Simulation 4 Flashcards
(36 cards)
A mother brings in her 15-year-old son, Steve, with complaints of
frequent mood changes, belligerence, weight loss (12 lbs.), and a sharp drop-off in his performance in school. He was also dropped from the wrestling team, as he seemed to be having trouble keeping up during practice sessions, and was beginning to perform poorly at competitive events. On a few occasions, the mother noticed that Steve had signs of slurred speech and evidence of poor coordination, yet there was no odor of alcohol. Finally, he seems to be frequently mildly confused, and she doesn’t know what to think of this.
A mother brings in her 15-year-old son, Steve, with complaints of
frequent mood changes, belligerence, weight loss (12 lbs.), and a sharp drop-off in his performance in school. He was also dropped from the wrestling team, as he seemed to be having trouble keeping up during practice sessions, and was beginning to perform poorly at competitive events. On a few occasions, the mother noticed that Steve had signs of slurred speech and evidence of poor coordination, yet there was no odor of alcohol. Finally, he seems to be frequently mildly confused, and she doesn’t know what to think of this.
What are the main complaints of Steve, the 15-year-old boy?
Frequent mood changes, belligerence, weight loss (12 lbs.), drop in school performance, poor coordination, slurred speech, mild confusion.
What is indicated by the weight loss of about 12 lbs. in young wrestlers?
It may be related to ‘making weight’ for wrestling, often involving heavy dieting and exercise.
What behavioral problems has Steve exhibited?
Failing to return home after school, staying out at friends’ homes, leaving home without permission, refusing homework, avoiding family, and belligerently refusing to talk.
What recent changes in hygiene and grooming were noted?
Steve presents as clean and well-groomed, maintaining his appearance as he always has.
How has Steve’s social life changed recently?
He has been avoiding family and has diminished his circle of friends, now only maintaining relationships with two key friends.
What is the significance of the episodes of slurred speech and decreased motor coordination?
These symptoms are concerning and not explained by alcohol use, indicating a potential underlying issue.
What additional information should be gathered for a provisional diagnosis?
In-depth coach report, in-depth teacher report, medical evaluation and report, sibling interviews.
What did the coach report about Steve’s behavior?
The coach noted lethargy, apathy, and difficulty with quick reactions and following instructions.
What concerns did Steve’s teachers express?
Declining performance, difficulty concentrating, and trouble following instructions.
What findings were noted during the medical evaluation?
Unexplained weight loss, decreased stamina, slurred speech, poor coordination, mild confusion.
What substances were found among Steve’s belongings indicating potential inhalant abuse?
Aerosol cans, ‘white-out’ bottles, tubes, and bottles of glue.
What is the primary concern regarding Steve’s potential inhalant use?
Risk of neurological damage from hypoxia and solvent toxicity, affecting executive functioning, language, coordination, memory, and learning capacity.
What is the most likely provisional diagnosis for Steve based on the intake information?
Inhalant Use, unspeci�ied (F18.90).
True or False: Steve has shown signs of psychotic behavior.
False.
Fill in the blank: The client has experienced episodes of _______ and decreased motor coordination.
slurred speech
What is indicated by the presence of aerosol paint cans in Steve’s room?
Potential involvement in graffiti activities and possible inhalant use.
What is the relevance of Steve’s family history?
His parents divorced when he was nine, and his father has remained largely absent, affecting family dynamics.
What is the significance of the client’s refusal to discuss behavioral issues?
It complicates the diagnostic process and may indicate denial or lack of insight.
What is the ICD-10 code for Inhalant Use, unspecified?
F18.90
This code is used for cases of inhalant use that do not fit into a more specific category.
What is the ICD-10 code for Illness, unspecified?
R69
This code is used when a specific illness cannot be identified.
What is the ICD-10 code for Inhalant use, unspecified with Inhalant-Induced Psychotic Disorder, unspecified?
F18.959
This code is used when inhalant use leads to psychosis, but specific details are not defined.
What is Mild Cognitive Impairment’s ICD-10 code?
G31.84
This condition indicates a decline in cognitive function that is not the primary focus of clinical attention.
What is the ICD-10 code for Unspecified Intellectual Disability?
F79
This diagnosis may arise from various causes but must relate to developmental factors occurring before age 18.
