Psych NP Case Studies

Psych NP Case Studies

Psych NP Case Studies Essay
Post: Didactic Discussion 5 PLEASE NOTE THAT EACH CASE STUDY HAS TO BE COMPLETED SEPARATELY AND EACH QUESTION ADDRESSED FOR EACH CASE STUDY. Post to the cases below, using the questions provided for each case (due Week 13). Developing comprehensive treatment plans is one of the advantages of private practice. Cases: Sex addiction- A forty-two-year-old white male presents to your outpatient clinic for treatment of “sex addiction.” He informs you that he has been dating a woman for the last nine months, and that she had made the discovery of pornography on his laptop computer. Psych NP Case Studies Essay. Apparently, she has shared this information with a girlfriend of hers, who is a licensed clinical social worker. The social worker friend immediately informs her girlfriend that the presence of pornography on his laptop indicates that he has sexual addiction. The client presents to your office to save his relationship, and to be cured of his “pornography addiction.” Paraphilic Disorders- A twenty-seven-year-old Caucasian female presents your outpatient clinic very concerned over a relationship that she has been involved in for the past few weeks. She informs you that she has been having sexual relations with a thirteen-year-old boy in her classroom. She states, “but he is very mature for his age.” Prior to this affair, she admits that on one other occasion she had sexual relations with a twelve-year-old, who told her that he was actually fifteen. She does admit to having ongoing sexually arousing fantasies involving young boys. She comes to you today out of fear that she will lose her job as a school teacher if this is discovered. Sexual Dysfunction- A forty-five-year-old African-American male comes to your outpatient office at the insistence of his wife. Psych NP Case Studies Essay .He reports that he no longer has sexual or erotic thoughts or fantasies, nor has any desire for sexual activity with his spouse. He reports that this is been going on for about the last year and a half, and that his wife is “fed up” with him ignoring their sexual relationship. Although he finds the topic very embarrassing to discuss, he is fearful that if you are unable to help him, that his wife will leave him. Questions to address in your main posting: Discuss the process of diagnostic differentiation (be specific about what your assessment would include specific to the diagnoses provided)- how would you determine symptoms belonging to each condition and how would you work with symptom overlap? Describe how the current setting in which the child lives would impact your care/treatment plan. Discuss physical assessments you would make with the client- include a description of any referrals you would consider (and what is the rationale for those referrals?) List laboratory testing and rationale for selected tests Discuss concerns with existing pharmacotherapeutic approaches and discuss any changes you would consider- include rationale for any changes you may suggest. Tell us about the psychotherapeutic approaches you would use with this client. Specifically, what psychotherapy will you use, and why? Will you make referrals for any type of specialized psychological testing? Will you refer the individual to group psychotherapy? Again, all responses should be evidence-based. Included discussion of possible strengths and weaknesses of each client. Describe discharge criteria-that is, what is it that the client must be able to successfully do, achieve, or complete, for you to discharge them from your current patient load? Psych NP Case Studies Essay

Psych NP case studies

Case 1

In diagnosing for sex addiction, I would consider certain elements. First, I would assess the client’s sex life to know whether it is less satisfying. I would also examine if pornography has made the client have relationship problems with his wife. Additionally, I would assess the pornography has led the client to engage in risky behaviors. Regarding the existing pharmacotherapeutic approaches, there are no medications approved by the US Food and Drug Administration (FDA). However, I recommend medication in the SSRI (selective serotonin reuptake inhibitors) group like paroxetine and citalopram to help the client relieve their symptoms (Rosenberg et al., 2014). The psychotherapeutic therapy that I would use includes psychosexual therapy that involves slowly changing actions that uphold sexual problems (Carnes & Adams, 2019). I would refer the client for group therapy to reduce the client’s isolation or shame through interaction with individuals who are struggling to conquer the same disorder. The client presents some strengths that include his mental stability and his excellent response to questions. One weakness that he portrays is that he appears nervous. The discharge criteria for this client involves his portrayal of starting to recover from sex addiction and remaining committed to it. Psych NP Case Studies Essay

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Case 2

In diagnosing the paraphilic disorder, I would consider certain aspects. I would first assess the clients’ medical condition to make sure that she does not suffer from a mental health disorder by conducting laboratory tests. I would also ask a series of question to help me evaluate presence of symptoms. The physical examination I would perform on the client includes checking if she shows sexual arousal by what attracts her. The Phamarcotherapeutic approaches involve administering antidepressants including lithium to the client (Moser, 2016). The psychotherapeutic approach I would apply in this case study is cognitive behavioral therapy which will help the client to recognize and prevent rationalizations concerning her behavior (Konrad et al., 2015). I would consider group therapy from my client to enhance self awareness by taking note of other peoples’ issues. The client’s strength was that she was cooperative in responding to questions. Her weakness was that she was full of anxiety. Before discharging the client, I ensured that the symptoms have reduced. She has now developed a hobby of reading hence does not have time to think of other things. Psych NP Case Studies Essay

Case 3

The diagnostic differentiation process for this client would involve assessing the client’s attitudes about sex and other elements that may contribute to the condition, including anxiety, fear, relationship issues, and past sexual abuse or trauma (Wincze & Weisberg, 2015). Physical assessment to be performed will involve checking the sensation, peripheral pulses blood pressure, texture, and size of the testes, and presence of vas deferens of the epididymis. Additionally, it would be necessary to examine any penile deformity, like Peyronie plaques and hypospadias. The primary laboratory testing for this condition would involve a blood test and urine test. When performing a blood test in the laboratory, a sample of the client’s blood will be checked for low testosterone levels, diabetes, heart disease, and other conditions. On the other hand, urine tests will be used to check for diabetes signs and other conditions.

The existing pharmacotherapeutic approaches forms managing this condition include alternate action mechanisms and hormone, gene-related therapy, and stem cell therapies. For alternate action mechanisms, dopamine has been found to play an essential role in the brain’s sexual signaling. Gene-related therapy involves the transfer of maxi-K ion channels to the penile tissues, which increases smooth muscle relaxation (Reddy &Vijay, 2017). The psychotherapeutic therapy that I would use includes psychosexual therapy that involves slowly changing actions that uphold sexual problems (Reddy &Vijay, 2017). I would refer the patient to a urologist to examine issues with the prostate gland that include nerve damage, enlarged prostate, prostate cancer, or polyuria. The strengths that this client presents include his lucid description of his condition and his willingness to answer questions that I ask him. However, he seems embarrassed to talk about his condition. The client should be able to express the comprehension of the correlation between physical condition and sexual issues. He should recognize acceptable and satisfying sexual practices and discover different methods and recommence sexual relations. Psych NP Case Studies Essay

References

Carnes, P. J., & Adams, K. M. (Eds.). (2019). Clinical management of sex addiction. Routledge.

Moser, C. (2016). DSM-5 and the paraphilic disorders: Conceptual issues. Archives of Sexual Behavior, 45(8), 2181-2186.

Konrad, N., Welke, J., & Opitz-Welke, A. (2015). Paraphilias. Current Opinion in Psychiatry, 28(6), 440-444.

Reddy, M. S., & Vijay, M. S. (2017). Pharmacological advances in the management of sexual dysfunction. Indian Journal of Psychological Medicine, 39(3), 219.

Rosenberg, K. P., Carnes, P., & O’Connor, S. (2014). Evaluation and treatment of sex addiction. Journal of Sex & Marital Therapy, 40(2), 77-91.

Wincze, J. P., & Weisberg, R. B. (2015). Sexual dysfunction: A guide for assessment and treatment. Guilford Publications. Psych NP Case Studies Essay

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