Complicated Pregnancy PMHNP Regis College NU-665C-01-23PCSP Family Psychiatric Ment. Hlth II,
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What would be your initial approach to assessment and diagnosis with this patient and her
family?
During the initial assessment, it is essential to ensure that the client feels safe,
comfortable, and met without judgement. Information from the client regarding past experiences
and current conce...
Complicated Pregnancy PMHNP Regis College NU-665C -01-23PCSP Family Psychiatric Ment. Hlth II 2 What would be your initial approach to assessment and diagnosis with this patient and her family? During the initial assessment, it is essential to ensure that the client feels safe, comfortable, and met without judgement. Information from the client regarding past experiences and current concerns will be obtained as well as all medical history, past and current treatments, and information from those she has chosen to include in her ca re. Through active listening, motivational interviewing and empathy, goals will be identified for treatment. Based upon the trauma related experience with childbirth, upsetting memories, emotional distress, anxiety related to past experience and upcoming delivery, consumption of fear, and difficulty feeling positive, it can be concluded that the client has PTSD (U.S. Department of Veterans Affairs, 2013). Since all anxiety symptoms are directly related to the pain associated with childbirth and can tied to PTSD, it is unlikely that she has a separate anxiety disorder. It has been acknowledged that the client has opiate use disorder, as evidenced by her use of prescribed buprenorphine. Due to the complexity of her case, additional consultation with her OBGYN will be needed in order to develop a treatment plan best suited for this client. A meeting should be arranged to discuss a plan that covers all aspects of care and pro vides the client with options that allow her to feel the most comfortable with treatment. It is evident that this client has strong concerns about the use of buprenorphine in pregnancy and her ability to obtain adequate pain control in delivery, this medication is FDA approved as safe for use and is the treatment of choice for opiate use disorder in pregnancy, it may be continued throughout pregnancy with careful monitoring; ho wever, due to increased blood volume, she may need an increased dose, this will be determined by her cravings, (North
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