Nbhc Case Studies

Presenting Problem: She has a hx of multiple failed placements and relates being placed in the programs for her substance abuse, anger and aggression. She has 2 past suicide attempmts one from an attempted hanging and the other from attempting to jump off a building. She reported feeling homicidal 7-8 times against her stepfather. Rhonda reported physical and emotional abuse from maternal uncle and incidents of sexual assault btwn the ages of 6 and 12.

The patient was admitted to the hospital by her daughter after discovering that she had abandoned her medication and was significantly experiencing adverse effects from the withdrawal. The patients’ medical history included renal dysfunction, anemia, malnourishment, back pain, and a family history of mental health. The patient has a psychiatric history of being previously placed in the same clinical structure eight months ago due to related issues including the failure to take her medication and increased levels of mental health conditions that led

P: Facilitator and PP met with the client and mother to identify situations and triggers that contribute to the client’s behaviors.

Susan is an 11 year old Latina/ Caucasian female who currently has been referred due many issues inside and outside the home. Susan is a victim of sexual abuse by her father. Susan is being put in adult situations of caring extensively for younger siblings, caring for the mother, and being a partner for the alcoholic father. Susan witnesses a great deal of violent behavior between her parents. The violence leads to the father becoming sexual with Susan. He looks to her for consoling and support. As a result, Susan is experiencing feelings of depression to the extent where she has attempted suicide and she reports that she cuts herself with safety pins when she witnesses her parents fighting. Susan has not learned appropriate interaction cues and due to the violent nature in the household,

8. Selenna has displayed disrespect, manipulating and defiant behaviors in the home. MHS report Selenna, refuses to talk about her past traumas to start the healing process.

Pt is a 12 y/o African American female presented at NNBHC with dx of ADHD combine type, ODD, Disruptive Mood Dysregulation D/O, Mood D/O, PTSD and Sexual Abuse (victim/ perpetrator), who have been feeling severely depressed and SI. Pt states that she has had SI with a plan to overdose or cut her wrist. Pt is considered high risk due her unsuccessful attempt to commit suicide on 7/5/2015 by taking a handful (unknown quantity) of Clonidine. She was hospitalized at CHKD until she was medially stable, than transferred to Maryview for mental stabilization. Pt states that she is unable to contract for safety at this time, and unsure of what she may do due to her impulsivity. Pt has also have been currently distributing nude pictures to adult males via cell phone. Virginia Beach Police Department is involved with the solicition of child pornography per report from pt mother. Pt have been using explicit communication of sexual acts via text message with males and females. Since 7/5/15 there have been a change in medication Vyvanse 70mg to 30mg. Pt have a hx of becoming verbally aggressive towards hospital staff when medications change. Pt denies any psychosis or paranoid thinking.

Presenting Problem: He has 2 Kempsville Acute visits, endorses anger and thoughts of suicides. Reported hx of Neurodevelopmental problems most recently as consistent with Autistic Spectrum Symptoms. He reported having intense anger toeards his parents but denies homicidal thoughts, acknowledges suicidal thinking. On May 27, 215 he pulled a knife on his mother, no injury occurred. Mother states he has been increasingly agitated. He has been posturing at his mother yeling clinching his fist at her as well as sneaking out and lying. Mother states he obtained the knife from his room and threatene her life. He states his mother swas chasing him around with a broom which is why he grabbed the kife. He states he is depressed all the time. He a Hx of suspensions for fighting while in school and he was the aggressor.

Pt mother describes the pt seems to be in a “trance state” when he is in an anger episode. Pt mother stated that the pt have punched holes in the walls. Pt mother stated pt became assaultive towards pregnant sister who has M.S. Pt mother stated she feels unsafe with the pt in home due to is impulsive anger outburst.

Presenting Problem: Pt is 16 y/o female who is currently at Tuckers Pavilion Acute facility. 8/7/16 Kelly refused to take her medication, and was generally noncompliant to staff directions. She communicated AWOL intent; she also broke a lightbulb to make a number of superficial cuts to her arm, but refused to turn in the glass an dstated that she had flushed it down the toilet. She refused first aid and refused to cooperate with staff directions. She also communicated that she was going to do worse things to herself, Intercept contacted crisis stabilization which transitioned the child to Tuckers Psychiatric at 6am. 8/12/16, Pt was upset to find out she was not getting discharged from Tuckers. Require hydroxyzine 50mg at 1530 medication

Anilda Rodriguez, adoptive mother/grand aunt, reported that her 14 year old, adoptive son Anthony Rodriguez, is disrespectful towards authority figures, failing all of his classes, multiple suspension from school and does not take ownership of his ungoverned behavior. According to Ms. Rodriguez she has been taking care of Anthony since he was 1 ½ year old. Ms. Rodriguez reported that Anthony is diagnose with ADHD and has an IEP. Ms. Rodriguez reported that the child has engaged in mental health services since the age of 5. Ms. Rodriguez reported that the child received appropriate mental health services and psychotropic medication (Focalin XR 25mg) prescribed by psychiatrist George Alvarado (718) 283-8215 (once a month) at Maimonides’s Mental

The reporter stated on 08/09/16, Tynia disclosed to her physician that at the age of 2 her 30 (+) adoptive brother raped her; it's unknown if the adoptive brother was 30 when the incident occurred or if he's 30 now. The reporter stated it's unknown if the child was in MI or LA when the abuse occurred, if she still has contact with the perpetrator, or if the abuse occurred more than once. The reporter also stated it's unknown if the incident was reported to law enforcement or DHS. According to the reporter, Ms. McWillie was aware of the incident,k but it's unknown when she became aware or if she took appropiate steps to report it to proper authorities. Ms. Miller stated Tynia has been diagnosed with ADHD, ADD, OCD, and PTSD and she has received

The client is a 14-year-old Hispanic female in a residential substance abuse treatment rehabilitation center. The client participated in Cognitive Behavioral Therapy anger management group. The client was admitted to the residential program in July of 2016 for her cannabis use. She was referred by Drug Court due to her failure to comply with the program rules. The client has a past of domestic violence and defiant behavior towards her mother and not abiding by curfew.

Pt was a hx of numerous IP hospitalizations, he recently was discharged 8/2015 from ChildHelp which he resided there for almost a year. Pt receives outpatient services with Norfolk CSB, and receives psychiatric with Dr. Marcus who is associated with Norfolk CSB.

Client’s name is C.H. she is a 45-year-old women who was admitted on August 15, 2016 for a right knee replacement with alcohol intoxication who was currently going through delirium tremens (DTs). Past medical history included hypertension, type II diabetes and alcohol abuse. The most pertinent relevant family/social factors about this patient was the fact that she has a history of physical abuse from her past boyfriend and a history of abuse with alcohol. This was a vital piece of information that helped to mold care for the patient. This patient was chosen due to the fact that the interaction of the patient was one that has not been previously explored during other clinical rotations and changed my overall perception on how patients should be treated.

This is a prospective study which approved by the Human Research Committee. From June 2010 to May 2013, after informed and consent, 140 patients with NPC were enrolled into our study when the following criteria were met; (1) completed chemo-radiation NPC patient who follow up with Doctor at interval of 6 months, 1 years, and 1.5 years who the doctor was predict of the recurrenct NPC and was sent for CT scan of the nasopharynx and (2) patient was older than 18-year-old. The exclusion criteria included; (1) patient who refused participating the study (2) patient who had not completed two years follow-up and (3) patient had the contraindication for contrast-enhanced CT scan such as, pregnancy, allergic iodinated contrast medium or renal impairment (GFR < 30 mL/min).