NU 674 Pediatric Anxiety and OCD

NU 674 Pediatric Anxiety and OCD

NU 674 Pediatric Anxiety an

NU 674 Pediatric Anxiety and OCD
NU 674 Pediatric Anxiety and OCD

d OCD

Case Study

Cora is a seven-year-old girl, the second of two children of a middle-class family living in a suburban area of a northwest city. Cora has one sister that is two years older than her. Her mother’s pregnancy was normal, with no complications and Cora’s birth was normal. Cora had colic the first three months, cried extensively, and was difficult to comfort. After three months she became passive and cried very little with comfort from her mother. Her growth and development appeared to be normal. She met all the developmental milestones in her first three years. She interacted normally with her sister and parents, except that she would become tearful and anxious when her parents would get a babysitter.

At age four, she was in nursery school and appeared to function normally except during the first month when Cora had difficulty when her father would drop her off at school. The nursery school was a small private school with a lot of personal attention given to each child. Although shy, she made friends and liked going to nursery school after she became adjusted to the new setting. Her parents liked the school so much that they decided to keep Cora in kindergarten at this school with her same teachers and friends. However, tuition at the school became a problem after Cora’s mother became sick with lupus and was unable to work.

At age six, Cora’s parents enrolled her in first grade at the public elementary school in their neighborhood. For the last two weeks, she has refused to go to school and has missed six school days. She began routinely brushing her hair before bed and insisted on making sure each side was brushed with an even number of strokes.  She also had her mother tuck her in bed on the right side and her father come after on the left side each night.  She would become very tearful and upset if the routine was not followed.  She is awake almost all night worrying about going to school and asks the same questions over and over about the environment, teachers, and other students. As the start of the school day approaches, she cries and screams that she cannot go, chews holes in her shirt, pulls her hair, digs at her face, punches the wall, throws herself on the floor, as well as experiences headaches, stomachaches, and vomiting. Over the past two weeks, she has become gloomy, has stopped reading for fun, and frequently worries about her mother’s Lupus and that she may die.  She asks her every night if she has dreamed about her funeral. In addition, Cora is phobic of dogs, avoids speaking and writing in public, and wets the bed every night.

Her parents immediately made an appointment to see her PCP. Her doctor conducted a thorough physical exam, found no physical abnormalities, and then referred her to you, a Family PMHNP.

Family history of mental health includes the following: mother has a history of panic disorder; her father has a history of treatment with medications for ADHD as a child, and she has a cousin diagnosed with Asperger’s syndrome.

Instructions

For your assignment, write a paper that addresses the following prompts using evidence-based references to support your answers:

  1. Summarize the case.
  2. What is your provisional diagnosis, as well as the possible differentials?
  3. Justify your answer with DSM-5 criteria (be short, brief, and to the point).
  4. Is Cora too young to diagnose, or is there a basis for early identification and intervention?
  5. What psychiatric scales or assessment tools might you use with this patient? With the parents? List and describe briefly.
  6. What would be your treatment plan for medications, if any? If you do choose to offer medication as part of the treatment plan, please address the following medications issues:
    1. Target symptoms
    2. Receptors affected
    3. Psychiatric and system effects
    4. Possible parental concerns
  7. What would be your school-based treatment plan, if any?
  8. What would be the implications for the families of children and adolescents with these diagnostic pictures?
  9. How does the mother’s health play into the picture of Cora’s diagnosis? What type of therapy would you recommend for Cora (and her family) to work through her issues?
  10. Identify resources for patients/families with this diagnosis in the form of community groups, web-sites, advocacy, as well as treatment resources available in your service area.
  11. What are you worried about (if anything)? Consider this question in terms of treatment, assessment, alliance, compliance, effectiveness, safety, and other factors.

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    NU 674 Pediatric Anxiety and OCD Grading Rubric

    Performance Category 100% or highest level of performance

    100%

    16 points

    		 Very good or high level of performance

    88%

    14 points

    		 Acceptable level of performance

    81%

    13 points

    		 Inadequate demonstration of expectations

    68%

    11 points

    		 Deficient level of performance

    56%

    9 points

     

    		 Failing level

    of performance

    55% or less

    0 points
     Total Points Possible= 50           16 Points    14 Points 13 Points        11 Points           9 Points          0 Points
    Scholarliness

    Demonstrates achievement of scholarly inquiry for professional and academic topics.

