Case studies in emergency room nursing: demographic profiles and presenting problems

¶ … DSM-IV-TR & Differential Diagnosis)

The client, Marie is a single, 25-year-old white female who is employed in an emergency room in a large urban hospital. Marie came to treatment on her own because of an inability to sleep, feeling down, and problems functioning at work.

DSM-IV-TR Diagnosis

Major depressive disorder

Anxiety disorders

Eating disorder

Sleeping disorder

Adjustment disorder

Other conditions that may be a focus of clinical attention

Axis IV

Occupational Problems

Other psychosocial problems

Axis V

Rating Level of Symptoms

Transient, slight symptoms that are reasonable responses to stressful situations; more than a slight impartment I social, occupational, or school functioning.

Differential Diagnosis

A differential diagnosis in this case must take into consideration other factors that may be a focus of clinical attention including conditions or problems for which the client may seek or be referred for professional help including: (1) relational problems; (2) problems related to abuse or neglect; (3) psychological factors affecting medical condition; and (4) other conditions. (Axis Disorders of the DSM-IV-TR, 2013)

III. Brief Conceptualization of the Client

The client is 25 years of age, and a white single female working in a large urban emergency room. It is likely that the job is a stressful one as the client is required to deal with such a large volume of patients in the course of her work. It is likely that the social life of the client is minimal at best with her work schedule and that she has little opportunity to meet those of her peer group in a social setting. Alternatively, the client may be in a difficult relationship resulting in her insomnia and poor eating habits. It is not know if she has an immediate support group in the form of family or friends so the client should be assessed for the existence of a support group as well. Working with the pubic as the client does often leaves the individual unable to quietn their mind once their work shift is completed so the client likely needs information on how to successfully transition between work and home so that she is able to eat and sleep normally. If these two issues are corrected, it is likely that the other issues will merely go away because the depressive feeling is closely associated to lack of sleep and proper nutrition. I addition, the client's problems functioning at work are also likely to be due to lack of sleep and improper nutrition. The client should be referred for additional assessment and knowledge sharing about her physical health and how this affects her mental and emotional health.