NRNP 6635 Week 10 Assignment

ByDaniel Rossi Updated on

NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders – Step-by-Step Guide

The first step before starting to write the NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders Instructions

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, 2022). 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. As you prepare for the Final Exam, the next class is NRNP 6645 Psychotherapy With Multiple Modalities, which begins with NRNP 6645 Week 1 Discussion: Biological Basis and Ethical/Legal Considerations of Psychotherapy.

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 Evaluation 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 evaluation 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 Evaluation, 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-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR 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.).

Scenario

Name: Sarah Higgins
Gender: female
Age: 11 years old
T- 97.4 P- 58 R 14 98/62 Ht 4’5 Wt 65lbs
Background: no history of treatment, developmental milestones met on time, vaccinations up to
date. Sleeps 9-10hrs/night, meals are difficult as she has hard time sitting for meals, she does get
proper nutrition per PCP. She has a younger brother. lives with her parents in Washington, D.C. No hx of head trauma.

NRNP 6635 Week 10 Assignment: Neurocognitive and Neurodevelopmental Disorders Example

Subjective:

CC (chief complaint): I have Persistent difficulties with attention, memory, and staying still.

HPI: Sarah Higgins, an 11-year-old female, has demonstrated persistent attention and memory difficulties since kindergarten. Her mother reports that Sarah frequently loses items necessary for school, forgets assignments, and has trouble sitting still, affecting her academic performance. These issues are observed both at home and in school settings. Despite various strategies attempted to manage these behaviors, significant challenges persist. Additionally, Sarah expresses feelings of frustration regarding her inability to keep up with peers, which occasionally impacts her social interactions.

Past Psychiatric History:
  • General Statement: No prior psychiatric treatment or formal diagnosis before the current evaluation.
  • Caregivers (if applicable): Raised by both parents in a stable home environment. No other caregivers involved.
  • Hospitalizations: No previous psychiatric hospitalizations.
  • Medication trials: None reported.
  • Psychotherapy or Previous Psychiatric Diagnosis: No previous psychotherapy or diagnoses.

Substance Current Use and History: No substance use reported. She has never been exposed to tobacco, alcohol, or drugs, consistent with her age and upbringing.

Family Psychiatric/Substance Use History: One distant relative may have had issues with mild depression, but no significant family history of psychiatric conditions or substance abuse.

Psychosocial History: Sarah is actively involved in school and lives with her parents and a younger brother in Washington, D.C. She experiences difficulties sitting still during meals but receives adequate nutrition. She enjoys art and has hobbies such as visiting museums, although she tends to move quickly from one exhibit to another. Socially, she is well-liked but occasionally finds herself isolated due to her hyperactivity and inattention.

Medical History:
  • Current Medications: None.
  • Allergies: No known allergies.
  • Reproductive Hx: Not applicable due to age.
ROS:
  • GENERAL: No weight loss, fever, or fatigue reported. Difficulty sitting still.
  • HEENT: Head, Eyes, Ears, Nose, Throat – No known issues. Normal vision and hearing as per age.
  • SKIN: No rashes or itching reported.
  • CARDIOVASCULAR: No history of chest pain, palpitations, or edema.
  • RESPIRATORY: No shortness of breath or cough.
  • GASTROINTESTINAL: Normal appetite and bowel habits.
  • GENITOURINARY: No dysuria or frequency.
  • NEUROLOGICAL: Symptoms of inattention and forgetfulness, possibly related to ADHD. No seizures or syncope.
  • MUSCULOSKELETAL: No joint pains or muscle weakness.
  • HEMATOLOGIC: No history of anemia or bleeding disorders.
  • LYMPHATICS: No enlarged nodes.
  • ENDOCRINOLOGIC: No signs of thyroid dysfunction or other hormonal issues.

Objective:

Physical exam:

General Appearance: Sarah is an alert and cooperative 11-year-old female, appearing her stated age. She exhibits mild fidgetiness during the examination but remains engaged.

Vital Signs:

  • Temperature: 97.4°F (36.3°C)
  • Pulse: 58 bpm
  • Respiration: 14 breaths per minute
  • Blood Pressure: 98/62 mmHg
  • Height: 4’5″ (135 cm)
  • Weight: 65 lbs (29.5 kg)

HEENT (Head, Eyes, Ears, Nose, Throat):

  • Head: Normocephalic, atraumatic.
  • Eyes: Pupils are equal, round, and reactive to light and accommodation. No conjunctival injection or icterus.
  • Ears: Tympanic membranes intact, no erythema or effusion.
  • Nose: No nasal discharge or congestion.
  • Throat: Oropharynx is moist and without erythema, exudates, or lesions.

