Deficit Hyperactivity Disorder


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The Assignment

Examine Case Study: A Young Caucasian Babe With ADHD You will be asked to accomplish three decisions apropos the medication to appoint to this client. Be abiding to accede factors that adeptness appulse the client’s pharmacokinetic and pharmacodynamic processes.

At anniversary accommodation point stop to complete the following:

At anniversary accommodation point stop to complete the following:

  • Decision #1
    • Which accommodation did you select?
    • Why did you baddest this decision? Support your       response with affirmation and references to the Learning Resources.
    • What were you acquisitive to accomplish by authoritative this       decision? Support your acknowledgment with affirmation and references to the       Learning Resources.
    • Explain any aberration amid what you accepted to       achieve with Accommodation #1 and the after-effects of the decision. Why were they       different?
  • Decision #2
    • Why did you baddest this decision? Support your       response with affirmation and references to the Learning Resources.
    • What were you acquisitive to accomplish by authoritative this       decision? Support your acknowledgment with affirmation and references to the       Learning Resources.
    • Explain any aberration amid what you accepted to       achieve with Accommodation #2 and the after-effects of the decision. Why were they       different?
  • Decision #3
    • Why did you baddest this decision? Support your       response with affirmation and references to the Learning Resources.
    • What were you acquisitive to accomplish by authoritative this       decision? Support your acknowledgment with affirmation and references to the       Learning Resources.
    • Explain any aberration amid what you accepted to       achieve with Accommodation #3 and the after-effects of the decision. Why were they       different?

case Study and the decisions

BACKGROUND

Katie is an 8 year old Caucasian changeable who is brought to your appointment today by her mother & father. They address that they were referred to you by their primary affliction provider afterwards gluttonous her admonition because Katie’s abecedary adapted that she may accept ADHD. Katie’s parents arise that their PCP acquainted that she should be evaluated by psychiatry to actuate whether or not she has this condition.

The parents accord the PMHNP a archetype of a anatomy titled “Conner’s Abecedary Rating Scale-Revised”. This calibration was abounding out by Katie’s abecedary and beatific home to the parents so that they could allotment it with their ancestors primary affliction provider. According to the scoring provided by her teacher, Katie is inattentive, calmly distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her absorption amount is short, and she is acclaimed to alone pay absorption to things she is absorbed in. The abecedary opined that she lacks absorption in academy assignment and is calmly distracted. Katie is additionally acclaimed to alpha things but never accomplishment them, and hardly follows through on instructions and fails to accomplishment her academy work.

Katie’s parents actively abjure that Katie has ADHD. “She would be active about like a agrarian being if she had ADHD” letters her mother. “She is never aggressive or has atmosphere outburst” adds her father.

SUBJECTIVE

Katie letters that she doesn’t apperceive what the “big deal” is. She states that academy is “OK”- her admired capacity are “art” and “recess.” She states that she finds her alternative capacity boring, and sometimes adamantine because she feels “lost”. She admits that her apperception does aberrate during chic to things that she thinks of as added fun. “Sometimes” Katie letters “I will aloof be cerebration about annihilation and the abecedary will alarm my name and I don’t apperceive what they were talking about.”

Katie letters that her home activity is aloof fine. She letters that she loves her parents and that they are actual acceptable and affectionate to her. Denies any abuse, denies blowing at school. Offers no alternative apropos at this time.

MENTAL STATUS EXAM

The applicant is an 8 year old Caucasian changeable who appears appropriately developed for her age. Her accent is clear, coherent, and logical. She is appropriately aggressive to person, place, time, and event. She is dressed appropriately for the acclimate and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported affection is euthymic. Affect is bright. Katie denies beheld or audition hallucinations, no delusional or batty anticipation processes readily appreciated. Absorption and absorption are grossly complete based on Katie’s accessory to the analytic account and her adeptness to calculation backwards from 100 by consecutive 2’s and 5’s. Insight and acumen arise age appropriate. Katie denies any baleful or bloodthirsty ideation.

Diagnosis: Absorption arrears hyperactivity disorder, predominantly absent presentation

Decision Point One

Select what the PMHNP should do:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-red.pngBegin Wellbutrin (bupropion) XL 150 mg orally daily

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-blue.pngBegin Intuniv continued absolution 1 mg orally at BEDTIME

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-yellow.pngBegin Ritalin (methylphenidate) chewable tablets 10 mg orally in the MORNING

Decision Point Two

Select what the PMHNP should do next:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-red.pngContinue aforementioned dosage of Ritalin and amend in 4 week

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-blue.pngChange to Ritalin LA 20 mg orally circadian in the MORNING

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-yellow.pngDiscontinue Ritalin and activate Adderall XR 15 mg orally daily

Decision Point Three

Select what the PMHNP should do next:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-red.pngMaintain accepted dosage of Ritalin LA and reevaluate in 4 weeks

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-blue.pngIncrease Ritalin LA to 30 mg orally daily

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-yellow.pngObtain EKG based on accepted affection rate

Decision Point One

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-yellow.pngBegin Ritalin (methylphenidate) chewable tablets 10 mg orally in the MORNING

RESULTS OF DECISION POINT ONE

  • Client      returns to dispensary in four weeks
  • Katie’s      parents address that they batten with Katie’s abecedary who notices that her      symptoms are abundant bigger in the morning, which has resulted in advance      in her all-embracing bookish performance. However, by the afternoon, Katie is      “staring off into space” and “daydreaming” again
  • Katie’s      parents are actual concerned, however, because Katie arise that her      “heart acquainted funny.” You access a beating amount and acquisition that Katie’s affection is      beating about 130 beats per minute

Decision Point Two

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-blue.pngChange to Ritalin LA 20 mg orally circadian in the MORNING

RESULTS OF DECISION POINT TWO

  • Client      returns to dispensary in four weeks
  • Katie’s      academic achievement is still improved, and the about-face to the LA      preparation is abiding Katie throughout the academy day
  • Katie’s      reports of her affection activity “funny” accept gone away. Beating was 92 during      today’s appointment visit

Decision Point Three

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/09/mm/attention_deficit_hyperactivity_disorder/img/pill-red.pngMaintain accepted dosage of Ritalin LA and reevaluate in 4 weeks

Guidance to Student

 

At this point, Katie’s affection are able-bodied controlled (her absorption is abiding throughout the academy day) and her ancillary furnishings accept gone abroad afterward change to a long-acting preparation. There is no adumbration at this point that the dosage should be added as it is consistently adapted to use the everyman able dosage of analeptic medication. Katie’s affection amount is adapted for an 8 year old babe and an EKG would not be adumbrated based on her affection rate.

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