Cannabis Case Scenario Discussion

20-year-old single male is brought to the emergency department (ED) by his friends in a scared and agitated state. He had been playing basketball several hours ago with his friends when he suddenly began complaining of being stung by bees. He began behaving erratically and saying that bees were coming out of his ears and mouth. He began accusing one of his friends of plotting against him and blaming him for his condition. He became agitated and ran away from the basketball court, darting in and out of traffic on the adjoining street. His friends had to track him down and force him to come to the hospital. His friends report that some of them had been smoking “weed” prior to the game, and the patient was a “newbie to weed.” His friends do not believe he has had any psychiatric problems in the past but cannot be sure. On examination, the patient appears anxious, apprehensive, and fearful. He looks around the room furtively, repeatedly spitting into a cup. He is fully aware of his surroundings, but his attention span is very short. His memory is intact and fully oriented. He no longer suspects his friend and holds out the cup he has been spitting into for the doctor to inspect for bees. He finds it unbelievable that he has bees crawling out of himself but cannot help feeling the sensation. Physical examination reveals redness of the eyes and an elevated pulse rate. Otherwise, the physical examination is normal. Neurologic examination is within normal limits. The patient complains of the bees “sucking out all [his] energy making [him] very hungry.”

To view the rubric for this assignment, click the three dots at the upper left-hand corner of this discussion, and click “show rubric”.

After reading the Case Scenario, post what you have learned thus far:

  • What is the most likely diagnosis with the appropriate ICD code? (In one paragraph, use patient signs and symptoms to support your diagnosis)
  • List at least three or more differentials (explain HOW you ruled them in and then out in one to two paragraphs)
  • What is the best diagnostic test? (In one paragraph, use EVIDENCE behind your testing)
  • What would be the next step? (In one paragraph, use the best evidence available to justify what would be the next step

Support your answers by using DSM 5 and use patient presentation for justification of your diagnosis, and recent journal articles, and use APA format.

Students may respond to their peer’s postings, however, it is not required.

Diagnosis with ICD code

Diagnosis with supporting signs and symptoms the patient presented, the rationale, and ICD code with specifiers if applicable.

20 to >18.0 pts

Meets or Exceeds Acceptable Criteria (EAC*)
Diagnosis and ICD code with specifiers if applicable is explicit, focused, and includes all criteria

18 to >16.0 pts

Acceptable
Diagnosis: 2/3 of parts fulfilled: Diagnosis is clear. Minor lapses in focus or relevancy to the criteria, ICD code may be missing or not be correct.

16 to >0.0 pts

Needs Improvement
1/3 parts fulfilled: Diagnosis loses focus and has major lapses in relevancy to the criteria

0 pts

No Marks
Did not complete
20 pts
Three Differentials

Three plausible differentials that includes patient symptoms and how they were ruled out

20 to >18.0 pts

Meets or Exceeds Acceptable Criteria (EAC*)
Differential diagnoses are plausible from the information in the scenario, information to rule out was included, there may or may not be some errors

18 to >16.0 pts

Acceptable
Differential diagnoses are mostly plausible from the information in the scenario but more information could have been included,

16 to >0.0 pts

Needs Improvement
Differential diagnoses are minimally plausible from the information in the scenario

0 pts

No Marks
Did not complete
20 pts
Diagnostic test

What is the best diagnostic test and what the evidence there is for using the test?

20 to >18.0 pts

Meets or Exceeds Acceptable Criteria (EAC*)
Includes a comprehensive description of the diagnostic tests and recommendations based on evidence-based practice

18 to >16.0 pts

Acceptable
Mostly includes a comprehensive description of the diagnostic tests and recommendations based on evidence-based practice

16 to >0.0 pts

Needs Improvement
Partially Includes a comprehensive description of the diagnostic tests and recommendations based on evidence-based practice

0 pts

No Marks
Did not complete
20 pts
The next step

In one paragraph, the student clearly states the next steps for the patient, with the rationale and the evidence for it.

20 to >18.0 pts

Meets or Exceeds Acceptable Criteria (EAC*)
Clearly states in one paragraph the next steps using evidence-based practice and provides rationale

18 to >16.0 pts

Acceptable
Mostly states in one paragraph the next steps using evidence-based practice and provides rationale, there are some errors

16 to >0.0 pts

Needs Improvement
Partially states in one paragraph the next steps using evidence-based practice and provides rationale

0 pts

No Marks
Did not complete
20 pts
Critical thinking

The student shows critical thinking skills moving toward the diagnosis, differentials, diagnostic test, and plan for the patient through a thorough discussion of conclusions drawn based on patient presentation as well as discussion of the next step.

10 to >9.0 pts

Meets or Exceeds Acceptable Criteria (EAC*)
Information is taken from source(s) with enough interpretation/evaluation to develop a comprehensive analysis or synthesis.

9 to >8.0 pts

Acceptable
Information is taken from source(s) with enough interpretation/evaluation to develop a coherent analysis or synthesis.

8 to >0.0 pts

Needs Improvement
Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.

0 pts

No Marks
Information is taken from source(s) without any interpretation/ evaluation.
10 pts
APA format

APA formatting for sentence structure, grammar, and reference citation

10 to >9.0 pts

Meets or Exceeds Acceptable Criteria (EAC*)
Skillful and proficient use of APA formatting of text, sentence structure, grammar, and reference citation

9 to >8.0 pts

Acceptable
Minimal problems with APA formatting of text, sentence structure, grammar, and reference citation

8 to >0.0 pts

Needs Improvement
Major problems with APA formatting of text, sentence structure, grammar, and reference citation

0 pts

No Marks
Did not complete
1
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