Neck: Supple, no cervical lymphadenopathy, no thyromegaly.

Cardiovascular: Heart rate and rhythm are regular, no murmurs, rubs, or gallops. Peripheral pulses are 2+ and symmetrical.

Respiratory: Lungs clear to auscultation bilaterally, no wheezes, rales, or rhonchi.

Gastrointestinal: Abdomen is soft, non-tender, non-distended, with normoactive bowel sounds in all quadrants. No hepatosplenomegaly.

Musculoskeletal: Full range of motion in all extremities. No joint swelling or deformities. Mild involuntary movements noted, possibly related to reported fidgetiness.

Skin: Warm and dry with no rashes or significant lesions. Mild eczema noted on flexural areas.

Neurological:

  • Mental Status: Sarah is alert and oriented to person, place, and time.
  • Cranial Nerves: All cranial nerves are grossly intact.
  • Motor: Normal muscle tone and strength in all four extremities.
  • Sensory: Intact to light touch.
  • Coordination: Appropriate for age, though slightly impulsive movements are noted.
  • Reflexes: Physiological reflexes are present and symmetrical.

Psychiatric: Sarah is polite and tries to cooperate, though her attention seems to drift periodically. She exhibits no overt signs of anxiety or distress during the exam.

Assessment:

Mental Status Examination:

Appearance: Sarah presents as a well-groomed and appropriately dressed 11-year-old female. She appears her stated age and maintains a mostly cooperative demeanor throughout the session, albeit with noticeable fidgetiness.

Behavior: Exhibits restless behavior with frequent shifting in her seat and intermittent attention to stimuli in the room other than the examiner. No psychomotor agitation or retardation observed.

Attitude Toward Examiner: Cooperative and polite, though her engagement fluctuates, likely due to difficulty maintaining attention.

Speech: Speech is clear, coherent, and of normal rate and volume. However, responses may be briefly delayed as she appears to gather her thoughts.

Mood: Describes her mood as “okay,” with a slightly subdued affect at times, but generally euthymic (neutral mood).

Affect: Affect is somewhat restricted in range; displays primary expressions of mild frustration or indifference during the interview. There is a congruence between stated mood and observed affect.

Thought Process: Linear and goal-directed, based on age and developmental level. Shows some difficulty in organizing thoughts when distracted.

Thought Content: No evidence of delusions, hallucinations, or overt paranoia. Expresses worries about school performance and losing personal items, which cause her distress.

Perceptions: No auditory or visual hallucinations reported or observed. Displays appropriate responses to the environment, despite occasional distraction.

Cognition:

  • Orientation: Oriented to person, time, and place.
  • Concentration: Struggles with tasks requiring sustained mental effort. Demonstrates difficulty in serially subtracting numbers and reciting the months backward.
  • Memory: Immediate recall is intact. Short-term memory shows lapses, particularly in recalling assignments or where items were placed. Long-term memory appears intact based on her recall of personal and family history.
  • Intelligence: Appears average for her age, though formal testing would be required for accurate assessment.

Insight and Judgment:

  • Insight: Partially aware of her difficulties, understanding that she has more trouble than others her age with attention and memory.
  • Judgment: Basic judgment seems intact for age. Makes reasonable decisions in familiar situations but may act impulsively when under stress or distracted.

Risk Assessment: No immediate risk of harm to self or others noted during the examination. No suicidal or homicidal ideation expressed or implied.

Differential Diagnoses:

1. Attention Deficit Hyperactivity Disorder (ADHD), Combined Presentation

Supporting Evidence:

  • Pertinent Positives: Difficulty maintaining attention in tasks, frequent loss of items necessary for tasks, forgetfulness in daily activities, fidgetiness, and restlessness.
  • Pertinent Negatives: No evidence of significant mood swings or episodes of emotional dysregulation that would suggest a mood disorder.
  • DSM-5-TR Criteria: Symptoms of inattention and hyperactivity-impulsivity are present for over 6 months in a manner inconsistent with developmental level and negatively impacting social and academic/occupational activities. The observed symptoms are not exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., Mood Disorder, Anxiety Disorder) (Cortese, 2020).

2. Generalized Anxiety Disorder (GAD)

Supporting Evidence:

  • Pertinent Positives: Expressed worries about school performance and losing personal items, which could be interpreted as excessive anxiety.
  • Pertinent Negatives: Lack of additional symptoms such as sleep disturbance due to worry, muscle tension, or significant irritability.
  • DSM-5-TR Criteria: Excessive anxiety and worry occurring more days than not for at least 6 months about a number of events or activities. The individual finds it difficult to control the worry. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Sarah’s primary difficulties focus more on attention and activity regulation than on pervasive anxiety (Carl et al., 2020).

