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 Adult and Older adult  with different psychiatric conditions). 8 different     notes     with different patients scenarios. NOTE: An Example document is attached bellow

As a Psychiatric Mental Health Nurse Practitioner (PMHNP), there are various activities that I would have completed during a given time period with patients. In order to provide a comprehensive overview, I will provide eight different progress notes in SOAP format, each with a different patient scenario. These progress notes are related to the care provided to adult and older adult patients with different psychiatric conditions.

Patient 1:

Subjective: Patient presents with symptoms of depression, including low mood, lack of interest in previously enjoyed activities, and feelings of hopelessness. Patient reports decreased energy levels and increased difficulty in concentrating. Patient denies any suicidal ideation or psychotic symptoms.

Objective: Patient’s affect appears sad and flat. Patient displays psychomotor retardation and decreased amount of verbalization. Patient’s hygiene is poor, with disheveled appearance. Patient’s vital signs are within normal limits.

Assessment: Patient is diagnosed with Major Depressive Disorder based on the DSM-5 criteria. The severity of the depression is assessed as moderate.

Plan: Initiated pharmacological treatment with an SSRI antidepressant, along with psychotherapy sessions. Educated patient about potential side effects and importance of adherence to medication regimen. Scheduled a follow-up appointment in two weeks to evaluate treatment response and adjust medication dosage if necessary.

Patient 2:

Subjective: Patient presents with symptoms of anxiety, including excessive worrying, restlessness, and difficulty sleeping. Patient reports experiencing panic attacks, with heart palpitations and shortness of breath. Patient denies any depressive symptoms or psychotic features.

Objective: Patient appears anxious and restless. Patient exhibits tachycardia and hypertensive blood pressure. Patient’s speech is rapid and pressured. Patient’s vital signs are consistent with anxiety.

Assessment: Patient is diagnosed with Generalized Anxiety Disorder based on the DSM-5 criteria. The severity of the anxiety is assessed as severe.

Plan: Initiated pharmacological treatment with a selective serotonin-norepinephrine reuptake inhibitor (SNRI) and scheduled therapy sessions focused on cognitive-behavioral techniques. Implemented relaxation exercises and stress management strategies. Scheduled a follow-up appointment in three weeks to evaluate treatment response and adjust medication dosage if necessary.

Patient 3:

Subjective: Patient presents with symptoms of bipolar disorder, including periods of elevated mood, decreased need for sleep, increased energy levels, and impulsive behaviors. Patient reports experiencing racing thoughts and grandiose ideas during these manic episodes. Patient denies any depressive symptoms or psychotic features.

Objective: Patient appears euphoric and talkative. Patient displays increased psychomotor activity and exhibits pressured speech. Patient’s vital signs are stable within normal limits.

Assessment: Patient is diagnosed with Bipolar I Disorder based on the DSM-5 criteria. The current presentation corresponds to a manic episode.

Plan: Initiated pharmacological treatment with a mood stabilizer and antipsychotic medication. Educated patient about the potential need for hospitalization if symptoms worsen or safety concerns arise. Scheduled a follow-up appointment in one week to assess treatment response and monitor any side effects.

Patient 4:

Subjective: Patient presents with symptoms of schizophrenia, including hallucinations, delusions, and disorganized thinking. Patient reports hearing voices and experiencing paranoid thoughts. Patient denies any mood disturbances or suicidal ideation.

Objective: Patient appears anxious and displays poor eye contact. Patient exhibits disorganized speech and thought process. Patient’s vital signs are stable within normal limits.

Assessment: Patient is diagnosed with Schizophrenia based on the DSM-5 criteria. The current presentation corresponds with positive symptoms.

Plan: Initiated pharmacological treatment with an atypical antipsychotic medication. Arranged for a referral to a community support program for additional psychosocial interventions. Scheduled a follow-up appointment in two weeks to evaluate treatment response and monitor for potential side effects.

