NURS 6630 Assessing and Treating Patients With ADHD

Sample Answer for NURS 6630 Assessing and Treating Patients With ADHD Included After Question

NURS 6630 Assessing and Treating Patients With ADHD

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. 

RESOURCES 

 

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.  

WEEKLY RESOURCES 

 

LEARNING RESOURCES 

Required Readings 

  • 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. 
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 
  • Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS DrugsLinks to an external site., 26(3), 245–268. https://doi.org/10.2165/11599630-000000000-00000 
  • Martin, L. (2020). A 5-question quiz on ADHD. Psychiatric TimesLinks to an external site.. https://www.psychiatrictimes.com/view/5-question-quiz-adhd 

Medication Resources 

Note: To access the following medications, use the Drugs@FDA resource. Type the name of each medication in the keyword search bar. Select the hyperlink related to the medication name you searched. Review the supplements provided and select the package label resource file associated with the medication you searched. If a label is not available, you may need to conduct a general search outside of this resource provided. Be sure to review the label information for each medication as this information will be helpful for your review in preparation for your Assignments. 

  • armodafinil 
  • amphetamine (d) 
  • amphetamine (d,l) 
  • atomoxetine 
  • bupropion 
  • chlorpromazine 
  • clonidine 
  • guanfacine 
  • haloperidol 
  • lisdexamfetamine 
  • methylphenidate (d) 
  • methylphenidate (d,l) 
  • modafinil 
  • reboxetine 

Required Media 

Note: This case study will serve as the foundation for this week’s Assignment. 

 

 

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 formattingLinks to an external site.. 

BY DAY 7 

Submit your Assignment.  

SUBMISSION INFORMATION 

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.  

  1. To submit your completed assignment, save your Assignment as WK9Assgn_LastName_Firstinitial 
  1. Then, click on Start Assignment near the top of the page. 
  1. Next, click on Upload File and select Submit Assignment for review. 

 

Rubric 

NURS_6630_Week9_Assignment_Rubric 

NURS_6630_Week9_Assignment_Rubric 
Criteria  Ratings  Pts 
This criterion is linked to a Learning OutcomeIntroduction 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. 
10 to >8.0 pts 

Excellent Point range: 90–100 

The response accurately, clearly, and fully summarizes in detail the case for the Assignment…. The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient. 

8 to >7.0 pts 

Good Point range: 80–89 

The response accurately summarizes the case for the Assignment…. The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient. 

7 to >6.0 pts 

Fair Point range: 70–79 

The response inaccurately or vaguely summarizes the case for the Assignment…. The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. 

6 to >0 pts 

Poor Point range: 0–69 

The response inaccurately and vaguely summarizes the case for the Assignment, or is missing…. The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. 

 

10 pts 
This criterion is linked to a Learning OutcomeDecision #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 to >17.0 pts 

Excellent Point range: 90–100 

The response accurately and clearly explains in detail the decision selected…. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected…. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients…. Examples provided fully support the decisions and responses provided. 

17 to >15.0 pts 

Good Point range: 80–89 

The response accurately explains the decision selected…. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected…. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response…. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response…. The response accurately explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided support the decisions and responses provided. 

15 to >13.0 pts 

Fair Point range: 70–79 

The response inaccurately or vaguely explains the decision selected…. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected…. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided may support the decisions and responses provided. 

13 to >0 pts 

Poor Point range: 0–69 

The response inaccurately and vaguely explains the decision selected…. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing…. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing…. Examples provided do not support the decisions and responses provided, or is missing. 

 

20 pts 
This criterion is linked to a Learning OutcomeDecision #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 to >17.0 pts 

Excellent Point range: 90–100 

The response accurately and clearly explains in detail the decision selected…. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected…. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients…. Examples provided fully support the decisions and responses provided. 

17 to >15.0 pts 

Good Point range: 80–89 

The response accurately explains the decision selected…. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected…. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response…. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response…. The response accurately explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided support the decisions and responses provided. 

15 to >13.0 pts 

Fair Point range: 70–79 

The response inaccurately or vaguely explains the decision selected…. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected…. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided may support the decisions and responses provided. 

