Assignment: Assessing and Treating Patients With ADHD

Assignment: Assessing and Treating Patients With ADHD
Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD.
To prepare for this Assignment:
• Review this week’s Learning Resources, including the Medication Resources indicated for this week.
• Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD.
The Assignment: 5 pages
Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
• Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Conclusion (1 page)
• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.Need to follow rubric exactly.
Needs at least 6 scholarly references that are current and relevant from the past 5 yearsHere is the instructors information.
Here is a general framework for what I am looking for on the decision tree assignments. Provide an introduction to the disease state discussed in the case. I am looking for a high-level summary that briefly describes the key aspects of that disease state. I do not want several pages of information related to the diagnosis of the disease state. Provide a high-level summary of the important pieces of information from the case-study that is presented. I do not want the entire case study presented. The goal is that you would be able to give your essay to someone that does not know anything about the assignment and for that individual to be able to understand the purpose of your essay. Again….focus on the important pieces of information that will help you make your decision. You also want to mention the purpose of the assignment. This can be brief. Decision Point 1, 2, and 3. At each decision point, list the options that are presented and describe your rationale for choosing the option you chose. I do not want general answers….”I chose sertraline because sertraline is an SSRI and SSRIs are approved for depression/anxiety”. I want VERY SPECIFIC reasons you chose the option you chose. These reasons must be backed by good evidence. Feel free to include studies comparing agents, side effects, dosing, patient considerations, therapeutic practice guidelines, comorbid conditions, etc…. You will also need to explain your rationale for not choosing the other two options. This is very important in your learning. Please remember that you will have MANY more medications to choose from than three in clinical practice. When you make your choice, you also need to describe your goals of treatment. What do you want to achieve by initiating the therapy you picked. Again….be specific. Defend your choices like you are in a courtroom. After each decision, you will be presented with the outcome of that decision. You need to discuss how that outcome was what you expected or if it was different than what you expected and why. You will do the above for all three decision points. You need to use evidence to support your rationale. [Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. Credible reference material only will be accepted. Sites such as WebMD and drugs.com (among others) will not be counted.]
Note about providing evidence…….. Please note that you need to be VERY SPECIFIC when describing the reason you chose the decision you made for each decision point. I cannot stress this enough. Here are some examples of what I do NOT want: • I chose sertraline (ZOLOFT) because it is an SSRI that treats depression. • Paroxetine (PAXIL) was chosen because paroxetine increases the levels of serotonin in the brain. • I decided to prescribe bupropion (Wellbutrin) because data supports the use of bupropion in…… • Think about the patient you are treating. I have had students discuss concerns with erectile dysfunction in pediatric patients and female patients on multiple occasions. You want to consider the patient you are treating. Here are some examples of what I DO want: • “As the PMHNP caring for this client, Zoloft 25 mg daily would be the first choice of therapy for this patient. Selective Serotonin Reuptake Inhibitors (SSRIs) are known to be the first line of treatment for children with depression (DeFilippis & Wagner, 2014). While sertraline and paroxetine are both SSRIs, sertraline is FDA approved when treating children whereas paroxetine has been found to be affective when treating children with depression, it is not specifically approved by the FDA at this point in time (Stahl, 2014b).” • “Paroxetine is not recommended in use for children due to its short half-life which can lead to withdrawal when the medication is stopped abruptly (Nathan & Gorman, 2015).” • Evidence supporting the effectiveness of one agent over another. How did one agent perform when compared to another medication in clinical trials. I really like seeing these types of comparisons. • What do the guidelines recommend? You can typically find the reason for their recommendation in the body of the guidelines. • What side effects are the most concerning for the patient case study? For example: you wouldn’t want to prescribe a medication that causes excessive sedation in a patient that operates heavy machinery or drives transport trucks across the country. • Consider genetics and the role genetics have in drug metabolism. • Evaluate for the potential for drug-drug interactions. The main point is to be very specific regarding the reason you made your choice. I have posted the essay requirements as a checklist. I would strongly recommend using the checklist prior to submitting your decision tree assignments to make sure you included the required information. Don’t forget to include information related to the ethical considerations and how they might impact your treatment plan and communication with your clients. In summary: What needs to be in your essay. Use this as a checklist prior to submitting each decision tree essay.RUBRICIntroduction 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.
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.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.
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.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.
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.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.
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.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.
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.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.
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.Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Uses correct grammar, spelling, and punctuation with no errors.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.
Uses correct APA format with no errors.
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