NURS 6630 Assessing and Treating Patients With ADHD
Sample Answer for NURS 6630 Assessing and Treating Patients With ADHD Included After Question
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.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
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
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NURS 6630 Assessing and Treating Patients With ADHD Rubric
NURS_6630_Week9_Assignment_Rubric
| NURS_6630_Week9_Assignment_Rubric | ||||||
| Criteria | Ratings | Pts | ||||
| This criterion is linked to a Learning Outcome 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. |
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10 pts | ||||
| This criterion is linked to a Learning Outcome Decision #1 (1–2 pages)• 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. |
|
20 pts | ||||
| This criterion is linked to a Learning Outcome Decision #2 (1–2 pages)• 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. |
|
20 pts | ||||
| This criterion is linked to a Learning Outcome Decision #3 (1–2 pages)• 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. |
|
20 pts | ||||
| This criterion is linked to a Learning Outcome 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. |
|
15 pts | ||||
| This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
|
5 pts | ||||
| This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
|
5 pts | ||||
| This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. |
|
5 pts | ||||
| Total Points: 100 | ||||||
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With ADHD
Title: NURS 6630 Assessing and Treating Patients With ADHD
ADHD is a disease common among children and often continues to adulthood. This chronic condition includes the combination of various persisting problems in a patient. Such problems include impulsive behavior, difficulty in sustaining attention, and always hyperactivity. Children diagnosed with ADHD would as well struggle with low self-esteem, poor performance in academics, and trouble relating with others (Enriquez-Geppert et al., 2019). The treatment of ADHD has taken various dimensions, with different drugs chosen for the treatment depending on the underlying conditions of a patient. While another patient may be treated using Wellbutrin XL or Ritalin chewable tablets, others may be treated using intuniv extended release 1mg orally. All these medications are approved to use in patients who have ADHD. Therefore, the purpose of this study is to assess and treat Katie, who has been diagnosed with ADHD.
Introduction to the Case
The case involves an 8-year-old Caucasian girl called Katie. The patient is presented for mental examination by her parents. Katie’s educator had earlier mentioned that she might have ADHD. The parents have also carried the Conner’s Teacher Rating Scale-Revised (CTRS-R) system completed and approved by her teacher. CTRSR is a professional method used to assess the learner’s attention in class. The result from the CTRSR shows that Katie is sometimes not attentive, easily confused, and troubled in remembering things told. Her reading, spelling, and arithmetic scores are below average. She struggles in completing assigned tasks, including homework. Sometimes she starts her homework but fails to complete it and rarely follows the assignment in the order provided by the instructor. The parents oppose the teacher’s assessment that Katie might have ADHD.
In the subjective assessment, Katie seems unconcerned about the issue and claims that school life is fine. She likes art and playing. She also claims that some subjects are boring and difficult to understand. She accepts that her mind sometimes wanders off issues she finds amusing. Again, she claims that she has perfect friends and family and has never been bullied at school. On the mental state assessment, she is oriented to date, occurrence, and location and has dressed appropriately for her age and temperature. Her voice is rational and simple and fails to make any noticeable mannerisms. She claims she has never had any auditory or sensory problems.
Decision #1
Initiate the treatment by giving Ritalin (methylphenidate) chewable tablets 10mg in the morning.
The selected decision
Based on the available choices, the first decision was Ritalin-10mg chewable tablets in the morning. Ritalin is one of the best medications for treating severe ADHD. Ritalin is a methylphenidate that stimulates the central nervous system (CNS), as highlighted by Caye et al. (2019). This drug is the first-line treatment for ADHD in children and adolescents.
What I was Hoping Achieve by Making this Decision
I hope that prescribing Ritalin 10mg chewable tablets would improve the patient’s condition and increase her concentration in class. The drug has been found to eb effective in improving the general attention and performance of students (Antshel & Russo, 2019). I would as well seek the consent of the parents before administering the medication.
Why the Other Two Decisions were Not Selected
The other two decisions were to use Wellbutrin XL and intuniv extended release 1mg orally. Wellbutrin is an antidepressant that is not commonly used to treat ADHD. The drug has immense side effects, such as suicidal ideation, which are risky for children who might not understand the best ways of dealing with such emotions (Antshel & Russo, 2019). On the other hand, Intuniv is not a stimulant primarily used to control oppositional habits among ADHD patients. Katie’s condition is described by lack of attention. However, this medication would not be effective in correcting her condition.
