Assignment: Assessing And Treating Patients With ADHD ✓ Solved

Assignment Assessing And Treating Patients With Adhdnot Only Do Child

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.

Sample Paper For Above instruction

Introduction:

Diego is a 9-year-old boy diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), predominantly inattentive presentation, characterized by difficulty sustaining attention, forgetfulness, and distractibility. His symptoms significantly impair his academic performance and daily functioning. His parents report that he is energetic but does not exhibit significant defiance or hyperactivity. The clinical assessment, including the Conners’ Teacher Rating Scale, supports the diagnosis. Diego’s age, gender, and symptomatology are critical considerations when initiating treatment to optimize outcomes and minimize adverse effects.

Initial Evaluation and Considerations:

In assessing Diego’s treatment plan, pharmacokinetic and pharmacodynamic factors are pivotal. Children metabolize medications differently than adults due to differences in liver enzyme activity, kidney function, and body composition (Swanson, 2000). Moreover, Diego’s age and weight influence drug dosing and efficacy. His cognitive and behavioral profile suggests that stimulant medication may be beneficial, especially considering that behavioral therapies are most effective when combined with pharmacological treatment (Stein et al., 2015). However, his age warrants cautious monitoring for side effects such as appetite suppression or sleep disturbances.

Decision #1: Initiate Methylphenidate (Immediate Release)

I selected starting methylphenidate immediate-release (IR) due to its well-documented efficacy in children and rapid onset of action. The primary goal was to improve attention, reduce distractibility, and enhance academic performance. Methylphenidate’s pharmacodynamics involve blocking dopamine and norepinephrine reuptake, increasing their availability in the synaptic cleft (Prince et al., 2016). As a short-acting formulation, IR methylphenidate allows for dose titration and management of side effects, such as decreased appetite or insomnia. The decision was also influenced by its relatively favorable safety profile in pediatric populations.

Alternative options included long-acting formulations or non-stimulant medications like atomoxetine. Long-acting stimulants reduce dosing frequency but may have slower titration and higher cost. Non-stimulants are considered when adverse effects or contraindications exist, but they may be less effective (Hodgkins et al., 2012). The choice of IR methylphenidate aligns with the goal of close symptom monitoring and individualized dosing to mitigate risks.

Decision #2: Monitor & Adjust Dosage Weekly

I chose to implement a weekly monitoring schedule to assess therapeutic response and side effects, adjusting the dose as needed. This approach allows for individualized treatment optimization and early detection of adverse effects, such as mood changes or appetite suppression (Stein et al., 2015). Regular follow-up enables shared decision-making with Diego’s parents, ensuring their concerns, such as potential side effects, are addressed transparently.

Monitoring includes parent and teacher reports, behavioral observations, and assessment of weight and sleep patterns. Ethical considerations include respecting family autonomy and promoting informed consent while ensuring safe medication management. Effective communication with Diego and his family emphasizes education about expected effects, side effects, and importance of adherence (American Psychiatric Association, 2013). If adverse effects become intolerable, alternative medications or non-pharmacological interventions will be considered.

Decision #3: Combine Pharmacotherapy with Behavioral Therapy

Recognizing that medication alone may not sufficiently address Diego’s difficulties, I recommended integrating behavioral therapy into his treatment plan. Behavioral interventions, such as cognitive-behavioral therapy (CBT) strategies and parent training, have demonstrated efficacy in improving ADHD symptoms and enhancing social and academic functioning (Stein et al., 2015). This comprehensive approach aligns with ethical principles of beneficence and non-maleficence, aiming to maximize benefits while minimizing harm.

Non-pharmacological interventions also respect family preferences for holistic care and may reduce medication dosages over time. Education emphasizes that combination therapy can lead to sustainable improvements and reduce reliance solely on medication, addressing ethical considerations of autonomy and informed decision-making (Anastopoulos et al., 2018).

Conclusion:

In summary, initiating methylphenidate IR with close weekly monitoring and integrating behavioral therapy constitutes an evidence-based, patient-centered approach in Diego's ADHD management. The plan considers age-specific pharmacokinetics, ongoing assessment of efficacy and side effects, and ethical principles guiding shared decision-making. Ongoing collaboration with the family and adaptation of treatment will optimize functional outcomes and quality of life for Diego.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
• Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26(3), 245–268.
• Prince, J. B., Wilens, T. E., Spencer, T. J., & Biederman, J. (2016). Stimulants and other medications for ADHD. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 99–112). Elsevier.
• Stein, M. A., et al. (2015). Evidence-based pharmacological treatment of ADHD in children, adolescents, and adults. Journal of Clinical Psychiatry, 76(4), e472–e508.
• Swanson, J. M. (2000). Children with ADHD: Problems, Diagnosis, and Treatment. Guilford Press.