{"id":265503,"date":"2024-01-15T05:30:24","date_gmt":"2024-01-15T05:30:24","guid":{"rendered":"https:\/\/nursingstudy.org\/?p=265503"},"modified":"2025-04-10T04:11:57","modified_gmt":"2025-04-10T04:11:57","slug":"adult-psychiatric-initial-interview-comprehensive-nursing-paper-example","status":"publish","type":"post","link":"https:\/\/nursingstudy.org\/examples\/adult-psychiatric-initial-interview-comprehensive-nursing-paper-example\/","title":{"rendered":"Adult Psychiatric Initial Interview Comprehensive Nursing paper example"},"content":{"rendered":"\n

Adult Psychiatric Initial Interview Comprehensive Nursing paper example<\/strong><\/h2>\n\n\n\n

Despite significant advancements in diagnostics and classification of\u00a0mental diseases and extensive knowledge by health providers and the general population regarding psychiatric conditions, treatable psychiatric disorders are often overlooked. (Adult Psychiatric Initial Interview Comprehensive Nursing paper example) For example, in primary care, at least half of the depressive symptoms go undiagnosed. An initial psychiatric assessment is a standard evaluation tool used by psychiatrists to evaluate perception, thought patterns, and personality disorders. This essay provides a complete comprehensive psychiatric assessment interview of a friend codenamed XY. (Adult Psychiatric Initial Interview Comprehensive Nursing paper example)<\/p>\n\n\n\n

