Read the following nursing situation and answer the questions at the end of the nursing situation. APA style John was in his early 20’s, single, living with his mother and 2 younger siblings, Bobby who is 6 y/o and Julie who is 14. John graduated from high school 2 years ago with his GED and since that time he has worked at Publix in the stock room on the night shift. Last week his mother received a call from his employer and informed her that John had gotten in an argument with a fellow employee at work. John wanted the cans to be alphabetized and refused to change his shelves even at the request of his supervisor. His supervisor has requested that John is evaluated by a psychiatrist/PMHNP before coming back to work. Chief Complaint: “I don’t know why my mom wanted me to come and talk to you. My boss shouldn’t have called my mom. I don’t think he can do that, do you? I was right that other guy didn’t know how to stack shelves. The cans need to be alphabetical, just like the library.” HPI: John likes things to be in order. He always takes the #2 bus home from work and if the #3 bus comes, which would take him home too, he waits for the #2 bus. When asked to explain this, he said he likes #2 because it comes after #1. John was Baker Acted last year when he got in a fight at the computer store when he thought the owner accused him of something he did not do. Medication: risperidone 0.5 mg at bedtime. Family History: John lives with his mother and 2 siblings. He refuses to talk about his father and states, “he is dead”, although his mother reports she is divorced and her husband lives out of town and offers no support. He is unable to share much information regarding his siblings as he reports he stays in his room and doesn’t like to talk to them. He does not think they are his “real” siblings. PMHNP: John was very guarded in his sharing of information and requested that no information be shared with his mother or work supervisor. He insisted there was nothing wrong with him. He is not aware he was Baker Acted last year and is unable to explain why he was hospitalized. Reports that medication is to help him sleep at night. Denies any issues with sleeping, eats well but likes to eat at certain times of the day and only certain items (all white food). John appears tired, hair uncombed, clothes clean and appropriate to the weather. He scored 22 on the Mini-Mental Status Exam and 5 on the PHQ-9 (Many questions has to be repeated and clarified). The PMHNP assured John he did well on his screening tools and asked him to come back in a week to talk a little more about his hopes and dreams for his future. Questions to answer: Based on this nursing situation, what would you identify as • John’s diagnosis? • Does he meet the full criteria for your diagnosis? • What specifiers might you use with your diagnosis? • What differential diagnoses might you be thinking- include both a DSM-5 diagnosis and a Physical Diagnosis? • What other assessment tools would you recommend for use with this client? • What would you determine to be the essence of caring in this situation? • Incorporate scholarly articles to support your diagnosis and/or differential diagnoses and potential treatment plan.
Youth is a phase that is particular and plentifully loaded up with psychological, enthusiastic and physical changes. Amid this period in a human life, ponder, honesty and creative energy are uncontrolled. Numerous abilities and exercises are found out that will help with the course the tyke's future will pursue. This could be depicted as a standout amongst the most fundamental time frames for the advancement of the individual they will in the end move toward becoming. A few researchers have addressed whether every individual has a center self. Utilizing a few precedents of the exploration of George Mead and John Hewitt-among others-it uncovers that there are key parts of the self that are created by cooperations inside societies and those inward networks. For a few youngsters there is a timeframe where a nonexistent companion is a basic piece of this course of self-improvement. It is hard to state if the nearness of a fanciful companion is something that originates from the center self or on the off chance that it emerges after a specific measure of socialization. I will look at the nearness of fanciful companions in more youthful youngsters lives, particularly those inside the preschool years. I will likely investigate the function(s) these fanciful companions may achieve in the improvement of the job, personality and self inside the youngster. Talk One idea originated from work done by George Herbert Mead, who is one of the main scholars managing work of representative interactionism and the advancement of oneself. His work built up ideas of position, play, diversion, and other fundamental hypotheses dependent on connections between oneself and societal effect. Mead's phases of improvement appear to rest completely upon relations with others. Mead (1934) saw the self as something which ages and results from relationship with different people. One of his hypotheses, the "twofold", is implied by the foundation of the self as a substance. A few encounters can prompt the introduction of a 'twofold' and can be spoken to by nonexistent companions made by the kid, and which enables them to control their encounters through play. He recommended that elements are shaped by human movement. The objectives of those exercises have two essential surmisings; individuals live in a universe of articles and societal lead is arranged to objectives and purposes. (Hewitt, 2003). When one perceives his/her self as a protest, contribution in societal communication is conceivable. (Mead, 1934) Another key factor in Mead's hypothesis is the improvement of the "summed up other" which-he accepts is imperative in the development of oneself. His idea of the "summed up other" resembles an execution, a perspective that a man should inventively accept with the end goal to consider the development of his/her own lead which is made with standards, desires and thoughts affected by the individuals from a specific societal gathering (Hewitt, 2003). The amusement and play organize must be gone through to achieve full improvement. The play arrange is distinguished as a period a tyke figures out how to take the characters of others and imagines about being the other. This formative period, known as the play arrange, enables the kid to expect the job of someone else and envisions him/herself to wind up that individual, endeavoring to accept and predict what he/she envisions the other individual may do.