xl 150 mg orally daily begin intuniv extended release 1 mg orally H e a l t h M e d i c a l

xl 150 mg orally daily begin intuniv extended release 1 mg orally H e a l t h M e d i c a l

Assignment: Assessing and Treating Patients With ADHD

Not only do children and adults have different
presentations for ADHD, but males and females may also have vastly
different clinical presentations. Different people may also respond to
medication therapies differently. For example, some ADHD medications may
cause children to experience stomach pain, while others can be highly
addictive for adults. In your role, as a psychiatric nurse practitioner,
you must perform careful assessments and weigh the risks and benefits
of medication therapies for patients across the life span. For this
Assignment, you consider how you might assess and treat patients
presenting with ADHD.

To prepare for this Assignment:

  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD.

The Assignment: 5 pages

Examine Case Study: A Young Caucasian Girl with ADHD. You
will be asked to make three decisions concerning the medication to
prescribe to this patient. Be sure to consider factors that might impact
the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all
options before selecting your decision and moving throughout the
exercise. Before you make your decision, make sure that you have
researched each option and that you evaluate the decision that you will
select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure
    to include the specific patient factors that may impact your decision
    making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your
    response with clinically relevant and patient-specific resources,
    including the primary literature.
  • Why did you not select the other two options provided in the
    exercise? Be specific and support your response with clinically relevant
    and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support
    your response with evidence and references to the Learning Resources
    (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan
    and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your
    response with clinically relevant and patient-specific resources,
    including the primary literature.
  • Why did you not select the other two options provided in the
    exercise? Be specific and support your response with clinically relevant
    and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support
    your response with evidence and references to the Learning Resources
    (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan
    and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your
    response with clinically relevant and patient-specific resources,
    including the primary literature.
  • Why did you not select the other two options provided in the
    exercise? Be specific and support your response with clinically relevant
    and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support
    your response with evidence and references to the Learning Resources
    (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan
    and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected
    for this patient. Be sure to justify your recommendations and support
    your response with clinically relevant and patient-specific resources,
    including the primary literature.

Note: Support your rationale with a minimum of
five academic resources. While you may use the course text to support
your rationale, it will not count toward the resource requirement. You
should be utilizing the primary and secondary literature.


Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

CASE STUDY

Attention Deficit Hyperactivity Disorder
A Young Girl With ADHD

A Young Girl With ADHD

BACKGROUND

Katie is an 8 year old Caucasian female who is brought to your office
today by her mother & father. They report that they were referred
to you by their primary care provider after seeking her advice because
Katie’s teacher suggested that she may have ADHD. Katie’s parents
reported that their PCP felt that she should be evaluated by psychiatry
to determine whether or not she has this condition.

The parents give you a copy of a form titled “Conner’s Teacher Rating Scale-Revised”.
This scale was filled out by Katie’s teacher and sent home to the
parents so that they could share it with their family primary care
provider. According to the scoring provided by her teacher, Katie is
inattentive, easily distracted, forgets things she already learned, is
poor in spelling, reading, and arithmetic. Her attention span is short,
and she is noted to only pay attention to things she is interested in.
The teacher opined that she lacks interest in school work and is easily
distracted. Katie is also noted to start things but never finish them,
and seldom follows through on instructions and fails to finish her
school work.

Katie’s parents actively deny that Katie has ADHD. “She would be
running around like a wild person if she had ADHD” reports her mother.
“She is never defiant or has temper outburst” adds her father.

SUBJECTIVE

Katie reports that she doesn’t know what the “big deal” is. She
states that school is “OK”- her favorite subjects are “art” and
“recess.” She states that she finds her other subjects boring, and
sometimes hard because she feels “lost”. She admits that her mind does
wander during class to things that she thinks of as more fun.
“Sometimes” Katie reports “I will just be thinking about nothing and the
teacher will call my name and I don’t know what they were talking
about.”

Katie reports that her home life is just fine. She reports that
she loves her parents and that they are very good and kind to her.
Denies any abuse, denies bullying at school. Offers no other concerns at
this time.

MENTAL STATUS EXAM

The client is an 8 year old Caucasian female who appears
appropriately developed for her age. Her speech is clear, coherent, and
logical. She is appropriately oriented to person, place, time, and
event. She is dressed appropriately for the weather and time of year.
She demonstrates no noteworthy mannerisms, gestures, or tics.
Self-reported mood is euthymic. Affect is bright. Katie denies visual or
auditory hallucinations, no delusional or paranoid thought processes
readily appreciated. Attention and concentration are grossly intact
based on Katie’s attending to the clinical interview and her ability to
count backwards from 100 by serial 2’s and 5’s. Insight and judgment
appear age appropriate. Katie denies any suicidal or homicidal ideation.

Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation

RESOURCES

§ Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein,
J. N. (1998). Revision and restandardization of the Conners’ Teacher
Rating Scale (CTRS-R): Factors, structure, reliability, and criterion
validity. Journal of Abnormal Child Psychology, 26, 279-291.

Decision Point One

Select what you should do:


Begin Wellbutrin (bupropion) XL 150 mg orally daily


Begin Intuniv extended release 1 mg orally at BEDTIME


Begin Ritalin (methylphenidate) chewable tablets 10 mg orally in the MORNING