Decision Tree Case Study
MUST BE ABLE TO COMPLETE DECISION TREE, INCLUDE CASE STUDY IN PAPER, and PROPERLY COMPLETE ASSIGNMENT IN ITS ENTIRETY
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.
Outcome Introduction to the case (1 page)Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. — 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.
Outcome Decision #1 (1–2 pages)• Which decision did you select?• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.— 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.
Outcome Decision #2 (1–2 pages)• Which decision did you select?• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.— 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.
Outcome Decision #3 (1–2 pages)• Which decision did you select?• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. — 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
Outcome Conclusion (1 page)• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.— 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.
CASE STUDY LINK— https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6630/DT/week_09/index.html
Assessing and Treating Patients with ADHD: A Case Study
Introduction
In this case study, we will examine the case of a young Caucasian girl with ADHD. We will explore the factors that may impact decision-making when prescribing medication for this patient. ADHD is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity. It is important to consider the unique needs and characteristics of each patient when assessing and treating ADHD.
The specific patient factors that may impact decision-making in this case include the age of the patient, her gender, her ethnicity, her medical history, and any comorbid conditions. These factors can influence the choice of medication, dosing, and potential side effects.
Decision #1
In decision #1, I would recommend prescribing methylphenidate, specifically Concerta, as the initial medication for this patient. Methylphenidate is a stimulant medication commonly used in the treatment of ADHD. It helps to improve attention, reduce hyperactivity, and control impulsivity.
I selected this decision because methylphenidate has a long history of effectiveness in treating ADHD symptoms in children. It is one of the most widely studied and prescribed medications for ADHD. There is a substantial body of evidence supporting its efficacy and safety in pediatric populations.
I did not select the other two options provided in the exercise. Atomoxetine, a non-stimulant medication, is an alternative choice for patients who cannot tolerate or do not respond to stimulant medications. However, given the patient’s age and the lack of specific contraindications, stimulant treatment should be considered as the first-line option. The third option, guanfacine extended-release, is also a non-stimulant medication commonly used in the treatment of ADHD. However, the evidence supporting its use in pediatric populations is not as robust as the evidence for methylphenidate.
By prescribing methylphenidate, the goal is to improve the patient’s attention, reduce hyperactivity, and enhance impulse control. Methylphenidate acts by increasing the availability of dopamine and norepinephrine in the brain, which are neurotransmitters involved in attention and impulse regulation. By addressing these core symptoms of ADHD, the patient’s overall functioning and quality of life can be improved.
Ethical considerations play a crucial role in the treatment plan and communication with patients. In the case of ADHD, it is essential to ensure informed consent from both the patient and the parents or legal guardians. The potential benefits and risks of medication therapy should be clearly communicated, and any concerns or questions from the patient and their family should be addressed. Open and honest communication, respect for autonomy, and the principle of beneficence are essential in ethical decision-making.
Decision #2
In decision #2, I would recommend continuing with the current medication, methylphenidate (Concerta), at the current dose. Continuation of medication is a common approach in the treatment of ADHD, as long-term management is often necessary to maintain symptom control and optimize functioning.
I did not select the other two options provided in the exercise. Increasing the dose of methylphenidate may be considered if the patient is not experiencing sufficient symptom improvement or if side effects are minimal. However, in this case, the decision to continue with the current dose is based on the assumption that the patient is responding well to the medication and experiencing symptom reduction without significant side effects. Switching to another stimulant medication, such as dextroamphetamine, may be an option if the patient is not responding adequately to methylphenidate. However, since the current medication is effective, it is reasonable to continue with it.
By continuing with the current medication, the goal is to maintain symptom control and optimize the patient’s functioning. Regular monitoring and follow-up will be necessary to assess the ongoing efficacy and safety of the medication.
Ethical considerations continue to be important in the treatment plan and communication with patients. Regular evaluation of the patient’s response to medication, side effects, and any concerns or questions they may have should be addressed. Collaboration and shared decision-making with the patient and their family are essential in ensuring the best possible outcomes.
Decision #3
In decision #3, I would recommend adding behavioral therapy, specifically cognitive-behavioral therapy (CBT), as an adjunct to medication treatment. CBT is a evidence-based approach that helps individuals with ADHD develop skills to manage their symptoms, improve organizational skills, and address any co-occurring psychological issues, such as anxiety or low self-esteem.
I did not select the other two options provided in the exercise. Increasing the dose of methylphenidate may be considered if the patient is not experiencing sufficient symptom improvement or if side effects are minimal. However, since the patient is already responding well to the current dose, adding behavioral therapy would be a more appropriate next step. Switching to another stimulant medication, such as dextroamphetamine, may also be an option if the patient is not responding adequately to methylphenidate. However, given the effectiveness of the current medication, adding behavioral therapy would be a more comprehensive approach.
By adding behavioral therapy to the treatment plan, the goal is to provide the patient with additional strategies and coping skills to manage their symptoms and improve their overall functioning. CBT can help the patient develop effective organizational skills, improve time management, and address any co-occurring psychological issues that may be