How Ethical Considerations May Impact the Treatment Plan
While my selected treatment plan focuses on improving Katie’s condition, it would trigger beneficence and nonmaleficence ethical principles. Choosing Ritalin over provided drugs would trigger these two ethical principles (Caye et al., 2019). Ritalin appears to provide the patient with more medicinal benefits with reduced side effects (harm) on the patient.
Decision #2
Switch to Ritalin LA 20 mg PO in the morning.
Reasons for Selecting this Decision
When the patient came for her second appointment after four weeks, her instructor reported that her problems were more intense in the morning. However, she would begin her episodes of fantasy in the afternoon. Her academic success improved, but her parents were worried about her abnormal heart rate, and her pulse rate was 130 BPM. In my second option, I will switch to Ritalin 20mg PO taken in the morning. The patient heat was strange because Ritalin chewable tablets 10 mg PO is an immediate-release form that can even induce tachycardia (Antshel & Russo, 2019).
Why the Other Two Decisions were Not Selected
Proceeding with a similar dosage of Ritalin on the patient after the four-week assessment is not the correct option because it does not eliminate the afternoon lapse in her attention. Again, Ritalin does not resolve the tachycardia effect on the patient (Antshel & Russo, 2019). In her case, it would be better to switch to Ritalin LA 20mg PO taken in the morning if chewable tablets 10mg had been proven inactive after four weeks.
What I Was Hoping to Achieve by Making This Decision
I hoped changing to Ritalin LA 20mg PO in the morning would solve the drug’s side effects. The patient would record an increased concentration span throughout the day. I also hoped that the LA formulation would have no side effects and solve the tachycardia effect (Ghanaatgar et al., 2022).
How Ethical Considerations May Impact the Treatment Plan
In this case, one of the ethical concerns is nonmaleficence (do not harm) and beneficence because the patient already shows a positive response to the given drug. Again, shifting Katie to an extended-release form is another better choice for offering a long-term medicinal benefit to the patient (Ghanaatgar et al., 2022). Switching to Ritalin LA 20mg PO taken in the morning of Ritalin also aims to solve the patient’s tachycardia problem (reducing harm).
Decision #3
The decision at this point is to continue giving the patient Ritalin LA 20mg dosage in the morning.
Reasons for Selecting this Decision
The patient is back to the clinic after four weeks with the reports on her enhanced academic performance and improved symptoms. The patient also noted that the funny heart rate has also vanished. Her tests showed a heart rate of 92 beats per minute, improving. At this stage, I agreed to maintain Ritalin LA 20mg PO taken in the morning on the patient and re-evaluate her condition after another four weeks to determine her progress. The patient’s condition has changed daily, and the adverse effects have vanished (Caye et al., 2019). This shows that the choice of changing the medication on the patient was warranted.
Why the Other Two Decisions were Not Selected
Increasing the dosage of Ritalin LA to 30mg is not warranted at this stage because the effects of ADHD seem to disappear with the Ritalin LA 20mg dosage in the morning. Besides, it is recommended to use a lower dosage of Ritalin LA because raising the dosage could worsen the side effects (Zečević et al., 2019). The patient’s heartbeat is acceptable according to her age. However, other symptoms of abnormality other than tachycardia should prompt the parent to take Katie for an electrogram (EKG) focusing on her actual heart rhythm.
What I Expect to Achieve
The therapeutic decision to switch from Ritalin 10 mg chewable tables to Ritalin LA 20mg PO taken in the morning was reached because the patient was reacting positively to Ritalin LA. I aimed to keep the patient on the same medication and observe her change over four weeks. The ethical principles of beneficence and nonmaleficence came into play at this stage because of switching to Ritalin LA 20mg PO taken in the morning (Pakdaman et al., 2018). However, the patient showed an improved outcome with the Ritalin LA dosage.
How Ethical Considerations May Impact the Treatment Plan
Ethics demands that a healthcare professional select the best option that would not have the patient change their conditions for the better. In this case, beneficence and nonmaleficence have been taken into account by not allowing the parents of the patients to undertake an EKG without reason.
Conclusion
Katie is an 8-year-old Caucasian girl admitted to the mental facility by her parents after her teacher suspected that she had ADHD. The teacher assessment shows that Katie is not attentive, is quickly frustrated, and rarely follows orders from her instructor, as shown by the updated CTRS system. The patient claims that her mind wanders off to pleasant thinking. She had difficulty in learning and understanding subjects such as algebra. Her behavioral examination is regular in terms of her focus and discipline.
