NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

    April 23, 2024

NRNP 6635: Psychopathology and Diagnostic Reasoning
 
Faculty Name
 
Assignment Due Date
 
Subjective:
 
CC (chief complaint):
 
HPI:
 
Past Psychiatric History:
 
· General Statement:
 
· Caregivers (if applicable):
 
· Hospitalizations:
 
· Medication trials:
 
· Psychotherapy or Previous Psychiatric Diagnosis:
 
Substance Current Use and History:
 
Family Psychiatric/Substance Use History:
 
Psychosocial History:
 
Medical History:
 
· Current Medications:
 
· Allergies:
 
· Reproductive Hx:
 
ROS:
 
· GENERAL:
 
· HEENT:
 
· SKIN:
 
· CARDIOVASCULAR:
 
· RESPIRATORY:
 
· GASTROINTESTINAL:
 
· GENITOURINARY:
 
· NEUROLOGICAL:
 
· MUSCULOSKELETAL:
 
· HEMATOLOGIC:
 
· LYMPHATICS:
 
· ENDOCRINOLOGIC:
 
Objective:
 
Physical exam: if applicable
 
Diagnostic results:
 
Assessment:
 
Mental Status Examination:
 
Differential Diagnoses:
 
Reflections:
 
References

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