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.

Progress Notes in SOAP format for Psychiatric Mental Health Nurse Practitioner

Patient 1:
Date: [Insert Date]
Subjective:
The patient, a 40-year-old adult, presented with symptoms of anxiety, including restlessness and a persistent feeling of worry. She reported difficulty concentrating and sleeping, which has been affecting her daily functioning.

Objective:
During the session, the patient showed signs of increased heart rate and shallow breathing. She appeared tense and exhibited fidgeting behaviors. Patient’s mood was anxious and apprehensive. The patient’s affect was congruent with her reported anxiety symptoms.

Assessment:
Based on the patient’s symptoms and assessment findings, a diagnosis of generalized anxiety disorder (GAD) was made. The patient’s anxiety symptoms are having a significant impact on her daily life.

Plan:
The patient was educated about GAD and its symptoms. Psychoeducation regarding relaxation techniques, deep breathing exercises, and stress management strategies was provided. The patient was encouraged to engage in regular physical exercise and to practice mindfulness-based stress reduction techniques. Medication options were discussed, and the patient expressed interest in considering pharmacological treatment. Referral for ongoing therapy was made.

Patient 2:
Date: [Insert Date]
Subjective:
The patient, a 65-year-old older adult, reported feeling sad and having a lack of interest in activities she once enjoyed. She denied any suicidal thoughts but expressed a sense of hopelessness, fatigue, and difficulty sleeping.

Objective:
During the session, the patient appeared tearful and had a flat affect. Her speech was slow, and she had poor eye contact. The patient’s mood was consistently depressed.

Assessment:
Based on the patient’s depressive symptoms and assessment findings, a diagnosis of major depressive disorder (MDD) was made. It was determined that the patient’s symptoms have significantly interfered with her ability to function.

Plan:
The patient was educated about MDD and the importance of seeking treatment. Psychoeducation regarding the importance of self-care activities, such as engaging in hobbies, maintaining a healthy diet, and regular sleep patterns, was provided. The patient was referred to a therapist and given information about local support groups. Pharmacological treatment options were also discussed, and the patient expressed willingness to start antidepressant medication.

Patient 3:
Date: [Insert Date]
Subjective:
The patient, a 50-year-old adult, presented with symptoms of irritability, impulsivity, and difficulty focusing. She reported frequently becoming angry and engaging in impulsive behaviors. These symptoms have been interfering with her relationships and daily functioning.

Objective:
During the session, the patient exhibited rapid speech, restlessness, and a heightened sense of energy. She appeared agitated and had difficulty staying seated. The patient’s mood was irritable throughout the session.

Assessment:
Based on the patient’s symptoms and assessment findings, a diagnosis of attention-deficit/hyperactivity disorder (ADHD) was made. The patient’s symptoms are causing significant impairment in her occupational and social domains.

Plan:
The patient was educated about ADHD and its symptoms. Psychoeducation regarding effective time management strategies, organization techniques, and self-regulation skills was provided. The patient was referred to a therapist for cognitive-behavioral therapy (CBT) and given recommendations for ADHD coaching. Medication options were discussed, and the patient expressed interest in trying ADHD medication.

Patient 4:
Date: [Insert Date]
Subjective:
The patient, a 70-year-old older adult, presented with symptoms of forgetfulness and occasional confusion. She expressed concerns about her memory and experiencing difficulty performing everyday tasks.

Objective:
During the session, the patient demonstrated forgetfulness and had difficulty recalling recent events. She appeared frustrated and had a labile affect. The patient showed signs of mild cognitive impairment.

Assessment:
Based on the patient’s symptoms and assessment findings, a diagnosis of mild neurocognitive disorder was made. The patient’s cognitive impairment is having an impact on her ability to function independently.

Plan:
The patient was educated about mild neurocognitive disorder and its potential progression. Psychoeducation regarding memory enhancement techniques, cognitive stimulation activities, and maintaining a healthy lifestyle was provided. Referral to a neuropsychologist for further evaluation was made. The patient’s family was also involved in the discussion and provided with resources on caregiver support.

Patient 5:
Date: [Insert Date]
Subjective:
The patient, a 45-year-old adult, reported feeling excessively worried about her health. She frequently checks for signs and symptoms of illness, which has become time-consuming and distressing. The patient expressed concern about having a serious medical condition.