In my treatment plan, I took the first choice of 10 mg Ritalin in the morning, a chewable pill. The aim of using Ritalin was that it contains methylphenidate, which is one of the first-line medications for treating ADHD. Again, Ritalin is a stimulant that appears to be the most effective in treating common symptoms of limited attention. After four weeks, the patient reported notable treatment but her hallucinations would still appear in the afternoon. I switched to Ritalin LA 20mg PO taken in the morning to solve the noted side effect and improve her condition. The second assessment was positive because the patient had reduced symptoms of the infection. Therefore, the medication choice selected for the patient gave a desired positive outcome.
References
Antshel, K. M., & Russo, N. (2019). Autism spectrum disorders and ADHD: Overlapping phenomenology, diagnostic issues, and treatment considerations. Current Psychiatry Reports, 21(5), 1-11. https://doi.org/10.1007/s11920-019-1020-5
Caye, A., Swanson, J. M., Coghill, D., & Rohde, L. A. (2019). Treatment strategies for ADHD: an evidence-based guide to select optimal treatment. Molecular Psychiatry, 24(3), 390-408. https://doi.org/10.1038/s41380-018-0116-3
Enriquez-Geppert, S., Smit, D., Pimenta, M. G., & Arns, M. (2019). Neurofeedback as a treatment intervention in ADHD: Current evidence and practice. Current Psychiatry Reports, 21(6), 1-7. https://doi.org/10.1007/s11920-019-1021-4
Ghanaatgar, M., Taherzadeh, S., Ariyanfar, S., Jahromi, S. R., Martami, F., Gharaei, J. M., … & Shahrivar, Z. (2022). Probiotic supplement as an adjunctive therapy with Ritalin for treatment of attention-deficit hyperactivity disorder symptoms in children: a double-blind placebo-controlled randomized clinical trial. Nutrition & Food Science. https://doi.org/10.1108/NFS-12-2021-0388
Pakdaman, F., Irani, F., Tajikzadeh, F., & Jabalkandi, S. A. (2018). The efficacy of Ritalin in ADHD children under neurofeedback training. Neurological Sciences, 39(12), 2071-2078. https://doi.org/10.1007/s10072-018-3539-3
Zečević, D., Tešović, M., & Fatić, S. (2019). The Use of Neurofeedback in the Treatment of ADHD-Review of Papers. Speech And Language 2019, 227. http://www.iefpg.org.rs/Conference/2019/S&L2019_PROCEEDINGS.pdf#page=227
A Sample Answer 2 For the Assignment: NURS 6630 Assessing and Treating Patients With ADHD
Title: NURS 6630 Assessing and Treating Patients With ADHD
In the case study provided, a primary care practitioner suggested the patient, a Caucasian girl of eight years old, for therapy after her teacher expressed concern that she could have attention-deficit/hyperactivity disorder (ADHD). Based on Katie’s teacher’s evaluation using the “Conner’s Teacher Rating Scale-Revised,” it has been observed that she displays signs of inattentiveness, being easily distracted, having difficulty retaining previously learned information, and struggling in spelling, reading, and arithmetic. She tends to focus on select topics and has a limited attention span. Her teacher says she seems disinterested and often gets distracted during her studies. Katie disregards instructions, initiates tasks without completing them, and overlooks her academic responsibilities. Katie’s parents strongly deny that their daughter has ADHD. According to the patient’s mother, Katie would exhibit hyperactive behavior if she had ADHD. She also notes that her daughter consistently displays respectful behavior and rarely shows signs of defiance or emotional outbursts. The patient’s diagnosis is Attention deficit hyperactivity disorder, predominantly inattentive presentation, as determined by the mental status examination results.
Developing a treatment plan for young children with mental health problems can be challenging due to the safety concerns associated with this age group. To ascertain the most efficacious prescription strategies, it is critical to consider the unique characteristics of each patient, which may influence how pharmaceuticals are metabolized within the organism and their interactions with its diverse systems. Several factors, including the child’s underlying condition, age, race or ethnicity, gender, and presence of symptoms, play a crucial role in determining the most appropriate treatment regimen (Nazarova et al., 2022). This paper centers on the decision-making process for managing an 8-year-old with ADHD who predominantly displays inattentive behavior.
Decision Point One
Decision and Justification
Katie will initially be started on chewable 10 mg Ritalin (methylphenidate) pills, which will be taken orally every morning. The 2018 National Institute for Health and Care Excellence (NICE) guideline suggests that methylphenidate should be the initial pharmacological intervention for children over five and adolescents with ADHD (Mechler et al., 2022). Methylphenidate inhibits the reabsorption of dopamine and norepinephrine, as demonstrated in a recent study by Nazarova et al. (2022). The selective inhibition of these neurotransmitter transporters causes an increase in dopamine and NE concentrations in the synaptic cleft (Groom and Cortese, 2022). The chewable version is often advised for youngsters since it contains sweeteners that assist in hiding the medication’s taste. Methylphenidate treatment for ADHD in youth is thought to be safe when used for two years (Drechsler et al., 2020). Following up on prescribed exams is essential, especially for heart rate and pulse monitoring.
