Behavioral Psychiatric Assessment

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Behavioral Psychiatric Assessments I would like for you to consider the behavioral health issues you have dealt with in your clinical settings up until now, and submit to the objectives assignment link 2 objectives you have set for yourself to improve your interaction with patients with behavioral health problems. And, how you plan to meet them. The behavioral health issues I dealt with this semester include: anxiety, depression, dementia, smoking cessation, and insomnia. The goal during the interaction with patients with psychiatric issues was focused on improving my communication skills when taking history and performing physical assessments. Of particular note were the differences in approach between a behavioral health patient and…show more content…
Anxiety The objective in managing and treating patients with anxiety was to understand the clinical presentation of anxiety, the diagnostic tools used in diagnosing this illness, and the treatments used to manage the different types of anxiety. The first goal is to understand the presentation of anxiety which may include: apprehension, restlessness, and insomnia. Other symptoms are fatigue, paresthesia, near syncope, dizziness, palpitations, tachycardia, chest pain and tightness, dyspnea, hyperventilation, nausea and vomiting. The patients presenting with anxiety and depression should also have lab work to include: TSH, CBC, urinalysis, urine drug screen testing. This lab work will check for anemia, hypothyroidism, and insomnia which can also lead to anxiety or can exacerbate the condition. I have been able to perform interview, history, and assessments based on the DSM-IV criteria. Other diagnostic tools that have not been utilized as much this semester are Hamilton Anxiety scale and Zung Anxiety Self-Assessment but I hope to learn more about them in the coming semester (Dunphy, Winland-Brown, Porter, Thomas,…show more content…
Treatment lasts for 12 weeks. Insomnia I also worked with patients who came into the clinic with complaints of insomnia. These patients presented with difficulty falling or staying asleep, irritability, and daytime sleepiness or fatigue. The objective is to know the diagnostic studies done to diagnose severe insomnia which include: brain CT, MRI, sleep history, and sleep laboratory studies. The non-pharmacologic therapies are behavioral therapy, relaxation therapy, and cognitive therapy. The pharmacologic management includes: Temazepam 7.5-30mg at bedtime (use for 1-2 weeks) Ambien 5-10mg at bedtime (4 weeks max) Lunesta 2-3mg at bedtime. Start with 1mg for elderly. Rozerem 8mg PO 30 min before bedtime. Do not take with meals. Trazodone 50-100mg at bedtime Paxil 10-20mg at bedtime Reference Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2011). Primary care: The art and science of advanced practice nursing (3rd ed.). Philadelphia: F.A Davis. Arcangelo, V.P. & Peterson, A.M. (2006). Pharmacotherapeutics for advanced practice: A practical approach (2nd ed.). Philadelphia, PA: Lippincott Williams & Wilkins. ISBN 13:

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