NRNP 6645 Week 2 Assignment – Family Assessment Example NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note

NRNP 6645 Week 2 Assignment – Family Assessment Example

NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note

The Psychiatric/ Mental health nurse performs complex functions in care delivery. They assess families and individuals comprehensively to determine areas of need, their physical and cognitive health, and their family cohesiveness. They work with the interprofessional team to fulfill these needs. Assessing families is somewhat complex and differs from individual analysis because the focus is to manage the family trauma and rewire the dysfunctional patterns in the family. This comprehensive psychiatric evaluation note focuses on Patti’s family and a dysfunctional pattern blamed on the arrival of her daughter, who had been left behind in Iran and recently rejoined the family.

CC: (chief complaint): “Chaos in Patti’s family since her daughter rejoined the family.”

HPI: A mother (Patti), her daughter, and the family therapists came to the healthcare facility complaining of chaos in the family since her daughter Shireen came to the US. The family immigrated from Iran 12 years ago, and a 10-year-old daughter was left behind before processing her visa and joining the family in the United States. Chaos (blaming, arguing, cursing) arose when she rejoined the family and told them of the trauma and abandonment she went through after she was left behind during the immigration.

Patti complains that her children are out of control, and she no longer feels in charge. The family therapist states that Shireen, the 21-year-old, claims she needs more money than a therapist and refuses to attend all appointments. Shireen has been through trauma after being sexually and physically abused by her father when the mother chose to stay with the four kids in the US and not return to Iran.

Patti is also attached to her culture; the daughters try to detach from their mother and live independently. Patti has had two foot surgeries, creating more family tension. Patti often feels hopeless, helpless, and detached from the children and has been advised to get psychiatric help. Patti admits to needing help to learn to detach from the kids and live independently because of her cultural affiliations.

Past Psychiatric History:

• General Statement: The client has a history of fights and disagreements in the family due to cultural problems and started family therapy about two years ago
• Caregivers (if applicable): Not applicable
• Hospitalizations: 2 years ago, after two-foot surgeries
• Medication trials: None
• Psychotherapy or Previous Psychiatric Diagnosis: None

Substance Current Use and History: Denies current and past substance use history.

Family Psychiatric/Substance Use History: History of domestic trauma (battery), child sexual, immigration trauma of leaving a child behind, fairly traumatic current illness for the mother

Psychosocial History: The client and her children were born in Iran and migrated to the US 12 years ago, leaving a daughter behind who rejoined them later. She has five children; the oldest daughter is a 24-year-old daughter, a 21-year-old daughter, an 18-year-old son who is a student, and a 15-year-old son.The 21-year-old got married recently. The oldest daughter works in promotional jobs and working on getting her real-estate job license. The father, back in Iran, remarried and did not admit her mistakes of abusing Shireen.

Patti worked at caregiving and has not been involved in any current or past legal issues. After bringing her child for medical attention in the US, Patti decided to stay and ran away from her husband, who used to beat and abuse her as she protected the children. At home, she quarrels with the children, argues, and curses over issues such as the need for assistance, controlling the children’s lives and dogs, and spending personal time, and she admits that there is a need for change.

Medical History:

• Current Medications: None
• Allergies:No known drug or food allergies
• Reproductive Hx:She has four children. LMP three weeks ago, no pregnant or lactating, heterosexual.

ROS:

• GENERAL:  The patient denies any recent weight gain, fatigue, weakness, fever, chills, or night sweats
• HEENT: Denies headaches or recent traumas. Eyes: Denies pain, itchiness, dryness, or drainage. Ears: Denies ear pain, drainage, ringing, loss of balan