3. Adjustment Disorder with Anxiety

Supporting Evidence:

  • Pertinent Positives: Some symptoms of anxiety and stress could be related to adjustments in her life, such as adapting to school requirements.
  • Pertinent Negatives: No major life changes or stressors reported that would typically precipitate an adjustment disorder.
  • DSM-5-TR Criteria: Emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s). Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months. There’s a lack of a clear temporal stressor linked directly to the onset or exacerbation of her symptoms (Dragan et al., 2021).
Critical Thinking Process:

In evaluating Sarah, the priority was to determine which condition most comprehensively accounted for the breadth of her symptoms and the chronicity of her reported difficulties. The persistent nature of her inattention, hyperactivity, and impulsivity across various settings (home and school) from a young age is more characteristic of ADHD than the episodic or situational anxiety suggested by the other diagnoses.

The absence of pervasive anxiety symptoms and the specific pattern of forgetfulness and losing items point more towards ADHD’s combined presentation, rather than anxiety disorders, where we might expect more pervasive and persistent worries across a variety of life contexts, not just forgetting or losing things. Furthermore, the exclusion criteria for ADHD were not met by any other condition, particularly psychotic or mood disorders, which might explain her symptoms through another pathology.

Thus, ADHD stands out as the primary diagnosis not only due to the presence of its hallmark symptoms but also because it best explains her difficulties across different domains of her life, fulfilling both the inclusion criteria of the DSM-5-TR and distinguishing her condition from other potential diagnoses.

Reflections:

If I had the opportunity to conduct the session with Sarah, I would focus on enhancing engagement techniques tailored specifically to her attention span and interests. This could involve incorporating more interactive elements, such as games or activities that align with cognitive assessment, to maintain her focus and make the session feel more engaging for a child her age. Moreover, structuring the session with more frequent, shorter breaks could help manage her restlessness and potentially improve the quality of the interaction.

Beyond the standard considerations of confidentiality and informed consent, which are fundamental in dealing with any patient, particularly minors, a deeper dive into ethical considerations might include assessing the potential for stigma and its impacts. Diagnosing a child with ADHD carries a risk of stigmatization in both educational and social settings.

Ethically, it is crucial to communicate with Sarah and her mother about how to manage this diagnosis discreetly and effectively, emphasizing strengths and coping strategies rather than deficits. Furthermore, ensuring that Sarah’s consent is considered in the process—even though she is a minor—respects her developing autonomy and helps in building trust.

In terms of health promotion and disease prevention, it is important to consider interventions that can mitigate the effects of ADHD on Sarah’s long-term health. This includes educational interventions tailored to her learning style, potentially incorporating more kinesthetic elements into her study routines or using digital apps that can help in organizing her tasks and schedules.

Preventive measures should also involve regular follow-ups to monitor her condition and any side effects if medication is initiated. Given Sarah’s age and the onset of her developmental phase, introducing her to skills for managing stress and enhancing her executive functioning could be beneficial. These skills will not only help in her immediate context but also build a foundation for managing potential challenges during adolescence.

Considering patient factors such as Sarah’s age, cultural background, and her family’s socioeconomic status, developing a support plan that includes her school environment and potential community resources is essential. Engaging with her teachers and school counselors can ensure that she receives consistent support across all environments. Additionally, understanding the family’s dynamics and their cultural views on mental health is crucial for effective management and support of Sarah’s condition.

References

Carl, E., Witcraft, S. M., Kauffman, B. Y., Gillespie, E. M., Becker, E. S., Cuijpers, P., Powers, M. B. (2020). Psychological and pharmacological treatments for generalized anxiety disorder (GAD): a meta-analysis of randomized controlled trials. Cognitive Behaviour Therapy, 49(1), 1-21. https://doi.org/10.1080/16506073.2018.1560358

Cortese, S. (2020). Pharmacologic treatment of attention deficit–hyperactivity disorder. New England Journal of Medicine, 383(11), 1050–1056. https://doi.org/10.1056/NEJMra1917069

Dragan, M., Grajewski, P., & Shevlin, M. (2021). Adjustment disorder, traumatic stress, depression and anxiety in Poland during an early phase of the COVID-19 pandemic. European journal of psychotraumatology, 12(1), 1860356. https://doi.org/10.1080/20008198.2020.1860356