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:
Case Study: A Young Caucasian Girl with ADHD
Note: This case study will serve as the foundation for this week’s 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 patientspecific resources, including the primary literature

Rubric, case study and problem statement in detail is also attached. Please let me know if you need me to send any resources which are listed in the materials



Expert Solution Preview

Introduction:
The Assignment requires an evaluation of a case study of a young Caucasian girl with Attention Deficit Hyperactivity Disorder (ADHD) and making decisions on the medications to prescribe. As a psychiatric nurse practitioner, careful assessments are needed, and the risks and benefits of medication therapies for patients across various life stages must be weighed. This paper will evaluate how to assess and treat patients with ADHD and provide recommendations for this specific patient.

Decision #1:
The selected decision is to prescribe 18mg of Concerta, a stimulant medication for the patient. This medication is commonly prescribed for ADHD symptoms and has a duration of 12 hours, which is beneficial for school and homework. The dosage can be titrated up or down based on the patient’s response. One reason for selecting this medication is that it has been found to improve attention and behavioral control. Additionally, research suggests that long-term treatment with Concerta does not have any adverse effects on growth. The two options were not selected because Adderall can increase heart rate, and non-stimulants such as Strattera may take time to take effect. The aim is to improve the patient’s attention and behavioral control while avoiding any adverse effects.

Ethical considerations must be acknowledged, and consent must be obtained from the patient or their guardian before prescribing the medication. The patient should be made aware of the potential risks and benefits of the medication, and close monitoring of any potential side effects should be done.

Decision #2:
The selected decision is to continue the prescription with the same medication with an increased dosage of 27mg of Concerta. This is based on the patient’s response to the initial dose. Research suggests that treatment with Concerta yields better improvements in symptom control than Strattera. Additionally, the extended-release formulation of Concerta may reduce the likelihood of medication abuse.

The other two options were not selected because increasing the dose of Adderall can cause side effects such as insomnia and irritability, while Strattera may take longer to show the desired effect. Ethical considerations must be considered, and the patient should have regular check-ins with the clinician to monitor their response and any side effects.

Decision #3:
The selected decision is to continue the prescription with the same medication of 27mg of Concerta and monitor the patient’s response. This decision is based on the fact that Concerta has been found to be an effective treatment for patients with ADHD. It also has a longer duration of action, which is beneficial for long school days. The goal is to maintain the patient’s symptom control and improve their academic and social function.

The other two options have not been selected because increasing the Adderall dose can lead to negative side effects, and the effects of Strattera may take time to manifest. Regular monitoring and close communication with the patient and their family members are essential due to ethical considerations.

Conclusion:
The case study evaluated an ADHD patient, and based on clinical evidence and patient-specific factors, decisions on medication prescriptions were made. The use of Concerta was deemed appropriate for the patient’s symptoms, and careful monitoring and ethical considerations were recommended for each decision. As a psychiatric nurse practitioner, it is important to weigh the risks and benefits of medication therapies and communicate clearly with the patient and their family members about the treatment plan.