List 8 PROGRESS NOTES in SOAP format of the . Describe the activities you completed during this time period with patients. NOTE: ( The progress notes has to be related with what the Psychiatric Mental Health Nurse Practitioner do with Child and adolescents with different psychiatric conditions). 8 different notes with different patients scenarios.
Progress Note 1:
Date:
Patient Name:
Age:
Diagnosis:
Subjective: The patient presented with symptoms of anxiety, including excessive worry, restlessness, and difficulty concentrating. She reported feeling overwhelmed with school work and peer pressure. She expressed concerns about her academic performance and social interactions.
Objective: During the session, I conducted a comprehensive psychiatric assessment, including a mental status examination. The patient appeared tense and exhibited rapid speech. Her thoughts were racing, and she displayed signs of psychomotor agitation. She reported difficulty falling asleep and experiencing recurrent nightmares.
Assessment: Based on the assessment findings, the patient meets the criteria for generalized anxiety disorder. The symptoms significantly impact her daily functioning and well-being.
Plan: I discussed therapeutic interventions, including cognitive-behavioral therapy to address the patient’s anxiety. We also explored coping strategies, such as deep breathing exercises and journaling. I will collaborate with the patient’s school counselor to develop a supportive academic plan. Additionally, I prescribed an anxiolytic medication to help manage her symptoms.
Progress Note 2:
Date:
Patient Name:
Age:
Diagnosis:
Subjective: The patient reported feeling sad, hopeless, and lacking interest in activities she once enjoyed. She described difficulty concentrating and experiencing thoughts of worthlessness. She expressed a desire to isolate herself from peers and family.
Objective: During the session, the patient appeared tearful, displayed psychomotor retardation, and had a flat affect. She endorsed fatigue, changes in appetite, and disrupted sleep patterns. The patient’s responses on the Beck Depression Inventory indicated severe depressive symptoms.
Assessment: The patient meets the diagnostic criteria for major depressive disorder. Her symptoms significantly interfere with her functioning and quality of life.
Plan: I discussed the importance of psychotherapy and recommended weekly sessions to address the patient’s depressive symptoms. We explored the potential benefits of antidepressant medication and initiated a trial with a selective serotonin reuptake inhibitor. I provided psychoeducation about managing depressive symptoms and encouraged the patient to engage in pleasurable activities.
Progress Note 3:
Date:
Patient Name:
Age:
Diagnosis:
Subjective: The patient presented with disruptive behavior and difficulty following rules at home and school. He reported getting into frequent arguments with his parents and siblings. The patient expressed frustration with academic tasks and displayed low frustration tolerance.
Objective: During the session, the patient demonstrated restlessness and exhibited impulsivity. He displayed difficulty maintaining attention and often interrupted the conversation. His teachers reported a decline in academic performance and disruptive behavior in the classroom.
Assessment: The patient’s symptoms and behavior align with a diagnosis of attention-deficit/hyperactivity disorder (ADHD). His impulsivity, inattention, and hyperactivity significantly impact his ability to function in various settings.
Plan: I discussed the benefits of psychoeducation and behavior management strategies for ADHD. I recommended initiating stimulant medication to improve his attention and reduce impulsivity. We will collaborate with the school to implement accommodations and modifications to support his academic performance. I referred the patient for individual therapy to address emotional regulation and coping skills.
Progress Note 4:
Date:
Patient Name:
Age:
Diagnosis:
Subjective: The patient reported recurrent thoughts of self-harm, including suicidal ideation. She expressed feelings of worthlessness, hopelessness, and guilt. The patient shared episodes of binge eating followed by purging behaviors.
Objective: During the session, the patient exhibited decreased energy, psychomotor agitation, and diminished affect. She displayed difficulties with impulse control and reported weight fluctuations. Her responses on the self-harm assessment indicated a high risk for self-harm.
Assessment: The patient meets the diagnostic criteria for borderline personality disorder with comorbid depression and bulimia nervosa. Her symptoms pose a significant risk to her safety and well-being.
Plan: I discussed the importance of safety planning and referred the patient for immediate intensive outpatient treatment. We initiated pharmacotherapy to manage her depressive symptoms and discussed the benefits of dialectical behavior therapy. I emphasized the importance of establishing a support system and provided crisis hotline numbers for her to utilize during difficult moments.