\"Adult<\/figure>\n\n\n\n
Criteria<\/strong><\/td>Clinical Notes<\/strong><\/td><\/tr>
Informed Consent<\/strong><\/td>The client provided verbal and written informed consent for the psychiatric interview. The client demonstrated his ability to respond to the clinical questions. The client appears to have understood the risks and benefits attached to the psychiatric assessment as explained by the practitioner.(Adult Psychiatric Initial Interview Comprehensive Nursing paper example)<\/td><\/tr>
Subjective<\/strong><\/td>Verify Patient \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Name: XY \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 DOB: May 30, 1996 \u00a0 Demographic: Caucasian \u00a0 Gender Identifier Note: Male \u00a0 CC: The client is concerned with \u201chearing strange sounds and inability to concentrate.\u201d \u00a0 HPI: No past illness or hospitalization. \u00a0 Pertinent history in the record and from the patient: Diagnosed with ADHD 5 years ago, manage through medication. Immunization up to date. \u00a0 During assessment: The patient describes his mood as anxious. Patient self-esteem<\/a> appears low. He feels disappointed in himself and his frustration, which is getting worse with time. Reports change in concentration, energy, sleep patterns, and appetite. \u00a0 \u00a0 The patient reports reduction in activity, reports increase in agitation, and risky behaviours. He experiences abnormal fears and panic attacks. He reports delusions and hallucinations. \u00a0(Adult Psychiatric Initial Interview Comprehensive Nursing paper example) The patient reports symptoms of eating disorders. There is a 2-pound weight loss in the past month. \u00a0 SI\/ HI\/ AV: Patient denies homicide and suicide ideation, violent behavior, and SIBx. The patient reports inappropriate behaviours. \u00a0 Allergies: NKDFA \u00a0 Past Medical Hx: Medical history: Patient reports no cardiac, respiratory, head injury, endocrine or neurological issues. The patient denies a history of chronic infections, including TB, Hepatitis C, HIV, and MRSA. Surgical history: No previous surgical procedure. \u00a0 Past Psychiatric Hx: Previous psychiatric diagnoses<\/strong>: Diagnosed with ADHD at age 5. His ADHD condition is stable \u2013 managed through medication. \u00a0 Previous medication trials<\/strong>: No medical trial participated. (Adult Psychiatric Initial Interview Comprehensive Nursing paper example)\u00a0<\/strong> Safety concerns:<\/strong> History of Violence to Self: Reported punching a wall to the point of bruising and bleeding. History of Violence to Others: Reported occasional fights in school. Auditory Hallucinations: Reports paracusia Visual Hallucinations: Reports no visual hallucinations. \u00a0 Mental health treatment history<\/strong> discussed:<\/strong> History of outpatient treatment: None reported Previous psychiatric hospitalizations: None reported Prior substance abuse treatment: None reported \u00a0 Trauma history: <\/strong>The client reports childhood bullying at school. Denies other sources of trauma, such as parental neglect or abuse, domestic violence, or other traumatizing events. \u00a0 Substance Use:<\/strong> Denies using or abusing alcohol or nicotine\/tobacco products. The client denies using or abusing ETOH and other illegal drugs Current Medications: \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Methylphenidate 20mg orally daily. \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Supplements: Elemental Zinc 10mg \u00a0 Past Psych Med Trials: None reported. \u00a0 Family Medical Hx: None reported \u00a0 Family Psychiatric Hx: \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Substance use: Parents consume alcohol weekly. \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Suicides: None reported. \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Psychiatric diagnoses\/hospitalization: Father diagnosed with diabetes. Other members are healthy.\u00a0\u00a0\u00a0(Adult Psychiatric Initial Interview Comprehensive Nursing paper example)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Developmental diagnoses: None reported. \u00a0 Social History: Occupational History: Unemployed. No previous employment record. Military service: Denies involvement with the military. Education history:\u00a0 Bachelor of Commerce graduate. Developmental History: Had normal childhood development. \u00a0 Legal History: Reported for initiating and carrying on a fight in the neighborhood. Spiritual\/Cultural Considerations: Christian \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 ROS: Constitutional: No fever. Reports 2-pound weight loss. Eyes: Vision is intact ENT:\u00a0 Hearing and sense of smell intact. No sore throat. Cardiac: No chest pain, edema, or breathing difficulty. \u00a0 Respiratory: No shortness of breath, cough, or wheezing\u00a0 Musculoskeletal: Denies joint pain or swelling Neurologic: Denies history of seizures, blackout, or numbness. Endocrine: No polyuria or polydipsia. Allergy: NKFDA(Adult Psychiatric Initial Interview Comprehensive Nursing paper example)<\/td><\/tr>
Verify Patient: <\/em>Name, Assigned identification<\/strong> number (e.g., medical record number), Date of birth, Phone number, Social security number, Address, Photo.  <\/em> Include demographics, chief complaint, and subjective information from the patient, names, and relations of others present in the interview.<\/em>  <\/em> HPI:<\/em> , Past Medical and Psychiatric History,<\/em> Current Medications, Previous Psych Med trials,<\/em> Allergies.<\/em>  Social History, Family History.<\/em> Review of Systems (ROS) \u2013 if ROS is harmful, \u201cROS noncontributory\u201dor\u201cROS negative except for\u2026.\u201d<\/em><\/td><\/tr>
