Please see the attachment for instructions

Identify a problem or concern from your selected population. Write a 1-3 page description of your problem and support the need to address this in your population with 3 evidence-based articles. Include title and reference page.

Free of plagiarism, references… I will be attaching the work where it says the goal and objective, that you can mention it as having been achieved… develop the work well but it does not have to be so extensive, just comply with the parameters that they ask for and that's it.

In 450–500 words, address the following:

Learning From Experiences

· Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.

· Reflect on the 3 most challenging patients you encountered during the practicum experience. What was most challenging about each? ADHD CHILDREN MALE… MDD OLDER ADULT MALE DUE TO LOST HIS SON X COVID… FEMALE PTSD BY BORDER PROCESSOR TO ARRIVE IN THE USA

· What did you learn from this experience? 

· What resources were available?

· What evidence-based practice did you use for the patients?

· What would you do differently? 

· How are you managing patient flow and volume?  How can you apply your growing skillset to be a social change agent within your community?

Communicating and Feedback

Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.

Answer these questions: How am I doing? I FEEL that I have grown professionally, that THE UNIVERSITY PREPARED ME with a lot of knowledge blah blah blah, the two preceptors that I have had have been a very positive influence.. BLAH BLAH BLAH

What is missing? I don't think I'm missing anything, I feel ready to take the step to get my board exam blah blah blah

Reflect on the formal and informal feedback you received from your Preceptor. EXCELLENT .. ALL POSITIVE EXCELLENT PRECEPTOR blab la bla

 When it comes to facilitating spiritual care for patients with worldviews different from your own, what are your strengths and weaknesses? If you were the patient, who would have the final say in terms of ethical decision-making and intervention in the event of a difficult situation? 

2

Generalized Anxiety Disorder
Middle-Aged White Male With Anxiety

 

BACKGROUND INFORMATION

The client is a 46-year-old white male who works as a welder at a local steel fabrication factory. He presents today after being referred by his PCP after a trip to the emergency room in which he felt he was having a heart attack. He stated that he felt chest tightness, shortness of breath, and feeling of impending doom. He does have some mild hypertension (which is treated with low sodium diet) and is about 15 lbs. overweight. He had his tonsils removed when he was 8 years old, but his medical history since that time has been unremarkable. Myocardial infarction was ruled out in the ER and his EKG was normal. Remainder of physical exam was WNL.

He admits that he still has problems with tightness in the chest and episodes of shortness of breath- he now terms these “anxiety attacks.” He will also report occasional feelings of impending doom, and the need to “run” or “escape” from wherever he is at.

In your office, he confesses to occasional use of ETOH to combat worries about work. He admits to consuming about 3-4 beers/night. Although he is single, he is attempting to care for aging parents in his home. He reports that the management at his place of employment is harsh, and he fears for his job. You administer the HAM-A, which yields a score of 26.

Client has never been on any type of psychotropic medication.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. He is appropriately dressed. Speech is clear, coherent, and goal-directed. Client’s self-reported mood is “bleh” and he does endorse feeling “nervous”. Affect is somewhat blunted, but does brighten several times throughout the clinical interview. Affect broad. Client denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, as is insight. He denies suicidal or homicidal ideation.

You administer the Hamilton Anxiety Rating Scale (HAM-A) which yields a score of 26.

Diagnosis: Generalized anxiety disorder

RESOURCES

§ Hamilton, M. (1959). Hamilton Anxiety Rating Scale. Psyctests, doi:10.1037/t02824-0

Decision Point One

Select what you should do:

Begin Paxil 10 mg po daily

Begin Imipramine 25 mg po BID

Begin Buspirone 10 mg po BID