J.D.
13 y/o
Female

Borderline Personality Disorder

Oppositional Defiant Disorder

Disruptive Mood Dysregulation Disorder

Attention Deficit Hyperactive Disorder

Hypothyroidism

Asthma

Guanfacine: Treating ADHD, but can also help with ODD.

Prazosin: for nightmares.

Quetiapine

Zoloft (Depression, anxiety)

Levothyroxine

Albuterol

Nursing Diagnosis 1: Risk for self-mutilation related to history of physical, sexual, and emotional abuse and impulse behavior as evidenced by fresh superficial scarring on wrists and statements of history of self-mutilating behaviors.

Nursing Diagnosis 2: Impaired Social Interaction related to unacceptable social behaviors as evidenced by dysfunctional interactions with peers and destructive behaviors towards self and others.

Nursing Diagnosis 3: Powerlessness related to consistent negative feedback in hospital stays as evidenced by dependence on others and verbal expressions of having no control with irritability and anger.

Side Effects: Sedation, dizziness, fatigue.

Side Effects: Dizziness, headache, nausea.

Side Effects: Sedation, weight gain, constipation.

Side Effects: Insomnia, constipation, sedation or agitation.

Side Effects: Restlessness, tremors, palpitations.

Side Effects: (usually only seen when too high of doses cause hyperthyroidism reaction), Insomnia, irritability, weight loss.

Key:
Purple - Psychiatric Disorders
Orange - Psychiatric Medications
Teal - Medical Diagnoses
Yellow -Medical Medications
Red - Side Effects
Blue - Patient
Green -Nursing Diagnoses
Pink Lines - Important Connections (Psych to Non-Psych)

Having advanced medical conditions to try and understand/manage while also dealing with psychiatric conditions likely contributes to feelings of powerlessness, confusion, and overall irritability at medical staff.

Outbursts related to Oppositional Defiant Disorder and Disruptive Mood Dysregulation Disorder could trigger an anxiety attack and potentially an asthma exacerbation.

The symptoms of hypothyroidism could be mistaken for side effects of patients psychiatrics medications or a relapse of depression. It is important to pay close attention to what may be causing fatigue, coldness, constipation, and weight gain.

Major Depressive Disorder & Generalized Anxiety Disorder