Decision tree | Nursing homework help


 

BACKGROUND

In psychopharmacology you met Katie, an 8-year-old Caucasian womanly, who was brought to your appointment by her dowager (age 47) and senior (age 49). You worked through the occurrence by recommending practicservicecogent ADHD medications. As you growth in your PMHNP program, the occurrences gain entangle over notification for you to genus through.

For this occurrence, you see Katie and her parents repeatedly. The parents entertain reputed that the medication absorbed to Katie does not look to be accelerationing. This has prompted you to remeditate the singularity of ADHD. You gain meditate other irrelativeial diagnoses and indicate what notification you demand to precisely assess the DSM-5 criteria to shape the singularity of ADHD or another empiricism after a opportunity low cue features.

When parents bear their slip to your appointment, they may entertain interpret symptoms on the internet or they may entertain been told by the nurture “your slip has ADHD”. Your singularity gain either stabilitate or disprove that singularity.

Katie’s parents reputed that their PCP felt that she should be evaluated by psychiatry to indicate a irrelativeial singularity and to prepare medication, if implied. The PMHNP shapes this cue firmness naturalized on meetings and observations of the slip, her parents, and the duty of the parents and pedagogue.

To set-on-foot, meditate what duty tools you government demand to evaluate Katie.

  • Child Behavior Check List
  • Conners’ Pedagogue Rating Scale

The parents produce the PMHNP a vision of a constitute titled “Conner’s Pedagogue Rating Scale-Revised” (Availservicecogent at: https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000099.1 ). This flake was occupied out by Katie’s pedagogue and sent abode to the parents so that they could divide it after a opportunity their provider. According to the scoring granted by her pedagogue, Katie is inconsiderate, easily bewildered, shapes defective mistakes in her nurturework, forgets things she already versed, is penniless in spelling, interpreting, and arithmetic. Her attendation span is abrupt, and she is eminent to barely pay attendation to things she is careful in. She has inaptitude interacting after a opportunity peers in the rankspace and likes to dramatize by herself at nook.

When meetinging Katie’s parents, you ask encircling pre- and post-natal narrative and you voice that Katie is the chief born after a opportunity parents who were terminate to 40 years old when she was born. She had a low 5 specific Apgar score. The parents say that she met regular developmoral milestones and perchance had some inaptitude after a opportunity snooze during the pre-nurture years. They mark that Katie has inaptitude socializing after a opportunity peers, she is hush at abode and spends a lot of date guarding TV.

SUBJECTIVE

You respect Katie in the appointment and she is not serviceservicecogent to sit quiescent during the meeting. She is eternally interrupting twain you and her parents. Katie declarations that nurture is “OK”- her cosset subjects are “art” and “recess.” She states that she finds some subjects boring or too involved, and casually flinty owing she feels “lost”. She advances that her dainty does abandon during rank. “Sometimes” Katie declarations “I gain proper be thinking encircling celebrity else and not looking at the pedagogue or other students in the rank.”

Katie declarations that her abode history is proper filmy. She declarations that she loves her parents and that they are very cheerful-tempered-tempered and bark to her. Denies any abuse, denies frank at nurture. She offers no other concerns at this date.

Katie’s parents show subordinately uneasy encircling their daughter’s problems. You mark the dowager is fidgeting after a opportunity her rings and guard opportunity you are talking. The senior is tapping his foundation. Other than that, they look cool and rectilinear self-assertive in the meeting regularity.

MENTAL STATUS EXAM

The client is an 8-year-old Caucasian womanly who shows well-mannered-behaved-behaved exposed for her age. Her oration is absolved, entire, and argumentative. She is well-mannered-behaved-behaved oriented to peculiar, locate, date, and episode. She is mature well-mannered-behaved-behaved for the sphere and date of year. She demonstrates no voiceworthy mannerisms, gestures, or tics. Self-reputed humor is euthymic. Affect is unavowed. Katie says that she doesn’t incline any ‘voices’ in her mind but does advance to having an unreal adherent, ‘Audrey’. No declarations of delusional or paranoid purpose regularityes. Consideration and care are subordinately scant naturalized on Katie’s abrupt answers to your questions.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHAT IS YOUR DIAGNOSIS FOR KATIE?
In your write-up of this occurrence, be assured to attach specific symptoms presented in the occurrence to DSM–5 criteria to patronage your singularity.

 

The Assignment:

Examine Case 1. You gain be asked to shape three firmnesss regarding the singularity and matter for this client. Be knowing to meditate co-morbid material as well-mannered-behaved-behaved as moral factors that government application the client’s singularity and matter.

At each Firmness Point, seal to entire the following:

  • Decision #1: Differential Diagnosis
    • Which Firmness did you picked?
    • Why did you picked this Decision? Patronage your tally after a opportunity sign and references to the Learning Resources.
    • What were you hoping to consummate by making this Decision? Patronage your tally after a opportunity sign and references to the Learning Resources.
    • Explain any unlikeness betwixt what you expected to consummate after a opportunity Firmness #1 and the results of the Decision. Why were they irrelative?
  • Decision #2: Matter Drawing for Psychotherapy
    • Why did you picked this Decision? Patronage your tally after a opportunity sign and references to the Learning Resources.
    • What were you hoping to consummate by making this Decision? Patronage your tally after a opportunity sign and references to the Learning Resources.
    • Explain any unlikeness betwixt what you expected to consummate after a opportunity Firmness #2 and the results of the Decision. Why were they irrelative?
  • Decision #3: Matter Drawing for Psychopharmacology
    • Why did you picked this Decision? Patronage your tally after a opportunity sign and references to the Learning Resources.
    • What were you hoping to consummate by making this Decision? Patronage your tally after a opportunity sign and references to the Learning Resources.
    • Explain any unlikeness betwixt what you expected to consummate after a opportunity Firmness #3 and the results of the firmness. Why were they irrelative?
  • Also discern how holy meditateations government application your matter drawing and message after a opportunity clients and their families.

 Decision Point One
A-i pickeded Consideration Arrears Hyperactivity Disorder, predominantly inconsiderate introduction

B- Firmness Point Two

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.Explain why i did not picked Autism Spectrum Empiricism (ASD), lenient and co-occurring;  and why i did not picked Specific Learning Empiricism after a opportunity Impairment in Balbutiation and 315.1 Impairment in Mathematics

RESULTS OF DECISION POINT ONE

  • Client insucceed to clinic in impure weeks
  • You pickeded Consideration arrears hyperactivity empiricism, predominantly inconsiderate introduction. Naturalized on this dainty, sketch the rest of the cue evaluation that you gain precede on this slip and their parents. Be knowing to discern standardized duty instruments that you would administer

 Decision Point Two

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

A-I SELECTED  

Begin Adderall XR 10 mg orally daily

B- EXPLAIN WHY YOU DID NOT SELECT  Wellbutrin 75 mg orally daily

 AND DID NOT SELECT Strattera 25 mg orally daily

 

RESULTS OF DECISION POINT TWO

  • Client insucceed to clinic in impure weeks
  • Katie’s parents look categorically joyous upon their repay stating that Katie is paying over attendation in nurture, but voice that there is quiescent space for correction, in-particular in the afternoon
  • They declaration that Katie’s pedagogue has reputed that Katie is serviceservicecogent to conduct her attendation throughout the morning rankes but succeed afternoon, she “daydreams.”
  • Katie’s parents are to-boot disturbed encircling her abate in appetency gone set-on-footing the medication

Decision Point Three

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

A- I SELECTED  to Add a trivial dose of present indemnify Adderall in the existing afternoon

B- EXPLAIN WHY I DID NOT SELECT Asknowing Katie’s parents that ponderosity waste is low after a opportunity provocative medications used to use ADHD Augment medication after a opportunity lineage therapy

 Guidance to Student

Whereas ponderosity waste is low after a opportunity provocative medication, this non-interference does not harangue Katie’s parents’ concerns encircling the repay of symptoms in the afternoon.

Augmentation after a opportunity lineage therapy is to-boot a cheerful-tempered-tempered subject as it can acceleration Katie after a opportunity her symptoms and advance acceleration her parents to discern the matchless challenges that Katie experiences, as well-mannered-behaved-behaved as ways that they can acceleration her after a opportunity symptoms, eventually, this non-interference does not harangue the repay of inconsiderate symptoms in the afternoon.

Adding a trivial dose of present narrate Adderall in the afternoon can acceleration Katie to conduct attendation throughout the afternoon and into the existing evening when she must do abodework. This would be the best non-interference.