When children take bupropion, their behavior may alter. They may become more aggressive and agitated, have depressed symptoms, or have thoughts of harming themselves (Castells et al., 2020). Therefore, it was not an optimal decision. For this reason, Intuniv was not chosen because of the significant risks associated with it, including syncope, bradycardia, and psychological symptoms such as depression, hallucinations, and thoughts of suicide (Lilja et al., 2022).
Expected Outcome
In the next four weeks, the patient is anticipated to have reduced symptoms associated with ADHD (Young et al., 2021). Throughout this timeframe, the individual is expected to enhance her capacity to concentrate, maintain attention, communicate with efficacy, execute mathematical assignments, and exhibit mastery in spelling. Her cognitive advancement will persist throughout this phase.
Ethical Considerations
Considering the kid’s age of eight, it falls within the parents’ legal jurisdiction to make decisions regarding her health. To assist them in making informed choices about their daughter’s health, the PMHNP should educate parents about the condition and available treatments (Rodrigues et al., 2020).
Decision Point Two
Decision and Justification
The second intervention was taking a 20 mg extended-release Ritalin dosage every morning. Extended-release medications typically exhibit a gradual onset of action. Medications are commonly administered in a controlled manner and gradually released into the patient’s circulatory system throughout the day. After consumption, some of the drug is quickly absorbed; this usually happens in the early morning (Mechler et al., 2022). These medications provide a practical choice for patients seeking a single tablet that provides long-lasting symptom relief (Groom & Cortese, 2022). According to Nazarova et al. (2022), the administration of this medication is limited to a single dose per day, which enhances its degree of simplicity and convenience. The patient exhibited an increased pulse rate, a known and extensively studied adverse effect of Ritalin. According to Drechsler et al. (2020), this effect is anticipated to diminish over time.
Because the client may have symptoms later in the day after the drug’s effects have dissipated, it is recommended against continuing the methylphenidate dosage (Castells et al., 2020). Lilja et al. (2022) suggest a possible increase in non-suicidal behavior among young individuals linked to the use of Adderall. Based on the evidence, it may not be recommended to transition from Ritalin to Adderall.
Expected Outcome
The patient should expect the extended-release medication to sufficiently manage their symptoms throughout the day for the following four weeks (Young et al., 2021). Significant improvement will be observed in the patient’s execution within an educational setting. The negative impacts of an increased heart rate will dissipate during this stage.
Ethical Considerations
The decision made by the PMHNP took into consideration the patient’s autonomy. The patient preferred gaining knowledge about the medication’s possible side effects and long-term efficacy rather than delving into its mode of action. To improve clients’ psychological well-being, it is essential to exercise professional judgment and make decisions with utmost consideration for their interests (Rodrigues et al., 2020).
Decision Point Three
Decision and Justification
It was advised to maintain the patient’s medication regimen for the third intervention and reassess after four weeks. The patient said the medicine reduced the adverse effects of a raised heart rate. Existing research indicates that the reduction of ADHD symptoms usually occurs within a period of eight to twelve weeks after determining the optimal dosage of Ritalin (Mechler et al., 2022). The medicine may be administered for a lengthy period at safe levels with no notable adverse effects (Drechsler et al.,2020). As a consequence, it is recommended that patients be re-evaluated after four weeks. Extended use of Ritalin may minimize the frequency of adverse effects by creating drug tolerance, hence enhancing its safety profile (Groom & Cortese, 2022).
Research has indicated that administering lower doses of Ritalin has been associated with favorable outcomes and a reduced risk of adverse effects (Castells et al., 2020). Therefore, there is no need to increase the dose to 30 mg. During the latest consultation, a patient’s heart rate peaked at 92, which falls within the expected range for her age. Thus, it was concluded that an ECG is unnecessary (Lilja et al., 2022).
Expected Outcome
It is expected that the child’s ADHD symptoms will improve in the following week if they continuously adhere to the prescribed treatment plan (Young et al., 2021). It is anticipated that she will succeed in her scholarly endeavors. There won’t be any adverse effects.