13 to >0 pts 

Poor Point range: 0–69 

The response inaccurately and vaguely explains in detail the decision selected…. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing…. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing…. Examples provided do not support the decisions and responses provided, or is missing. 

 

20 pts 
This criterion is linked to a Learning OutcomeDecision #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 to >17.0 pts 

Excellent Point range: 90–100 

The response accurately and clearly explains in detail the decision selected…. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected…. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients…. Examples provided fully support the decisions and responses provided. 

17 to >15.0 pts 

Good Point range: 80–89 

The response accurately explains the decision selected…. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected…. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response…. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response…. The response accurately explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided support the decisions and responses provided. 

15 to >13.0 pts 

Fair Point range: 70–79 

The response inaccurately or vaguely explains the decision selected…. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected…. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided may support the decisions and responses provided. 

13 to >0 pts 

Poor Point range: 0–69 

The response inaccurately and vaguely explains in detail the decision selected…. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing…. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing…. Examples provided do not support the decisions and responses provided, or is missing. 

 

20 pts 
This criterion is linked to a Learning OutcomeConclusion (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 to >13.0 pts 

Excellent Point range: 90–100 

The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient…. The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided. 

13 to >11.0 pts 

Good Point range: 80–89 

The response accurately summarizes the recommendations on the treatment options selected for this patient…. The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided. 

11 to >10.0 pts 

Fair Point range: 70–79 

The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient…. The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided. 

10 to >0 pts 

Poor Point range: 0–69 

The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing…. The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing. 

 

15 pts 
This criterion is linked to a Learning OutcomeWritten 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 to >4.0 pts 

Excellent Point range: 90–100 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 

4 to >3.5 pts 

Good Point range: 80–89 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time….Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. 

3.5 to >3.0 pts 

Fair Point range: 70–79 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic. 

3 to >0 pts 

Poor Point range: 0–69 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided. 

 

5 pts 
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 
5 to >4.0 pts 

Excellent Point range: 90–100 

Uses correct grammar, spelling, and punctuation with no errors. 

4 to >3.5 pts 

Good Point range: 80–89 

Contains a few (1 or 2) grammar, spelling, and punctuation errors. 

3.5 to >3.0 pts 

Fair Point range: 70–79 

Contains several (3 or 4) grammar, spelling, and punctuation errors. 

3 to >0 pts 

Poor Point range: 0–69 

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. 

 

5 pts 
This criterion is linked to a Learning OutcomeWritten 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 to >4.0 pts 

Excellent Point range: 90–100 

Uses correct APA format with no errors. 

4 to >3.5 pts 

Good Point range: 80–89 

Contains a few (1 or 2) APA format errors. 

3.5 to >3.0 pts 

Fair Point range: 70–79 

Contains several (3 or 4) APA format errors. 

3 to >0 pts 

Poor Point range: 0–69 

Contains many (≥ 5) APA format errors. 

 

5 pts 
Total Points: 100 

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A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With ADHD

Title: NURS 6630 Assessing and Treating Patients With ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a developmental psychiatric condition common in pediatric populations, although it also diagnosed in the adult population. It is diagnosed based on features attention deficits, hyperactivity, or impulsivity. The symptoms affect a patient’s level of functioning and cognitive ability (Cabral et al., 2020). The purpose of this assignment is to discuss the case of a child with ADHD, propose treatment interventions, and explain how ethical considerations impacted the patient’s treatment plan.

Case Overview

The case depicts an 8-year-old child, Katie, referred for psychiatric assessment of ADHD. Her teacher expressed concerns that she could have ADHD based on her behavior. Results from the ADHD assessment questionnaire filled by her teacher, shows that she has attention deficits, distracted, memory deficits, and has challenges in spelling, reading, and calculation. Besides, the child has a limited attention span, which is only better when doing things that she likes. Katie has less interest in school, fails to complete tasks, hardly adheres to instructions, and does not do her assignments.  However, her parents do not believe that she has ADHD because she is not defiant or have temper outbursts. Katie admits that her mind wanders in class and she often feels lost in her schoolwork. She is diagnosed with ADHD, inattentive presentation.

