NR 606 Week 8 Final Exam; Psychiatric NP Call Assessment Guide

Opening the Call (Establish Rapport + Verify Safety) Start efficiently but therapeutically. “Hi, this is [Your Name], the psychiatric NP. I understand you have concerns about your child—can you tell me what’s been going on?” Verify: Child’s name, age Caller identity (parent/guardian) Immediate safety screen (ALWAYS early): “Is your child safe right now?” “Any thoughts of hurting themselves or others?” 909637-221348Identify the Chief Concern Clarify which category you’re dealing with: Medication adverse effects Failure to improve Activation (e.g., SSRI-induced) Suicidality S)​y Ask: “What changes have you noticed?” “When did this start in relation to the medication?” 909637-222579Focused Clinical Assessment Symptom Characterization Onset, duration, severity Triggers or patterns Functional impact (school, sleep, appetite, behavior) 909637-223080Medication Review (CRITICAL) Medication name, dose, start date Recent dose changes Adherence (“Have any doses been missed?”) 909637-223460Side Effect Screening Target based on scenario: SSRIs: GI upset, sleep changes, activation, suicidality Stimulants: appetite suppression, insomnia, irritability Mood stabilizers/antipsychotics: sedation, weight gain, EPS 909637-223341Safety Assessment (NON-NEGOTIABLE) Especially for suicidality or activation: “Any thoughts about wanting to die?” “Any plans or attempts?” Access to means (medications, weapons) Level of supervision at home 909637-222826Scenario-Specific Clinical Reasoning Medication Adverse Effects Mild → monitor or adjust timing/dose Moderate/severe → consider dose reduction or discontinuation 909637-223750Failure to Improve Assess: Adequate dose? Adequate duration? (e.g., SSRIs need ~4–6 weeks) Adherence? Plan: 909637483530Increase dose vs switch medication vs augment Activation (common with SSRIs in pediatrics) Symptoms: Restlessness, agitation, impulsivity, insomnia Action: Reduce dose or