Expert answer:clinical journal

  

Solved by verified expert:i have enclosed 3 submissions/samples so please answer questions below and make sure they are original in content. Please complete 5 journals with the 9 questions below each.What were the highlights of this week’s clinical?What challenges did you face?Recall any online content that you have studied for the clinical.Which chief complaints did you see more often this week?List one set of guidelines that you reviewed as a result of your clinical experience this week.What are the most common differential diagnoses that you saw this week?How did you apply what you have learned?List one plan of care for one of the patients you saw this week, including all five aspects of the plan.What have you seen in the clinical environment that we haven’t covered in the online course?
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Ingrid Valerio
May 12th, 2019
1. What were the highlights of this week’s clinical?
I had the opportunity to train in icannotes for PMHNP care plans, treatment plans and
new patient assessments for 2 hours. I also had the opportunity to
2. What challenges did you face?
It was difficult driving for hours for clinicals also being there till 10pm. I like to have
work life balance and am unable to afford to quit my job.
3. Recall any online content that you have studied for the clinical.
My preceptor works with older medications, so Stahls Prescription Guide was very
useful. She is also well versed with group therapy and interventions. I also used the
clinical documentation book.
4. Which chief complaints did you see more often this week?
I saw 2 schizophrenic new patients, 1 suicidal ideation because of severe depression and
the rest were substance use disorder and bipolar.
5. List one set of guidelines that you reviewed as a result of your clinical experience this
week.
I reviewed the guidelines for bipolar disorders, treatment and interventions as well as
medications. Side effects and therapeutic plan (American Psychiatric Association, 2013).
6. What are the most common differential diagnoses that you saw this week?
Bipolar (manic phase) and schizophrenia.
7. How did you apply what you have learned?
8. List one plan of care for one of the patients you saw this week, including all five aspects
of the plan.
22 year old female patient with a diagnosis of bipolar disorder.
SMART GOAL
START
DATE
DUE
DATE
Patient and her family/support system will develop a safety plan/no 5/12/2019
self-harm contract in next appointment.
5/20/2018
Patient will become involved for at least 20 minutes of physical
activity at least three times per week target date 4 weeks.
5/12/2019
6/12/2019
Patient will identify and learn at least 2 coping skills.
5/12/2019
5/20/2019
Patient will score below 11 in GAD 7 for 4 consecutive sessions.
5/12/2019
6/12/2019
9. What have you seen in the clinical environment that we haven’t covered in the online
course?
Psychiatric mental health assessment and care planning. I believe they were briefly discussed
but not thorough to develop a plan.
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th
ed. American Psychiatric Publishing, Arlington, VA; 2013
Ingrid Valerio
May 19th, 2019
1. What were the highlights of this week’s clinical?
I was able to conduct initial assessment on three new patients. I went to clinicals
Thursday and all day Saturday. One of my patients had a diagnosis of schizophrenia and I
also had two other bipolar patients new to my preceptors practice.
2. What challenges did you face?
It was difficult driving for hours for clinicals also being there till 10pm. I like to have
work life balance and am unable to afford to quit my job. I also have another part time
job to pay for school and I feel even though the college does say you are able to work in
practice its not possible due to not having preceptors for PMHNP students.
3. Recall any online content that you have studied for the clinical.
Stahls Prescription Guide was very useful. I visited UpToDate for more current
information and treatment options for the patients my preceptor was seeing and the
medications the patients were on.
4. Which chief complaints did you see more often this week?
Most patients the preceptor schedules them to come every 4 days depending on if the
patient has an acute episode and to keep ambulatory. Insomnia and anxiety related to
depression and bipolar disorders.
5. List one set of guidelines that you reviewed as a result of your clinical experience this
week.
I reviewed the guidelines for bipolar disorders, treatment and interventions as well as
medications. Side effects and therapeutic plan (American Psychiatric Association, 2013).
6. What are the most common differential diagnoses that you saw this week?
Bipolar (manic phase) and schizophrenia.
7. How did you apply what you have learned?
8. List one plan of care for one of the patients you saw this week, including all five aspects
of the plan.
22 year old female patient with a diagnosis of bipolar disorder.
SMART GOAL
START
DATE
DUE
DATE
Patient and her family/support system will develop a safety plan/no 5/12/2019
self-harm contract in next appointment.
5/20/2018
Patient will become involved for at least 20 minutes of physical
activity at least three times per week target date 4 weeks.
5/12/2019
6/12/2019
Patient will identify and learn at least 2 coping skills.
5/12/2019
5/20/2019
Patient will score below 11 in GAD 7 for 4 consecutive sessions.
5/12/2019
6/12/2019
9. What have you seen in the clinical environment that we haven’t covered in the online
course?
Psychiatric mental health assessment and care planning. I believe they were briefly discussed
but not thorough to develop a plan.
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th
ed. American Psychiatric Publishing, Arlington, VA; 2013
Ingrid Valerio
May 25th, 2019
1. What were the highlights of this week’s clinical?
I was able to conduct initial assessment on two new patients. I went to clinicals Thursday
and all day Saturday. One of my patients had a diagnosis of bipolar and the other
dementia.
2. What challenges did you face?
I tend to work better with clear guidelines and expectations. I do not want my preceptor
to feel I am overstepping. She can be a little brusque and short. It makes me feel like a
child, so I try to be mindful and respectful of what she allows or wants me to do. It was
difficult driving for hours for clinicals also being there till 10pm, I was so tired from my
2 jobs that my husband ended taking me.
3. Recall any online content that you have studied for the clinical.
Stahls Prescription Guide was very useful. I visited UpToDate for more current
information and treatment options for the patients my preceptor was seeing and the
medications the patients were on.
4. Which chief complaints did you see more often this week?
Most patients the preceptor schedules them to come every 4 days depending on if the
patient has an acute episode and to keep ambulatory. Insomnia and anxiety related to
depression and bipolar disorders.
5. List one set of guidelines that you reviewed as a result of your clinical experience this
week.
I reviewed the guidelines for manic depression, generalized anxiety disorders treatment
and interventions as well as medications. Side effects and therapeutic plan (American
Psychiatric Association, 2013).
6. What are the most common differential diagnoses that you saw this week?
Bipolar (manic phase) and schizophrenia.
Anxiety with and without depression
Schizoaffective disorder and schizophrenia
7. How did you apply what you have learned?
Working with the patient supervised with my preceptor, getting more proficient with
documentation and assessments.
8. List one plan of care for one of the patients you saw this week, including all five aspects
of the plan.
21 year old male patient with a diagnosis of schizoaffective disorder.
SMART GOAL
START
DATE
DUE
DATE
Patient and her family/support system will develop a safety plan/no 5/18/2019
self-harm contract in next appointment.
5/25/2018
Patient will become involved for at least 20 minutes of physical
activity at least three times per week target date 4 weeks.
5/18/2019
6/12/2019
Patient will identify and learn at least 2 coping skills.
5/18/2019
5/25/2019
9. What have you seen in the clinical environment that we haven’t covered in the online
course?
Psychiatric mental health assessment and care planning. How to complete eLogs and what is
important.
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th
ed. American Psychiatric Publishing, Arlington, VA; 2013

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