Neurodevelopmental disorders (Essay Sample)

Week (enter week #): (Enter assignment title) Student Name College of Nursing-PMHNP, Walden University NRNP 6635: Psychopathology and Diagnostic Reasoning Faculty Name Assignment Due Date Subjective: CC (chief complaint): The 11 year old patient complains of having difficulty with mealtime behavior and positioning. HPI: The patient presents with difficulty with mealtime behavior and positioning. The parents indicate that Sarah has consistently exhibited behavior and positioning. She has been experiencing challenges during meals and indicating the reluctancy to sit for extended periods. Even though she receives adequate nutrition, the behavior appears to be a reluctatnt issue. She sleeps for about 9 to 10 hours daily and she reached her developmental milestones on time. Past Psychiatric History: Mother indicates no history of psychiatric illness. * General Statement: Patient has been experiencing issues with sitting for meals hence finding challenges in meals. * Caregivers (if applicable): Not indicated although may be parents since she lives with them. * Hospitalizations: No indication of any previous hospitalizations. * Medication trials: None. * Psychotherapy or Previous Psychiatric Diagnosis: Patient has not been involved in psychotherapy or psychiatric diagnoses. Substance Current Use and History: None. Family Psychiatric/Substance Use History: None. Psychosocial History: Unknown. Medical History: * Current Medications: None * Allergies: Unknown * Reproductive Hx: As a preadolescent the reproductive history is not applicable. ROS: * GENERAL: Patient looks appropriate for her age. Looks fatigued. No fever or chills noted. * HEENT: Head: No injury or abnormality noted. Eyes: No blurred vision, cataracts or color blindness noted. Ears: No hearing loss, or drainage. Nose: No congestion or blockage noted. Throat: No sore throat or swollen lymphnodes noted. * SKIN: No jaundice, rashes or lesions noted. * CARDIOVASCULAR: No chest pain, edema or discomfort noted. * RESPIRATORY: No shortness of breath or cough noted. * GASTROINTESTINAL: No abdominal pain, discomfort or pain noted. * GENITOURINARY: No polydipsia or polyuria noted. * NEUROLOGICAL: No numbness at the extremeties, ulcerations or paralysis noted. * MUSCULOSKELETAL: No pain or inflammation at the joints. No issues noted wwith range of motion. * HEMATOLOGIC: No anemia or bruising noted. * LYMPHATICS: No lymphadenopathy noted. * ENDOCRINOLOGIC: No heat intolerance or sweating noted. Objective: Physical exam: T- 97.4 P- 58 R 14 98/62 Ht 4’5 Wt 65lbs Diagnostic results: The patient should receive a Nutrition assessment to check on complete blood count, a comprehensive metabolic panel, and nutrient-specific blood tests, including iron levels and vitamin D. A gastrointestinal evaluation involves stool analysis for any parasitical infections or malabsorptions. The evaluation should involve an upper gastrointestinal series or endoscopy to identify any gut issues that may cause the patient’s manifestations. A further neurological examination is required to rule out physical issues that may affect the posture. An occupational therapy assessment is essential for sensory processing and motor skills related to mealtime activities. Assessment: Mental Status Examination: Sarah, an 11-year-old client, is alert, oriented, and prepared for the assessment. She is responsive to all the questions asked. She uses a relaxed tone with everyday speech and non-verbal cues indicating calmness. The client was well-groomed and maintained eye contact during the interview. However, in some cases, she has challenges expressing herself, especially when asked more detailed questions about her condition. She expresses her thoughts and perceptions of mealtime and food informatively, suggesting an unusual perception of food and mealtimes. Based on the data, the client met her developmental milestones on time; hence, her cognitive skills and abilities are within the expected range for her age. A nutrition assessment is essential since there are no concerns about her cognitive functions. The client’s challenges with mealtime behavior impact her social wellbeing, especially within her family context. The client’s difficulty with mealtime behavior and interaction with the family members during meals should be understood. The client’s mental and emotional wellbeing should be assessed further, including her challenges with mealtime behavior. Differential Diagnoses: Avoidant/Restrictive Food Intake Disorder (ARFID) ICD 10 [F50. 82]: The disorder involves children with an extreme selective eating and sometimes have little or no interest in eating food (Kennedy et al., 2023). The individuals may take food in a limited variety of preferred foods, which may affect their growth and cause inadequate nutrition. The individuals also indicate an avoidance of certain foods or textures without concerns about the body's weight or shape. The client's disorder can result in nutritional deficiencies and impact physical health. The client may experience sensory sensitivities, smells, tastes, and textures concerning foods, which may impact physical health.  Sensory Processing Disorder ICD 10 [F88]: The mental health condition involves difficulties processing and responding to sensory stimuli, impacting daily functioning (Purpura et al., 2022). The children will SPD manifest with symptoms including hypersensitivity or hyposensitivity to sensory input, affecting various senses such as touch, sound, taste, and smell. Hypersensitive children react strongly to stimuli, exhibiting discomfort or avoidance, while hypersensitive ones may seek excessive sensory stimulation. The individuals with the health condition manifest an overreaction to noise, intolerance to certain things like food, and exhibit impulsive behaviors. In such situations, the children have issues with engaging in social interactions (van den Boogert et al., 2022). Hypersensitive children may seek intense sensory input, displaying impulsive or restless behavior. Generalized Anxiety Disorder ICD 10 [F41.1]: The mental health condition characterized by persistent and excessive worry about various aspects of life (Steinsbekk, Ranum, & Wichstrøm, 2022). In relation to Sarah's situation, GAD may manifest as heightened anxiety and apprehension specifically linked to mealtime. The reluctance to sit for meals could indicate GAD-related avoidance behaviors, with underlying fears or concerns about the eating process.  Autism Spectrum Disorder ICD 10 [F ]: The neurodevelopmental disorder characterized by challenges in social interaction, communication, and repetitive behaviors (Salari et al., 2022). Based on the client's situation, it may be considered if her difficulty with mealtime behavior is associated with sensory sensitivities and ritualistic behaviors. Individuals with ASD may exhibit ...