are due to past traumas (“Chapter dissociative reactions in PTSD,” 2019). The patient has past traumas that are impacting her relationship with her family. Dissociative disorders can be a possible diagnosis for this patient as well.

 

Case Formulation and Treatment Plan

The best treatment plan for this patient is to address her PTSD condition. Treatment should include individual therapy, group therapy with her kids, antianxiety and antidepressant medications. Some approaches that might be good options for this patient include exposure therapy, anxiety management/relaxation training, cognitive-behavioral therapy (CBT), and supportive psychotherapy” (Piotrowski & Range, 2020). The mother will need to see a provider that can prescribe her some medications. The daughter should be evaluated independently and provided with appropriate resources.

Reflections

This was an interesting case. The patient will benefit from seeing a mental health provider for evaluation and starting medication. I think she will benefit from taking medications to help with her possible diagnosis of PTSD and Depression. She should also continue her psychotherapy.

 

References

Miller, L. (2019). PTSD and other traumatic disability syndromes: Differential diagnosis. SpringerBriefs in Psychology, 25-42. https://doi.org/10.1007/978-3-319-09081-8_3

Piotrowski, N. A., PhD, & Range, L. M., PhD. (2020). Post-traumatic stress disorder. Magill’s

Medical Guide

Rumball, F., Happé, F., & Grey, N. (2020). Experience of trauma and PTSD symptoms in autistic adults: risk of PTSD development following DSM‐5 and non‐DSM‐5 traumatic life events. Autism Research, 13(12), 2122-2132 NRNP-6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment.

Ogundele, M. O. (2018). Behavioral and emotional disorders in childhood: A brief overview for pediatricians. World journal of clinical pediatrics, 7(1), 9. Doi: 10.5409/wjcp.v7.i1.9

To prepare:

• Review this week’s Learning Resources and reflect on the insights they provide on family assessment. Be sure to review the resource on psychotherapy genograms.
• Download the Comprehensive Psychiatric Evaluation Note Template and review the requirements of the documentation. There is also an exemplar provided with detailed guidance and examples.
• View the Mother and Daughter: A Cultural Tale video in the Learning Resources and consider how you might assess the family in the case study.

 

NRNP-6645 Mother and Daughter: Cultural Tale Video Family Assessment Assignment

NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note Template

Chief Complaint (CC): The mother complains about being dependent on her kids, experiencing depression, dealing with abuse from her marriage, and having pain issues from past surgeries. The daughter wants more independence from her mother and believes her mom should adjust and allow her kids to live their lives.

History of Present Illness (HPI): A 40-year-old Iranian mother and her 23-year-old daughter come for a therapy consultation. There’s a conflict in their mother-daughter relationship. The mother feels lonely and depressed when alone, wanting her kids around, while the daughter and her kids feel suffocated by the mother’s presence and seek independence. The daughter wants to grow and find herself, while the mother’s behavior is strongly influenced by her Iranian culture.

Past Psychiatric History: The mother acknowledges depression but doesn’t specify if a psychiatrist diagnosed her.

General Statement: The mother expresses loneliness and depression, desiring more time with her adult children. The adult children, however, are seeking autonomy from their mother.

Caregivers (if applicable): Neither requires a caregiver as both are adults living independently.
Hospitalizations: The mother had past surgeries, but no history of psychiatric hospitalizations.
Medication Trials: No previous medication trials reported.
Psychotherapy or Previous Psychiatric Diagnosis: No prior psychotherapy or psychiatric diagnosis mentioned.

Substance Current Use and History: No substance use or history indicated for both mother and daughter.

Family Psychiatric/Substance Use History: No family history of substance use or history provided.

Psychosocial History: The patient, a 40-year-old Iranian female, has no formal education, and her 23-year-old daughter present for therapy. The mother married at 16, chosen by her family, and experienced verbal and physical abuse from her husband. She has 5 children with him, and two youngest live with her. The mother complains of depression, but no formal diagnosis is mentioned. She’s still controlled by her abusive husband, even though they’re not living together.

Medical History:

Current Medications: Medication information not disclosed during therapy.
Allergies: No allergies reported.
Reproductive History: The mother has 5 children, including three daughters aged 24, 23, and 21, and two sons aged 18 and 15.

Review of Systems (ROS): No system assessment conducted in the video.

General: The mother appears overweight and older than her age. The daughter seems to be in good health, but no specific health details are given.
HEENT: Not applicable.
Skin: Not applicable.
Cardiovascular: Not applicable.
Respiratory: Not applicable.
Gastrointestinal: Not applicable.
Genitourinary: Not applicable.
Neurological: Not applicable.
Musculoskeletal: Not applicable.
Hematologic: Not applicable.
Lymphatics: Not applicable.
Endocrinologic: Not applicable.

Physical Examination: No physical examination performed in the video.

Diagnostic Results: No discussion of lab results during the session.

Assessment

Mental Status Examination: Both mother and daughter were alert and oriented to self, place, and time. The mother was overweight and appeared older than her age. The daughter seemed to be in good physical health. Both appeared stressed due to their current mother-daughter relationship.

Differential Diagnoses:

I have come up with three possible differential diagnoses for this patient case:

1. Post-Traumatic Stress Disorder (PTSD)
2. Persistent Depressive Disorder (PDD)
3. Dissociative Disorders

Post-Traumatic Stress Disorder (PTSD) is my first potential diagnosis for this patient. PTSD occurs following a traumatic incident. The patient experienced both physical and verbal abuse during her marriage and while living with her husband. According to the DSM-5, PTSD is characterized by physical symptoms like fatigue or sleep disturbances. People with this disorder also experience stress reactions like irritability. The patient is displaying these symptoms, increasing the possibility of a PTSD diagnosis. The patient reported fatigue and depression. The daughter mentioned her mom’s irritability. Upon reviewing PTSD criteria, the patient qualifies for this diagnosis.

Persistent Depressive Disorder (PDD), also known as dysthymia, is my second diagnosis choice. PDD is a milder form of long-lasting depression. This mood disorder involves various depression symptoms like hopelessness, low self-esteem, general discontent, anger, sadness, and more. Depression can occur after traumatic events. The data from the video suggests the patient could be diagnosed with PDD.

Dissociative Disorders are also a possible diagnosis due to the past traumas that have affected the patient’s relationship with her family. This condition presents symptoms similar to PTSD and could be applicable in this case.

Case Formulation and Treatment Plan

The most appropriate treatment plan for this patient is to address her possible PTSD condition. The plan should involve individual and group therapy with her kids, along with antianxiety and antidepressant medications. Possible therapies include exposure therapy, anxiety management, cognitive-behavioral therapy (CBT), and supportive psychotherapy. The mother requires medication prescription, and the daughter should be independently evaluated and provided with necessary resources.

Reflections

This case was intriguing