Patient 5:

Subjective: Patient presents with symptoms of obsessive-compulsive disorder (OCD), including intrusive thoughts and recurrent compulsive behaviors. Patient reports spending excessive time on cleaning and organizing, and experiences distress if routines are not followed. Patient denies any depressive symptoms or psychotic features.

Objective: Patient appears anxious and displays signs of tension. Patient exhibits repetitive hand-washing behaviors and displays rigidity. Patient’s vital signs are stable within normal limits.

Assessment: Patient is diagnosed with Obsessive-Compulsive Disorder based on the DSM-5 criteria. The severity of OCD is assessed as moderate.

Plan: Initiated pharmacological treatment with a selective serotonin reuptake inhibitor (SSRI) and recommended exposure and response prevention therapy. Implemented relaxation techniques and provided psychoeducation on the nature of OCD. Scheduled a follow-up appointment in four weeks to evaluate treatment response and adjust medication dosage if necessary.

Patient 6:

Subjective: Patient presents with symptoms of post-traumatic stress disorder (PTSD), including intrusive memories, nightmares, and avoidance of triggers related to a past traumatic event. Patient reports increased anxiety and hypervigilance. Patient denies any depressive symptoms or psychotic features.

Objective: Patient appears emotionally distressed and displays signs of agitation. Patient exhibits signs of hyperarousal, such as increased startle response and difficulty concentrating. Patient’s vital signs are stable within normal limits.

Assessment: Patient is diagnosed with Post-Traumatic Stress Disorder based on the DSM-5 criteria. The severity of PTSD is assessed as severe.

Plan: Initiated pharmacological treatment with a selective serotonin reuptake inhibitor (SSRI) and referred patient to a therapist specialized in trauma-focused therapy. Implemented grounding exercises and relaxation techniques. Scheduled a follow-up appointment in six weeks to evaluate treatment response and adjust medication dosage if necessary.

Patient 7:

Subjective: Patient presents with symptoms of attention-deficit/hyperactivity disorder (ADHD), including difficulty with focus, impulsivity, and hyperactivity. Patient reports experiencing chronic difficulties in academic and occupational settings. Patient denies any mood disturbances or psychotic features.

Objective: Patient appears restless and displays fidgeting behaviors. Patient exhibits difficulty sustaining attention and frequently interrupts others. Patient’s vital signs are stable within normal limits.

Assessment: Patient is diagnosed with Attention-Deficit/Hyperactivity Disorder based on the DSM-5 criteria. The severity of ADHD is assessed as moderate.

Plan: Initiated pharmacological treatment with a stimulant medication and recommended behavioral interventions. Collaborated with patient’s academic and occupational settings to implement strategies for optimal functioning. Scheduled a follow-up appointment in three weeks to evaluate treatment response and monitor for potential side effects.

Patient 8:

Subjective: Patient presents with symptoms of substance use disorder, specifically alcohol dependence. Patient reports experiencing cravings, loss of control, and continued use despite negative consequences. Patient denies any mood disturbances or psychotic features.

Objective: Patient appears withdrawn and exhibits signs of intoxication. Patient displays tremors and exhibits poor coordination. Patient’s vital signs are stable within normal limits.

Assessment: Patient is diagnosed with Alcohol Use Disorder based on the DSM-5 criteria. The severity of alcohol dependence is assessed as severe.

Plan: Initiated pharmacological treatment with a medication to support abstinence and referred patient to a substance abuse counselor. Implemented motivational interviewing techniques to enhance readiness for change. Scheduled a follow-up appointment in one week to evaluate treatment response and monitor for potential withdrawal symptoms.

These progress notes provide a snapshot of the activities completed with patients presenting different psychiatric conditions. The treatment plans implemented encompass a combination of pharmacological interventions, psychotherapy techniques, and referrals to appropriate resources, all aimed at optimizing patient outcomes and promoting overall mental health.