Objective                 <\/strong><\/td>Vital Signs: <\/strong>Stable Temp:98.5 F \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 BP: 115\/75 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 HR: 72 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 R:15 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 O2: 95 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ht:5\u20195\u2019\u2019 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Wt:130lbs \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 BMI: 21.6 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 LABS: Lab findings: WNL Tox screen: Negative Alcohol: Negative \u00a0 Physical Exam: MSE: The client appears anxious yet cooperative and conversant. The client is oriented x 4. The client is appropriately dressed for time and occasion. However, the client\u2019s psychomotor behavior seems abnormal. The client does not maintain appropriate eye contact. The client shows restlessness and fidgeting, with a reported mood of anxiety.<\/a> \u00a0Memory: Immediate, recent, and remote memory intact Speech: Fast-talking, normal tone with crowded thoughts. \u00a0 TC: Denies suicide and homicide ideation. Cognition is grossly intact. Attention and concentration span is limited. The client appears knowledgeable.\u00a0 The client\u2019s judgment and insight are grossly intact. Thoughtform: Logical and goal-directed \u00a0 The client demonstrates an ability to articulate needs. The client is motivated to comply and adhere to the treatment plan. The client reflects a willingness and ability to participate in the psychiatric assessment. (Adult Psychiatric Initial Interview Comprehensive Nursing paper example)\u00a0<\/td><\/tr>
<\/a>This is where the \u201cfacts\u201d are located.<\/em> Vitals,<\/em> **Physical Exam (if performed, will not be conducted every visit in every setting)<\/em><\/strong><\/em><\/strong> Include relevant labs, test results, and MSE, risk assessment, and psychiatric screening measure results.<\/em><\/em><\/td><\/tr>
Assessment<\/strong><\/td>DSM5 Diagnosis: Schizophrenia – This is the primary diagnosis. DSM-5 criteria for schizophrenia include the following and are presented by XY (APA, 2013):\u00a0 DelusionsHallucinationsDisorganized speechDisorganize motor activity \u00a0 Dx: –\u00a0\u00a0 Schizoaffective disorders. This diagnosis is refuted. DSM5 criteria for schizoaffective disorder presented by XY include (APA, 2013): Mood episodesDepression with psychotic features \u00a0 Dx: –\u00a0\u00a0\u00a0 Delusional Disorder. This diagnosis is refuted. DSM5 criteria for Delusional disorder presented by XY include (APA, 2013): The presence of one (or more) delusions with a duration of 1 month or longerImpaired function and behaviorOther psychological effects do not cause the disturbance. \u00a0 Dx: –\u00a0\u00a0\u00a0 Attention Deficit Hyperactive Disorder. This diagnosis is refuted. DSM5 criteria for Delusional disorder presented by XY include (APA, 2013): Abnormalities of attentionHyperactivity \u2013 Impulsivity Difficulty sustaining focus DisorganizedLack of comprehensionLow frustration toleranceIrritability \u00a0 The client appears to have the capacity to respond to psychiatric medication. This creates a possibility for a consensus with the client, consequently encouraging psychotherapy (Angell & Bolden, 2015). The client appears to comprehend the need for psychotherapy and is willing to adhere to the proposed medication.(Adult Psychiatric Initial Interview Comprehensive Nursing paper example)<\/td><\/tr>
Include your findings, diagnosis, and differentials (DSM-5 and any other medical diagnosis) along with ICD-10 codes<\/u>, treatment options, and patient input regarding treatment options (if possible), including obstacles to treatment.<\/em>  <\/em> Informed Consent Ability<\/em><\/td><\/tr>
Plan<\/strong>  <\/strong> (Note some items may only be applicable in the inpatient environment)  <\/strong><\/td>\u00a0 The patient is not in immediate danger<\/a> to himself and those around him, as reported in HPI. The following variables tend to affect the likelihood of medical hospital admission of people with schizophrenia (Olfson et al., 2011): antipsychotic medication no adherence poor global functioning co-occurring substance use disorders \u00a0 Safety Risk\/Plan:\u00a0 The client is stable and has control over his behaviors. The client does not pose a significant risk to himself and others. The client denies unusual perceptions and appears the respond abnormally to internal and external stimuli. \u00a0(Adult Psychiatric Initial Interview Comprehensive Nursing paper example) \u00a0 Pharmacologic interventions: Titrate Methylphenidate to 30mg orally daily. Methylphenidate is effective for treating ADHD and has a high tolerance (Huss et al., 2017).Increase zinc supplement to 20mg daily. Add propanol 40mg for anxiety three times a day before meals and at bedtime. Propanol has a significant effect on anxiety (Steen et al., 2016).Refer for CBT. CBT is effective for managing auditory hallucinations and delusions (Candida et al., 2016). Education, including health promotion, maintenance, and psychosocial needs Importance of psychological health Importance of medication Safety planning The client is to return to the clinic after every four weeks. In addition, the patient is to visit a psychotherapist every two weeks. Time spent in the interview: 25 minutes. The visit lasted 40 minutes Date: 5\/18\/2021\u00a0\u00a0\u00a0 Time: 0435<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