(Handel, 1988). Amid this stage, imperative capacities are gained; the advancement of job understanding, the capacity to accept the status of others, the honed feeling of one as a substance, and the capacity to build up limits inside that job… it is a stage a youngster will find and extend knowledge of themselves as well as other people. Amid this period, a kid can learn and increment their comprehension of their whole universe, including themselves. While the play arrange normally relates to the time span kids have nonexistent associates it is basic to have a total comprehension of the following stage, the diversion organize. The basic distinction between the play and the diversion organize is that in the last the kid must fathom the disposition of all the others engaged with that amusement (Mead, 1934). Progression to the amusement arrange is when kids can join and consider not just their achievements yet relate to the activities of others. This mindfulness originates from collaborations with other individuals. After the amusement arrange has passed the kid has arrived, hopefully, at the point they can have framed a "summed up other" and can envision themselves as another element, regardless of whether it be a man or society. The improvement of a "summed up other" and acquiring a feeling of jobs and limits is critical in turning into a fruitful individual inside society. Kids don't entirely pursue the socialization that they are presented to; affirming one's self-sufficiency is one method for building up their autonomy and division from others. It creates the impression that nonexistent companions can serve this job. The correct way that a fanciful companion is showed is obscure in any case, much research has been performed on this topic– yet there is no contention that it is a creation having a place with and started by the tyke alone. Marjorie Taylor (1999), a therapist who has considered youngsters and their fanciful companions, affirms that normally, a nonexistent buddy is an astounding case of a private demonstration of imagination controlled by the kid him or herself. The nonexistent companion can't be seen, collaborated with or known without the guide of the kid. It is an entire item and connection that has a place exclusively with the kid. There are likewise signs that even very youthful kids never totally free touch with the dream status of their fanciful allies (Taylor, 1999). A tyke who has a fanciful companion is a typical marvel and does not consequently result from mental issues or disregard. In any case, it ought to be noticed that circumstances, for example, mental issues as well as disregard ought not be neglected while surveying a youngster with a nonexistent companion. Nonexistent companions can serve different positive goals in territories of the tyke's improvement. A nonexistent companion could help in making sentiments of significance, power, certainty, and could prompt a more noteworthy acknowledgment of oneself. Having a nonexistent companion is one of the main free acts isolating the kid from his/her mom or the youngster's essential guardian. A charming aspect regarding fanciful sidekicks is that youngsters can manager them around, coordinate their exercises, and direct their correspondence with others. There are a couple of contextual analyses proposing that if youngsters' feeling of power over fanciful sidekicks is lessened, the imagine companion now and then vanishes (Taylor, 1999). This connection can help a tyke to practice his/her self-sufficiency and grow more individual communication abilities. A second capacity of nonexistent companions is the capacity to help the youngster create more grounded social limits. A few researchers think about the significance of nonexistent companions to be an impetus for improvement. Ordinarily, fanciful companions offer an outlet which a youngster can utilize both reality and dream to learn good and bad and additionally what is adequate with regards to various jobs. Machin composed: dream enables kids to think about good and social issues at a safe separation in the place that is known for pretend (Machin and Davies, 2003). A fanciful companion could be a specialist among dream and reality and an instrument with which the kid can investigate their limits. One marker that nonexistent companions may be illustrative of youngsters getting to be self-governing is that they ordinarily do impart the data to their folks. Research has demonstrated that in spite of the fact that the parent's absence of learning with respect to their youngster's nonexistent companion does not consequently originate from the tyke's refusal to uncover data about their companion. A nonexistent companion could be a methods a tyke uses to separate among dream and reality and an instrument with which the youngster can investigate their limits. Kids learn through the reactions of others and that their practices have results (Handel, 1988). A kid's production of a fictional universe likewise offers an other place where kids can find out about the requirements, sentiments, and desires for other people. Finding about jobs and societal limits and desires from nonexistent companions could integrate with the change between Meads' play and amusement stages, conquering any hindrance between the play and diversion arrange since the youngster interfaces with the fanciful companion as well as displays its responses and considerations. It is muddled to recognize whether fanciful companions serve a positive capacity in a kid's advancement of feeling of self, job securing, and character dependent on this examination. Research of earlier investigations prompted my hypothesis that fanciful companions may present with creating personality in kids and help the youngster learn societal limits. The development of these attributes in a tyke for the most part results in their capacity to work well while interfacing with others, permits a specific level of trust in themselves, and gives a level of freedom or potentially eagerness which will help the kid to execute their self-governance. On a very basic level, it creates the impression that fanciful companions offer those that have them an opportunity to discover structure in a non conventional design. As per numerous past investigations, roughly 33% of all youngsters between the ages of more than two to four years old have at least one fanciful companions and they have a tendency to be more continuous among females. Some in the scholarly network, and additionally, numerous inside the overall population do respect the presence of fanciful companions as an awesome sign with respect to the youngster and will take part in exchange and acknowledgment of the nonexistent companions. Notwithstanding, in the meantime as there are those that recognize imagin>GET ANSWER