Objective:
During the session, the patient displayed OCD-like behaviors, such as repetitive hand washing and constant reassurance seeking. Her mood was anxious, and she appeared tense. The patient’s affect reflected her anxious state.

Assessment:
Based on the patient’s symptoms and assessment findings, a diagnosis of illness anxiety disorder (IAD) was made. The patient’s anxiety related to health concerns is significantly affecting her daily life.

Plan:
The patient was educated about IAD and its impact on her mental well-being. Psychoeducation regarding cognitive-behavioral therapy (CBT) techniques, such as exposure and response prevention, was provided. The patient was referred to a therapist specializing in OCD and anxiety disorders. The use of medications, specifically selective serotonin reuptake inhibitors (SSRIs), was discussed as an adjunct to therapy.

Patient 6:
Date: [Insert Date]
Subjective:
The patient, a 55-year-old adult, reported difficulty sleeping and nightmares. He expressed feeling constantly on edge and having intrusive memories related to a traumatic event he experienced several months ago.

Objective:
During the session, the patient appeared hypervigilant and exhibited startle responses to unexpected sounds. He demonstrated avoidance behaviors and had a perseverative focus on the traumatic event. The patient had a flat affect, and his mood was consistently anxious.

Assessment:
Based on the patient’s symptoms and assessment findings, a diagnosis of post-traumatic stress disorder (PTSD) was made. It was determined that the patient’s symptoms are significantly impacting his quality of life.

Plan:
The patient was educated about PTSD and the concept of trauma. Psychoeducation regarding grounding techniques, relaxation exercises, and coping strategies for nightmares was provided. The patient was referred to a therapist specializing in trauma-focused therapy, such as eye movement desensitization and reprocessing (EMDR). The use of medications, particularly selective serotonin reuptake inhibitors (SSRIs), was discussed as an adjunct to therapy.

Patient 7:
Date: [Insert Date]
Subjective:
The patient, a 75-year-old older adult, reported difficulties with memory and orientation. She expressed confusion about her surroundings and frequently misplaces personal items. The patient’s family has noticed a decline in her cognitive abilities.

Objective:
During the session, the patient had difficulty recalling recent events and appeared disoriented to time and place. She exhibited deficits in attention and concentration. The patient’s affect was flat, and her mood was consistently apathetic.

Assessment:
Based on the patient’s symptoms and assessment findings, a diagnosis of major neurocognitive disorder due to Alzheimer’s disease was made. The patient’s cognitive impairment is having a significant impact on her daily functioning.

Plan:
The patient was educated about Alzheimer’s disease and its progressive nature. Psychoeducation regarding memory aids, environmental modifications, and communication techniques was provided. The patient’s family was involved in the discussions and given resources for caregiver support. Referral to a neurologist for further evaluation and management was made.

Patient 8:
Date: [Insert Date]
Subjective:
The patient, a 30-year-old adult, presented with symptoms of persistent sadness, low self-esteem, and difficulty in maintaining relationships. He reported feeling hopeless about the future and having thoughts of ending his life.

Objective:
During the session, the patient exhibited a flat affect and had poor eye contact. He appeared withdrawn and expressed passive suicidal ideation. The patient’s mood was consistently depressed.

Assessment:
Based on the patient’s symptoms and assessment findings, a diagnosis of major depressive disorder (MDD) was made. The patient’s depressive symptoms are significantly impacting his overall well-being.

Plan:
The patient was assessed for immediate safety and a safety plan was established. He was educated about MDD and the importance of seeking help. Psychoeducation regarding the importance of social support, healthy coping mechanisms, and self-care activities was provided. The patient was referred to a therapist for individual therapy. The use of medication, specifically selective serotonin reuptake inhibitors (SSRIs), was discussed, and the patient expressed willingness to consider pharmacological treatment.

In conclusion, these progress notes demonstrate the activities conducted by a Psychiatric Mental Health Nurse Practitioner when working with adult and older adult patients with various psychiatric conditions. The notes include assessment, diagnosis, and development of a treatment plan, which may involve psychoeducation, therapy referrals, medication options, and involvement of the patient’s support system.