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Critical thinking skills in the psychopathology of mental health patients

Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.

Scenario:
Kel is a 42-year-old certified public accountant (CPA) who dreams each year that she will board a cruise ship the day after Tax Day and go somewhere, anywhere, except Portsmouth, Virginia. Each year the dream, like the ocean, ebbs and flows, but this year she is not even going to think about such a “ridiculous idea.” In fact, she does not even have the energy to dream; getting out of bed and preparing to go to work is simply too labor intensive.

Each evening Kel retires to bed with a lack of energy to complete her normal tasks such as readying her clothes for work and making a lunch. She lacks the energy to shop in the evening; consequently, she eats mostly crackers and canned soup. She is not hungry, and her scale reflects this. She has lost 15 pounds over the last 2 months. She does not attend to her makeup or clothes; she finds both too taxing. The clothes she selects are drab and not ironed. At work she makes no effort to talk with her co-workers and does not initiate new contacts with clients. The normal work of filing taxes and writing reports, which she used to enjoy, are overwhelming, and she feels too disorganized to complete them. Telephone calls and e-mail messages from friends are ignored. Attendance at work is spotty.

Sue, her sister, becomes alarmed with Kel’s unanswered telephone calls and e-mails. Worried, she decides to visit her sister at home. She finds the apartment unclean and in disarray. Kel is unkempt, disheveled, and looks sad. Her voice is monotone and flat. Kel tells Sue that she feels “sad and hopeless. Nothing is ever going to change. I am a bad person and I can’t even do my work right. Although I sleep for many hours, I am still tired all the time.” Sue is alarmed at the changes in her sister and arranges for Kel to visit a health care worker at the medical clinic.

Questions:
Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers.

Describe the presenting problems.
Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes.
Formulate and prioritize a treatment plan.
Identify and discuss appropriate screening instruments for a patient who has suicidal ideation.

Sample Solution

In 1990, when the internet was born, a new era began. Since then, it has grown so powerfully that nowadays most people could not imagine their life without smart phones, computers. These innovations naturally make our life easier, but we do not often think about the enormous amount of electronic records (data) that are created about us. We cannot avoid leaving traces behind us online. However, anyone can easily access these data including where we are, what we are doing, how often we are doing these things, what we spend on and where we do our shopping. These data can be used easily and in many ways against us but on the other hand, it is useful in protecting us too. Companies and governments often refer to the observation of our daily life as it is done for security purposes only, but how far can they break the limits with our private sphere? They are working with data that they get from mobile phones, internet or the intelligent surveillance systems like CCTV cameras, drones, biometric data and so on to get information from society and use this information to create a safe environment and to assess the needs of consumers. Instead of Orwell’s’ Big Brother, in which he is talking about one big surveillance state, there are many small information monopolies. These “small brothers” are always there to watch everyone’s steps. Airlines have a huge database for booked and purchased tickets from which can see where or how often we travel, which countries are preferred by us and this way can be easily deduced for example where our relatives lives. In the Netherlands, the public transport company Arriva uses nominated travel cards (just for Dutch people); with this card, passengers can travel cheaper, but on the other hand the company knows where, when and how often they travel. Furthermore, if someone pays with his or her credit card they give information immediately about what they bought and where. These are all information that we share about ourselves that we do not know about or if we know it, it does not bother us. Can safety of the people be guaranteed with total privacy?
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