References<\/strong><\/h3>\n\n\n\n

American Psychiatric Association. (2013).\u202fDiagnostic and statistical manual of mental disorders\u202f (5th Ed.). American Psychiatric Publishing, Inc.\u202f\u202f\u00a0(Adult Psychiatric Initial Interview Comprehensive Nursing paper example)<\/p>\n\n\n\n

Angell, B., & Bolden, G. B. (2015). Justifying medication decisions in mental health care: Psychiatrists\u2019 accounts for treatment recommendations.\u00a0Social Science & Medicine<\/em>,\u00a0138<\/em>, 44-56. (Adult Psychiatric Initial Interview Comprehensive Nursing paper example)10.1016\/j.socscimed.2015.04.029<\/a><\/p>\n\n\n\n

Candida, M., Campos, C., Monteiro, B., Rocha, N. B. F., Paes, F., Nardi, A. E., & Machado, S. (2016). Cognitive-behavioral therapy for schizophrenia: an overview on efficacy, recent trends, and neurobiological findings.\u00a0MedicalExpress,\u00a03(5)(Adult Psychiatric Initial Interview Comprehensive Nursing paper example). https:\/\/doi.org\/10.5935\/MedicalExpress.2016.05.01<\/a>\u00a0<\/p>\n\n\n\n

Huss, M., Duhan, P., Gandhi, P., Chen, C. W., Spannhuth, C., & Kumar, V. (2017). Methylphenidate dose optimization for ADHD treatment: a review of safety, efficacy, and clinical necessity.\u00a0Neuropsychiatric disease and treatment<\/em>.(Adult Psychiatric Initial Interview Comprehensive Nursing paper example) 10.2147\/NDT.S130444<\/a><\/p>\n\n\n\n

\u00a0Olfson, M., Ascher-Svanum, H., Faries, D. E., & Marcus, S. C. (2011). Predicting psychiatric hospital admission among adults with schizophrenia.\u00a0Psychiatric Services<\/em>,\u00a062<\/em>(10), 1138-1145.(Adult Psychiatric Initial Interview Comprehensive Nursing paper example)<\/p>\n\n\n\n

Steenen, S. A., van Wijk, A. J., Van Der Heijden, G. J., van Westrhenen, R., de Lange, J., & de Jongh, A. (2016). Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis.\u00a0Journal of Psychopharmacology<\/em>,\u00a030<\/em>(2), 128-139(Adult Psychiatric Initial Interview Comprehensive Nursing paper example). https:\/\/doi.org\/10.1177\/0269881115612236<\/p>\n","protected":false},"excerpt":{"rendered":"

Adult Psychiatric Initial Interview Comprehensive Nursing paper example Despite significant advancements in diagnostics and classification of\u00a0mental diseases and extensive knowledge by health providers and the general population regarding psychiatric conditions,…<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_wpscppro_dont_share_socialmedia":false,"_wpscppro_custom_social_share_image":0,"_facebook_share_type":"","_twitter_share_type":"","_linkedin_share_type":"","_pinterest_share_type":"","_linkedin_share_type_page":"","_instagram_share_type":"","_medium_share_type":"","_threads_share_type":"","_google_business_share_type":"","_selected_social_profile":[],"_wpsp_enable_custom_social_template":false,"_wpsp_social_scheduling":{"enabled":false,"datetime":null,"platforms":[],"status":"template_only","dateOption":"today","timeOption":"now","customDays":"","customHours":"","customDate":"","customTime":"","schedulingType":"absolute"},"_wpsp_active_default_template":true},"categories":[1],"tags":[1744],"class_list":["post-265503","post","type-post","status-publish","format-standard","hentry","category-nursing-paper","tag-adult-psychiatric-initial-interview-assessment"],"_links":{"self":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts\/265503","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/comments?post=265503"}],"version-history":[{"count":1,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts\/265503\/revisions"}],"predecessor-version":[{"id":272035,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/posts\/265503\/revisions\/272035"}],"wp:attachment":[{"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/media?parent=265503"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/categories?post=265503"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nursingstudy.org\/examples\/wp-json\/wp\/v2\/tags?post=265503"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}