For my site evaluations, I did three History and Physicals on three different patients. The first patient I wrote about had was a woman who had aggressive and threatening behavior back at home. She was acting erratic and was brought in by her husband. The patient’s speech was hyperverbal and pressured. He said she did not sleep for 4-5 days. The first diagnosis I had on my differential was bipolar 1 disorder. The next diagnosis I had was drug-induced psychosis because the patient did admit to doing drugs like cocaine and marijuana often. The second patient I wrote about took 5 tablets of an SSRI. He was brought in for suicidal ideations, but the patient said he did not have the intent of hurting himself when he took those pills. He said he was suffering from depression and wanted to help himself with those pills. Since we did not know how long the depression was for, the first differential we had was an unspecified mood disorder. He also started a new job a few months back, so we also had an adjustment disorder with depressed mood as another differential diagnosis. The third patient was an older woman who was a retired correctional officer who presented with complaints of anxiety and trouble sleeping for 4 days. She was difficult to redirect during the interview and was very hyperverbal. My first differential for her was bipolar 1 disorder because I have seen multiple patients who presented very similarly to her. The patient also admitted to smoking marijuana to excess daily, so my second differential was cannabis abuse with cannabis-induced anxiety.

During my first site evaluation, my site evaluator went through my drug cards and my history and physical. He mentioned he enjoyed reading through my H&P, but thought one of my treatment plans could have been initiated a little better. During the second site evaluation my site evaluator commended me on my next two H&P’s. My journal entry was about the efficacy of Olanzapine-Samidorphan versus just Olanzapine for patients with schizophrenia and bipolar disorders and their metabolic changes that include weight gain on those antipsychotic medications.