    		 Presentation of information was exceptional and included all of the following elements:

    • Provides evidence of scholarly inquiry relevant to required TD topic(s).
    • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
    • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
    • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
    		 Presentation of information was good, but was superficial in places and included all of the following elements:

    • Provides evidence of scholarly inquiry relevant to required TD topic(s).
    • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
    • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
    • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
    		 Presentation of information was minimally demonstrated in all of the following elements:

    • Provides evidence of scholarly inquiry relevant to required TD topic(s).
    • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
    • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
    • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
    		  

    Presentation of information is unsatisfactory in one of the following elements:

    • Provides evidence of scholarly inquiry relevant to required TD topic(s).
    • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
    • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
    • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
    		  

    Presentation of information is unsatisfactory in two of the following elements:

    • Provides evidence of scholarly inquiry relevant to required TD topic(s).
    • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
    • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
    • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
    		 Presentation of information is unsatisfactory in three or more of the following elements

    • Provides evidence of scholarly inquiry relevant to required TD topic(s).
    • Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
    • Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
    • Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
     16 Points  14 Points  13 Points 11 Points 9 Points  0 Points
    Application of Course Knowledge

    Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations

    		 Presentation of information was exceptional and included all of the following elements:

    • Applies principles, knowledge and information from scholarly resources to the required topic.
    • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
    • Application of information is comprehensive and specific to the required topic.
    		 Presentation of information was good, but was superficial in places and included all of the following elements:

    • Applies principles, knowledge and information from scholarly resources to the required topic.
    • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
    • Application of information is comprehensive and specific to the required topic.
    		 Presentation of information was minimally demonstrated in the all of the following elements:

    • Applies principles, knowledge and information from scholarly resources to the required topic.
    • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
    • Application of information is comprehensive and specific to the required topic.
    		 Presentation of information is unsatisfactory in one of the following elements:

    • Applies principles, knowledge and information from scholarly resources to the required topic.
    • Applies facts, principles or concepts learned from and scholarly resources to a professional experience.
    • Application of information is comprehensive and specific to the required topic.
    		 Presentation of information is unsatisfactory in two of the following elements:

    • Applies principles, knowledge and information from scholarly resources to the required topic.
    • Applies facts, principles or concepts learned from scholarly resources to a professional experience.
    • Application of information is comprehensive and specific to the required topic.
    		 Presentation of information is unsatisfactory in three of the following elements

    • Applies principles, knowledge and information and scholarly resources to the required topic.
    • Applies facts, principles or concepts learned scholarly resources to a professional experience.
    • Application of information is comprehensive and specific to the required topic.
       10 Points 9 Points  6 Points  0 Points
    Interactive Dialogue

    Initial post should be a minimum of 300 words (references do not count toward word count)

    The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count)

    Responses are substantive and relate to the topic.

    		 Demonstrated all of the following:

    • Initial post must be a minimum of 300 words.
    • The peer and instructor responses must be a minimum of 150 words each.
    • Responses are substantive
    • Responses are related to the topic of discussion.
    		 Demonstrated 3 of the following:

    • Initial post must be a minimum of 300 words.
    • The peer and instructor responses must be a minimum of 150 words each.
    • Responses are substantive
    • Responses are related to the topic of discussion.
    		 Demonstrated 2 of the following:

    • Initial post must be a minimum of 300 words.
    • The peer and instructor responses must be a minimum of 150 words each.
    • Responses are substantive
    • Responses are related to the topic of discussion.
    		 Demonstrated 1 or less of the following:

    • Initial post must be a minimum of 300 words.
    • The peer and instructor responses must be a minimum of 150 words each.
    • Responses are substantive
    • Responses are related to the topic of discussion.
      8 Points 7 Points  6 Points         5 Points          4 Points  0 Points
    Grammar, Syntax, APA

    Points deducted for improper grammar, syntax and APA style of writing.

    The source of information is the APA Manual 6th Edition

    Error is defined to be a unique APA error. Same type of error is only counted as one error.

    		 The following was present:

    • 0-3 errors in APA format

    AND

    • Responses have 0-3 grammatical, spelling or punctuation errors

    AND

    • Writing style is generally clear, focused on topic,and facilitates communication.
    		 The following was present:

    • 4-6 errors in APA format.

    AND/OR

    • Responses have 4-5 grammatical, spelling or punctuation errors

    AND/OR

    • Writing style is somewhat focused on topic.
    		 The following was present:

    • 7-9 errors in APA format.

    AND/OR

    • Responses have 6-7 grammatical, spelling or punctuation errors

    AND/OR

    • Writing style is slightly focused on topic making discussion difficult to understand.
    		  

    The following was present:

    • 10- 12 errors in APA format

    AND/OR

    • Responses have 8-9 grammatical, spelling and punctuation errors

    AND/OR

    • Writing style is not focused on topic, making discussion difficult to understand.
    		  

    The following was present:

    • 13 – 15 errors in APA format

    AND/OR

    • Responses have 8-10 grammatical, spelling or punctuation errors

    AND/OR

    • Writing style is not focused on topic, making discussion difficult to understand.

    AND/OR

    • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.
    		 The following was present:

    • 16 to greater errors in APA format.

    AND/OR

    • Responses have more than 10 grammatical, spelling or punctuation errors.

    AND/OR

    • Writing style does not facilitate communication
      0 Points Deducted 5 Points Lost
    Participation

    Requirements

    		Demonstrated the following:

    • Initial, peer, and faculty postings were made on 3 separate days
    		 Failed to demonstrate the following:

    • Initial, peer, and faculty postings were made on 3 separate days
      0 Points Lost 5 Points Lost
    Due Date Requirements Demonstrated all of the following:

    • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

    A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

    		Demonstrates one or less of the following.

    • The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

    A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.