ADHD treatment comprises both pharmacological and psychotherapy interventions. However, various actors in this patient may impact treatment decisions, including her age, severity of ADHD symptoms, presence of other psychiatric comorbidities, drug allergies, and the parents’ treatment preferences (Childress, 2021).

Decision #1

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

Why This Decision was Selected

The patient was initiated on Ritalin because it is recommended as a first-line agent in treating ADHD in children older than six years. Ritalin is a psychostimulant and acts by increasing the activity of central dopamine and norepinephrine, the neurotransmitters involved in attention and executive function (Childress, 2021). Besides, Ritalin has tolerable side effects, which will promote medication compliance.

Bupropion was not selected since it is not approved by the FDA for ADHD in chuldren. It is usually prescribed off-label when stimulants are unsuccessful in treating ADHD and patients with comorbid conditions (Brown et al., 2018). Intuniv was not initiated because it is recommended as a second-line agent due to a lower efficacy than stimulants. The drug causes rebound hypertension if stopped abruptly and is thus a less ideal choice (Brown et al., 2018).

What I Hoped To Achieve

I hoped that Ritalin would alleviate ADHD symptoms within four weeks and that Katie’s teacher would report improved concentration and attention span in class. Feldman et al. (2018) explain that stimulants such as Ritalin improve academic performance in children with ADHD and their overall quality of life and lower the risk of children developing anxiety and depressive disorders later in life.

Ethical Considerations That May Affect the Treatment Plan

Ethical principles of nonmaleficence and beneficence influenced treatment decisions because the provider was obligated to select a treatment that would promote the best possible outcomes while promoting patient safety (Bipeta, 2019). Ritalin was selected because the evidence supports its efficacy in treating ADHD and its safety profile.

Decision #2

Switch to Ritalin LA 20 mg orally daily in the morning.

Why This Decision was Selected

Ritalin was changed to a long-acting formulation since the effects of the immediate-release preparation were only sustained for a limited duration. The half-life of immediate-release preparation is about four hours and should be administered 2-3 times per day to sustain the effects (Steingard et al., 2019). However, the long-acting preparation has a longer half-life of 10–12 hours, and its effects are sustained a whole day. Therefore, a long-acting formulation was the ideal choice for this patient so that she could concentrate in class the entire day.

The choice to continue the same Ritalin dose and reassess after four weeks was not appropriate because the patient had low concentration levels and was daydreaming in the afternoon. The symptoms would have persisted or worsened if the dose was not adjusted to either a long-acting formulation or 2-3 times daily dosing (Steingard et al., 2019). Besides, stopping Ritalin and starting Adderall XR was not ideal because stimulants should only be stopped if the maximum dose is not effective.

What I Hoped To Achieve

I expected that switching to a long-acting formulation would maintain the Ritalin’s effects for longer period. Katie’s teacher would report that she had adequate attention and concentration levels throughout the day. Long-acting stimulants act in phases to suppress ADHD symptoms throughout the day. A fraction of the dose is released immediately, while the rest goes into effect hours later (Steingard et al., 2019). Long-acting stimulants usually wear off in 12 to 16 hours.

Ethical Considerations That May Affect the Treatment Plan

Beneficence impacted the treatment plan since the clinician had to change the Ritalin dose to a formulation with better treatment outcomes than the initial one (Bipeta, 2019). The decision was selected with the patient’s well-being in mind, which means that beneficence was upheld.

Decision #3

Maintain the current Ritalin LA dose and reevaluate in 4 weeks.

Why This Decision was Selected

This was an ideal decision since the patient responded adequately to the Ritalin LA 20 mg. The patient had an improved academic performance and the effects of LA Ritalin lasted the entire day. The dose was also maintained since there were no reported side effects of the drug, and it was thus safe to continue. Brown et al. (2018) explain that pharmacologic treatment of ADHD in children and adolescents should start with long-acting stimulant drugs in most cases.