Ethical Considerations
The primary ethical goal of a nurse is to give precedence to improving a patient’s overall health while preventing any possible damage. The patient conveyed contentment over the outcomes of the therapy. It is crucial to adhere to the recommended dosage while also considering the patient’s autonomy to consistently assess the efficacy of the treatment (Rodrigues et al., 2020).
Conclusion
An eight-year-old with symptoms consistent with attention deficit hyperactivity disorder (ADHD) was recruited as a case study participant. When devising a treatment strategy, it is essential to consider many patient-specific variables that influence the metabolism, elimination, absorption, distribution, and interactions of medications inside the body. The appropriate medications depend on the client’s clinical symptoms, mental diagnosis, and demographic traits, such as age, race, and gender (Young et al., 2021). Based on the factors mentioned, it was decided to administer a 10mg Ritalin tablet in an edible format daily (Mechler et al., 2022). The recommendations of medical experts primarily influenced the decision. These experts have conducted research and concluded that the treatment is effective for alleviating ADHD symptoms and safe for use in kids (Groom & Cortese, 2022). According to Castells et al. (2020), it has been found that bupropion and Intuniv may have a higher likelihood of leading to unfavorable outcomes in kids and teens. Following four weeks, the patient revisited the clinic and provided an update on their symptoms, noting a decrease in symptoms alongside an observed increase in heart rate.
The second strategy involved modifying the course of therapy to LA Ritalin 20mg, which was administered in the morning to ensure sustained therapeutic effects during the day (Drechsler et al., 2020). It is not recommended to use Adderall due to the heightened risk of suicide and the challenges in maintaining a proper dosage (Lilja et al., 2022). The decision to continue medication and reassess the patient after four weeks was predicated on the patient’s worsened symptoms of ADHD and the lack of adverse effects associated with an increased heart rate (Nazarova et al., 2022). Safety considerations may exclude the need for electrocardiograms or dose adjustments of Ritalin in some circumstances. In light of many moral quandaries, the PMHNP regularly demonstrated adherence to ethical norms, including but not limited to beneficence, fairness, and respect for patient autonomy, in our decision-making process (Rodrigues et al., 2020).
References
Castells, X., Ramón, M. A., Cunill, R., Olivé, C., & Serrano, D. (2020). Relationship between treatment duration and efficacy of pharmacological treatment for ADHD: A Meta-Analysis and Meta-analysis of 87 randomized controlled clinical trials. Journal of Attention Disorders, 25(10), 1352–1361. https://doi.org/10.1177/1087054720903372
Drechsler, R., Brem, S., Brandeis, D., Grünblatt, E., Berger, G., & Walitza, S. (2020). ADHD: current concepts and treatments in children and adolescents. Neuropediatrics, 51(05), 315–335. https://doi.org/10.1055/s-0040-1701658
Groom, M. J., & Cortese, S. (2022). Current pharmacological treatments for ADHD. In Current topics in behavioral neurosciences (pp. 19–50). https://doi.org/10.1007/7854_2022_330
Lilja, M., Sandblom, E., Lichtenstein, P., Serlachius, E., Hellner, C., Bhagia, J., & Halldner, L. (2022). The effect of autistic traits on response to and side-effects of pharmacological ADHD treatment in children with ADHD: results from a prospective clinical cohort. Journal of Neurodevelopmental Disorders, 14(1). https://doi.org/10.1186/s11689-022-09424-2
Mechler, K., Banaschewski, T., Hohmann, S., & Häge, A. (2022). Evidence-based pharmacological treatment options for ADHD in children and adolescents. Pharmacology & Therapeutics, 230, 107940. https://doi.org/10.1016/j.pharmthera.2021.107940
Nazarova, V. A., Соколов, А. В., Chubarev, V. N., Tarasov, V. V., & Schiöth, H. B. (2022). Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods, and trends in clinical trials. Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.1066988
Rodrigues, R., Lai, M., Beswick, A., Gorman, D. A., Anagnostou, E., Szatmári, P., Anderson, K. K., & Ameis, S. H. (2020). Practitioner Review: Pharmacological treatment of attention‐deficit/hyperactivity disorder symptoms in children and youth with autism spectrum disorder: a systematic review and meta‐analysis. Journal of Child Psychology and Psychiatry, 62(6), 680–700. https://doi.org/10.1111/jcpp.13305
Young, J. R., Yanagihara, A., Dew, R. E., & Kollins, S. H. (2021). Pharmacotherapy for Preschool Children with Attention Deficit Hyperactivity Disorder (ADHD): Current Status and Future Directions. CNS Drugs, 35(4), 403–424. https://doi.org/10.1007/s40263-021-00806-z