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
Examining and Treating Clients with ADHD Paper
Examining, Treating, Clients, ADHD, Paper
Examine case study: a young caucasian girl with adhd you will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
At each decision point stop to complete the following:
- decision #1
- which decision did you select?
- why did you select this decision? Support your response with evidence and references to the learning resources.
- what were you hoping to achieve by making this decision? Support your response with evidence and references to the learning resources.
- explain any difference between what you expected to achieve with decision #1 and the results of the decision. Why were they different?
- decision #2
- why did you select this decision? Support your response with evidence and references to the learning resources.
- what were you hoping to achieve by making this decision? Support your response with evidence and references to the learning resources.
- explain any difference between what you expected to achieve with decision #2 and the results of the decision. Why were they different?
- decision #3
- why did you select this decision? Support your response with evidence and references to the learning resources.
- what were you hoping to achieve by making this decision? Support your response with evidence and references to the learning resources.
- explain any difference between what you expected to achieve with decision #3 and the results of the decision. Why were they different?
Case study and the decisions
Background
Katie is an 8 year old caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because katie’s teacher suggested that she may have adhd. Katie’s parents reported that their pcp felt that she should be evaluated by psychiatry to determine whether or not she has this condition.
The parents give the pmhnp a copy of a form titled “conner’s teacher rating scale-revised”. This scale was filled out by katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic.
Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work.
Katie’s parents actively deny that katie has adhd. “she would be running around like a wild person if she had adhd” reports her mother. “she is never defiant or has temper outburst” adds her father.
Subjective
Katie reports that she doesn’t know what the “big deal” is. She states that school is “ok”- her favorite subjects are “art” and “recess.” She states that she finds her other subjects boring, and sometimes hard because she feels “lost”.
She admits that her mind does wander during class to things that she thinks of as more fun. “sometimes” katie reports “i will just be thinking about nothing and the teacher will call my name and i don’t know what they were talking about.”
Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time.
Mental status exam
The client is an 8 year old caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic.
Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on katie’s attending to the clinical interview and her ability to count backwards from 100 by serial 2’s and 5’s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation.
Diagnosis: attention deficit hyperactivity disorder, predominantly inattentive presentation
Decision point one
Select what the pmhnp should do:
begin wellbutrin (bupropion) xl 150 mg orally daily
begin intuniv extended release 1 mg orally at bedtime
begin ritalin (methylphenidate) chewable tablets 10 mg orally in the morning
Decision point two
Select what the pmhnp should do next:
continue same dose of ritalin and re-evaluate in 4 week
change to ritalin la 20 mg orally daily in the morning
discontinue ritalin and begin adderall xr 15 mg orally daily
Decision point three
Select what the pmhnp should do next:
maintain current dose of ritalin la and reevaluate in 4 weeks
increase ritalin la to 30 mg orally daily
obtain ekg based on current heart rate
Decision point one
begin ritalin (methylphenidate) chewable tablets 10 mg orally in the morning
Results of decision point one
- client returns to clinic in four weeks
- katie’s parents report that they spoke with katie’s teacher who notices that her symptoms are much better in the morning, which has resulted in improvement in her overall academic performance. However, by the afternoon, katie is “staring off into space” and “daydreaming” again
- katie’s parents are very concerned, however, because katie reported that her “heart felt funny.” You obtain a pulse rate and find that katie’s heart is beating about 130 beats per minute
Decision point two
change to ritalin la 20 mg orally daily in the morning
Results of decision point two
- client returns to clinic in four weeks
- katie’s academic performance is still improved, and the switch to the la preparation is lasting katie throughout the school day
- katie’s reports of her heart feeling “funny” have gone away. Pulse was 92 during today’s office visit
Decision point three
maintain current dose of ritalin la and reevaluate in 4 weeks
Guidance to student
At this point, katie’s symptoms are well controlled (her attention is sustained throughout the school day) and her side effects have gone away following change to a long-acting preparation.
There is no indication at this point that the dose should be increased as it is always advisable to use the lowest effective dose of stimulant medication. Katie’s heart rate is appropriate for an 8 year old girl and an ekg would not be indicated based on her heart rate.
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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