It was not ideal for increasing Ritalin LA to 30 mg since the initial 20 mg dose worked effectively and lasted the whole day with a single dose. Besides, a higher dose may result in side effects, which would be undesirable. An EKG was not also requested since the palpitations had diminished and the heart rate was normal. Advanced cardiac exams such as EKG are recommended if a patient presents with side effects of chest pain, loss of consciousness, and symptoms suggestive of heart disease (Brown et al., 2018).

What I Hoped To Achieve

I expected that maintaining Ritalin LA would continue to alleviate the patient’s ADHD and improve her school grades. Childress (2021) explains that daytime functioning and evening commitments should influence the chosen stimulant formulation. A long-acting formulation should be chosen as an alternative to an immediate release to improve adherence and lower the risk of misuse.

Ethical Considerations That May Affect the Treatment Plan

Nonmaleficence impacted the treatment plan since the clinician had to choose the safest treatment intervention with a lower risk of harming the patient (Bipeta, 2019). Interventions that pose a risk to the patient were not selected, such as increasing the dose or changing the drug.

NURS 6630 Assessing and Treating Patients With ADHD Conclusion

Katie presented with symptoms of distractibility and inattention mainly observed in school. The patient factors that would impact prescribing decisions include age, the severity of symptoms, the presence of other psychiatric comorbidities, drug allergies, and the parents’ treatment preferences (Childress, 2021). The patient was initiated with Ritalin chewable tablets 10 mg since it is an FDA-approved drug for treating ADHD in children from six years. The drug also has a tolerable safety profile (Childress, 2021). Although the patient’s concentration and attention improved, the drug did not sustain the effects the whole day, and the symptoms recurred in the afternoon. As a result, immediate release Ritalin was switched to a LA formulation to maintain its effects for longer.

The long-acting formulation adequately sustained the drug’s desired effects the whole school day. As a result, the patient’s academic performance improved, and she reported the palpitations had abated. The patient was maintained on the Ritalin LA 20 mg dose since there were no reported side effects and the desired treatment outcomes were attained (Steingard et al., 2019). Increasing the dose might have resulted in side effects and was thus not recommended. Beneficence and nonmaleficence impacted the treatment plan. The clinician had to select treatment interventions associated with the best outcomes and least side effects to promote the best treatment outcomes without compromising the patient’s safety.

 

NURS 6630 Assessing and Treating Patients With ADHD References

Bipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care. Indian journal of psychological medicine41(2), 108–112. https://doi.org/10.4103/IJPSYM.IJPSYM_59_19

Brown, K. A., Samuel, S., & Patel, D. R. (2018). Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners. Translational Pediatrics7(1), 36–47. https://doi.org/10.21037/tp.2017.08.02

Cabral, M. D. I., Liu, S., & Soares, N. (2020). Attention-deficit/hyperactivity disorder: diagnostic criteria, epidemiology, risk factors and evaluation in youth. Translational Pediatrics9(Suppl 1), S104. https://doi.org/10.21037/tp.2019.09.08

Childress, A. C. (2021). Novel Formulations of ADHD Medications: Stimulant Selection and Management. Focus (American Psychiatric Publishing)19(1), 31–38. https://doi.org/10.1176/appi.focus.20200032

Steingard, R., Taskiran, S., Connor, D. F., Markowitz, J. S., & Stein, M. A. (2019). New Formulations of Stimulants: An Update for Clinicians. Journal of child and adolescent psychopharmacology29(5), 324–339. https://doi.org/10.1089/cap.2019.0043

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)

NURS 6630 Assessing and Treating Patients With ADHD
NURS 6630 Assessing and Treating Patients With ADHD
  • 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 theNURS 6630 Assessing and Treating Patients With ADHDprimary 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.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.

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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.

 

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK9Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 9 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 9 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.

NURS 6630 Assessing and Treating Patients With ADHD Grading Criteria

 

To access your rubric:

Week 9 Assignment Rubric

 

Check Your Assignment Draft for Authenticity

 

To check your Assignment draft for authenticity:

Submit your Week 9 Assignment draft and review the originality report.

 

Submit Your Assignment by Day 7 of Week 9

To participate in this Assignment:

Week 9 Assignment

Lopes Write Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource