Clinical Settings Response Assignment
Order ID |
53563633773 |
Type |
Essay |
Writer Level |
Masters |
Style |
APA |
Sources/References |
4 |
Perfect Number of Pages to Order |
5-10 Pages |
Description/Paper Instructions
Assignment for discussion:
Answer the following questions about the case study:
Explain how you would apply what you learned from the Response case studies to your own clinical practice.
Share any additional interview and communication approaches that you think would be useful with your colleague’s patient.
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Suggestions for extra health-related concerns to consider
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Use your own experience and further research to back up a claim.
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Explain your reasons in APA format, citing at least TWO separate references from recent evidence-based literature.
Response to a Case Study
Case 1: Volume 1, Case #13: The mischievous 8-year-old girl
Make a list of three questions you’d ask the patient if they came into your clinic. Give an explanation for why you’re asking these questions.
1.How do you think you’re doing in school?
Reason: Children with ADHD exhibit academic underachievement as a result of inattentiveness and disruptive behavior. These habits have an impact on their overall academic achievement, resulting in difficulties in reading, spelling, and math (Leahy, 2018).
2.How do you feel about your relationships with your family, instructors, and friends?
The purpose of this question is to obtain information on this patient’s social abilities. The majority of ADHD youngsters struggle with peer relationships and emotional dysregulation. As a result, it’s probable that this patient will complain about constantly getting in trouble with her professors and not being liked by her friends as a result of her poor social skills ( Sjowall, D., & Thorell, L. B. 2014)
3. Do you have trouble reading and following instructions, as well as understanding and completing your assignments?
Reason: Most ADHD youngsters have difficulty following directions, either because they don’t comprehend them or because they don’t want to. As a result, the majority of children face academic difficulties ( Parker, 2005)
Determine who you need to speak with or seek feedback from in the patient’s life in order to better analyze the patient’s situation. Include specific questions you’d like to ask these folks, as well as why you’d like to ask them.
Parents of the patient (Mother and Father), grandparents of the patient (if they are close to the child), siblings, friends, and teachers who engage with the patient.
Among the questions would be:
1.When did you first notice her symptoms and become concerned?
This question would be posed to parents or grandparents who assist in the patient’s care.
The majority of children are inattentive and hyperactive. Most of them are unable to follow instructions or focus on a work for an extended period of time. However, there may come a moment when a parent becomes concerned about these symptoms and seeks expert advice or diagnosis.
2. Does anyone on her father’s or mother’s side of the family suffer from ADHD?
This is a question for the patient’s parents and grandparents who are familiar with his or her history. This question is intended to determine whether ADHD runs in the family and whether it is genetic.
3. To the patient’s mother: Did you smoke or drink while you were pregnant?
Reason: Prenatal alcohol and cigarette usage can cause a child to be born with ADHD.
4. Will the patient be able to complete her schoolwork in a timely manner?
Reasoning: This is a question that can be asked of both parents and teachers. This is to see if the patient is capable of finishing her chores.
5. Can the patient converse and play normally with his or her friends?
The query is addressed to her instructors and friends. Because most ADHD patients lack social skills, they prefer to be alone and do not interact well with their classmates (CDC 2019).
6. Is the patient a class disruption?
The question is addressed to the teacher. The majority of ADHD individuals exhibit disruptive behavior, talk excessively, are extremely energetic, and have difficulty managing urges.
7.Does the patient have any learning disabilities?
The majority of children with ADHD struggle in math, reading, and spelling (Wender, 2000).
Explain what kinds of physical exams and diagnostic tests the patient should have and how the results will be used.
There is no one laboratory test that can be utilized to diagnose ADHD at this time. Continuous performance tests (CPT) are used by psychiatrists to diagnose patients. Boutros, Fraenkel, & Feingold (2005) describe this as an automated scoring test with automated outcomes analysis and interpretation.
Because brain injury is one of the reasons of ADHD, a neurologic exam such as an EEG or MRI of the brain would be required to check that the patient does not have any. To see if the patient exhibits all of the symptoms of ADHD, a DSM5 diagnostic exam would be performed ( Leahy, 2018).
The first thing to do on this patient would be to perform a full physical examination from head to toe. Because the patient has a fever and a painful throat, it’s critical to figure out why she has a temperature and a sore throat. Throat cultures will be taken to determine which organisms are causing the sore throat. Blood cultures will also be required to determine whether the patient has a systemic infection. The hearing and vision tests are the other tests to perform. This is to ensure that these difficulties are not the root of all of the problems (CDC2019).
Make a list of three possible diagnosis for the patient. Choose the one you believe is most likely and explain why.
ADHD (Attention Deficit Hyperactivity Disorder) is a type of attention deficit hyperactivity disorder.
The inability to pay attention, control impulses and actions, as well as overactivity, are all symptoms of attention-deficit/hyperactivity disorder (ADHD). Although most children will exhibit some of these traits, ADHD is distinguished by the severity, pattern, and persistence of these traits (CDC 2019).
Excessive daydreaming, carelessness, frequently losing or shifting objects, excessive talkativeness, careless blunders, and intense fidgeting and wriggling are all indicators of ADHD ( CDC 2019). ADHD is caused by the mother’s usage of alcohol and tobacco while pregnant, low birth weight, brain injury, early delivery, and exposure to pollutants such as lead ( Parker,2005).
Because the symptoms of ADHD are similar to those of some normal children, diagnosing ADHD can be challenging. As a result, no one test has been developed and tested to successfully identify ADHD. Physical exams may be used to rule out abnormalities in hearing and vision, which could be the cause of some behaviors.
A.D.H.D. (Attention Deficit/Hyperactivity Disorder) and
Co-morbidity of Oppositional Defiant Disorder (ODD)
For at least 6 months, a child with Oppositional Defiant Disorder (ODD) demonstrates intense anger, irritability, temper tantrums, refuses to follow orders and directions, and is easily irritated (Ehmke, 2019). Wender (2000) estimates that 20-30% of children with ADHD also have learning difficulties, and that 35% of those with ADHD have Oppositional Defiant Disorder (ODD). Learning challenges, such as difficulties reading, spelling, and math, are common in children with ADHD (Wender, 2000).
Delays in Development
Learning, behavior, physical, and language difficulties are common in children with developmental or intellectual impairments. Developmental delays develop in childhood, but proper diagnosis is only achievable after the age of five, when reliable IQ testing are available. Children with developmental delays are always behind their peers in terms of reaching age-related milestones. A child is said to have global developmental delays if they are behind in more than one area of development (Stojanovic,2020).
Although the exact cause of developmental delays is unknown, premature birth, genetic factors, and illness during pregnancy are likely to be some of the causes. Other underlying abnormalities such as Down’s Syndrome, autism, cerebral palsy, fetal alcohol spectrum disorders, and Angelman’s Syndrome, among other neurological and genetic illnesses, can cause developmental delays (Chung et al, 2011).
Based on pharmacokinetics and pharmacodynamics, list two pharmacologic agents and their dosing that would be appropriate for the patient’s ADHD therapy. Provide a justification for why you might prefer one agent over the other in terms of mechanism of action.
Methylphenidate (D,L) is a central nervous system stimulant approved by the FDA for the treatment of ADHD in both children and adults. According to the Centers for Disease Control and Prevention (CDC), children on fast-acting methylphenidate experience a 70-80% reduction in ADHD symptoms. Methylphenidate increases norepinephrine and dopamine activity while inhibiting dopamine reuptake, improving concentration, attention, and alertness ( Fairman, Peckham, & Sclar, 2020).
At this age, the patient can start with a 10mg transdermal patch every 9 hours, increasing by 5mg weekly to a maximum dose of 30mg every 9 hours (Stahl,2014b). When compared to adults, the pharmacokinetics of methylphenidate (D.L.) in children show a delay in lowest peak and second peak concentrations, resulting in higher drug concentrations in children due to their smaller body size and total volume of distribution (Rafael, 2008).
Guanfacine XR is an adrenoreceptor agonist that targets alpha 2A agonist sites in the brain’s prefrontal cortex. It is a non-stimulant medicine approved by the FDA for children and adolescents with symptoms of ADHD and Oppositional Defiant Disorder ( Ngairita, 2007).
Guanfacine improves attention, memory, planning, and control while also lowering impulsivity.
The dosage is determined in mg/kg (0.05mg/kg to 0.12mg/kg) and should be taken once a day. Guanfacine’s full advantages may take several days to manifest ( Stahl,2014b). Guanfacine should be taken whole with a little water or milk, and high fat foods should be avoided.
RUBRIC
QUALITY OF RESPONSE |
NO RESPONSE |
POOR / UNSATISFACTORY |
SATISFACTORY |
GOOD |
EXCELLENT |
Content (worth a maximum of 50% of the total points) |
Zero points: Student failed to submit the final paper. |
20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. |
30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. |
40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. |
50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. |
Use of Sources (worth a maximum of 20% of the total points). |
Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. |
5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. |
10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. |
15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. |
20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. |
Grammar (worth maximum of 20% of total points) |
Zero points: Student failed to submit the final paper. |
5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors |
10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors |
15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. |
20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. |
Structure of the Paper (worth 10% of total points) |
Zero points: Student failed to submit the final paper. |
3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. |
5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper |
7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. |
10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. |
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