Presentations of ADHD Nursing Paper
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages
Presentations of ADHD Nursing Paper
Presentations, ADHD, Nursing, Paper
Case 3: Volume 2, Case #21: Hindsight is always 20/20, or attention deficit hyperactivity
List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.
- Can you describe to me in your own words how you are feeling today and of late? This is an open-ended question to provide some insight on the patient, such as feelings, attitudes, and thoughts, mood, and how he perceives his well-being expressing his anxiety, any depression, and fatigue which should be taken into consideration.
- Do you feel your medications all work well for you? This gives an insight to if the client is taking his medications as prescribed. Individuals with attention-deficit/hyperactivity disorder (ADHD) may usually be non-compliant with their medication because of symptoms associated with the disease such as hyperactivity, impulsivity, and inattention (Stahl, 2013).
- Can you tell me what you mean by “torn in many directions”? This will help understand and assess if the client is pressured form work or from home and how it’s interfering with his social life.
- Do you have thoughts of hurting yourself or others? Because the client expressed feeling like he is “torn in many direction,” in addition to his increased anxiety and high energy levels, it is important to assess the client for suicide ideation and depression.
Identify people in the patient’s life you would need to speak to or get feedback from to assess the patient’s situation further. Include specific questions you might ask these people and why.
To get feedbacks to further assess my client, I would speak to his wife to provide some history in regards to his moods over the years, any past triggers, his routine sleep/wake cycle, and also any information on how he was in his earlier years. From the information given, the client did show signs of ADHD as a kid.
If the mother was present, I would ask about family history of ADHD and any other history of mental health disorder when the client was young. According to Starck, Grünwald, and Schlarb (2016), about 40% of ADHD children have at least one parent with clinical ADHD symptoms.
Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.
Diagnosis of ADHD is based on clinical evaluation; therefore, no laboratory-based medical tests are available to confirm the diagnosis; however, basic laboratory studies that may help confirm diagnosis and aid in treatment are as serum CBC count with differential, electrolyte levels, thyroid function tests, and liver function tests before beginning stimulant therapy (Soreff, 2018).
Other sources for exams or diagnostics are ADHD symptom checklists and a standardized behavior rating scales (Children and Adults with Attention-Deficit/Hyperactivity Disorder [CHADD], 2019). According to CHADD (2019), ADHD rarely occurs alone, and research has shown that more than two-thirds of people with ADHD have one or more co-existing conditions that include depression, anxiety disorders, learning disabilities and substance use disorders; therefore a comprehensive evaluation includes screening for co-existing conditions.
List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.
1) Generalized Anxiety Disorder (GAD): According to American Psychiatric Association (2017), GAD involves persistent and excessive worry that interferes with daily activities accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension or problems sleeping and sometimes the worries focus on everyday things such as job responsibilities, family health or minor matters.
With this client, he reports having financial worries and also “he worries and is tense most of the time.” He also has been anxious for so many years mostly since college and now graduate school and feels “torn in many directions” working part-time and going to school. He is generally tensed, restless, irritable, and worries about things even outside school and work, and this has caused him to be argumentative and temperamental most of the time; therefore, this most likely would be my primary diagnosis.
2) Attention Deficit Hyperactivity Disorder (ADHD)
3) Other Specified Anxiety Disorder
List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
Atomoxetine 40mg daily: Atomoxetine (ATX) boosts neurotransmitter norepinephrine/noradrenaline, increase dopamine in profrontal cortex, blocks norepinephrine reuptake pumps, increases noradrenergic neurotransmission, and can also increase dopamine neurotransmission in frontal cortex of the brain (Stahl, 2014b).
Therapeutic actions can be seen as early as the first day of dosing and may continue to improve for 8–12 weeks. It is important to monitor blood pressure (Stahl, 2014b) According to Asherson et al. (2014), the low abuse and diversion potential of ATX, once or twice daily dosing with enduring efficacy, stable effect throughout the day, and demonstrated effectiveness in reducing ADHD symptoms in patients with comorbid social anxiety and alcohol use disorders, make ATX an important medication to consider when treating adult patients with ADHD.
Buspar 15mg BID: It is used in the management of anxiety disorders and depression and in the class of serotonin receptor partial agonist (Stahl, 2014b). According to Rabatin and Keltz (2002), Buspirone has no potential for dependence, withdrawal symptoms, or rebound anxiety after drug withdrawal.
Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations Lesson learned was that instead of using polypharmacy approaches with a limited evidence base it is best to consider using solid approved monotherapies also instead of considering adult ADHD as a diagnosis of exclusion, it is better to evaluate this symptom complex earlier in care by using a rating scale, such as the ASRS.
Another important lesson learned was to research typical comorbidities and presentations for adult ADHD patients along with diagnostic rating scales and instruments that may aid in diagnosing ADHD in adults; therefore it is very essential in making sure to get an accurate assessment in diagnosing and treating clients that present with several psychiatric disorders and always discuss the risks and benefits of any new psychoactive medication or dose adjustment and adhering to treatment at the same time monitoring its efficacy.
American Psychiatric Association. (2017). What Are Anxiety Disorders? Retrieved from https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders
Asherson, P., Bushe, C., Saylor, K., Tanaka, Y., Deberdt, W., & Upadhyaya, H. (2014). Efficacy of atomoxetine in adults with attention deficit hyperactivity disorder: an integrated analysis of the complete database of multicenter placebo-controlled trials. Journal of psychopharmacology (Oxford, England), 28(9), 837-46.
Children and Adults with Attention-Deficit/Hyperactivity Disorder. (2019). Diagnosis of ADHD in Adults. Retrieved from https://chadd.org/for-adults/diagnosis-of-adhd-in-adults/
Rabatin, J., & Keltz, L. B. (2002). Generalized anxiety and panic disorder. The Western journal of medicine, 176(3), 164-8.
Soreff, S. (2018). Attention Deficit Hyperactivity Disorder (ADHD) Workup. Retrieved from https://emedicine.medscape.com/article/289350-workup#showall
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Starck M, Grünwald J, & Schlarb AA. (2016). Occurrence of ADHD in parents of ADHD children in a clinical sample. Neuropsychiatric Disease and Treatment, Vol 2016, Iss Issue 1, Pp 581-588 (2016), (Issue 1), 581. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsdoj&AN=edsdoj.0945878b277f40c58b2346f4c66f35f3&site=eds-live&scope=site
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.
GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
Do You Have Any Other Essay/Assignment/Class Project/Homework Related to this? Click Here Now [CLICK ME] and Have It Done by Our PhD Qualified Writers!!
Presentations of ADHD Nursing Paper
Tired of getting an average grade in all your school assignments, projects, essays, and homework? Try us today for all your academic schoolwork needs. We are among the most trusted and recognized professional writing services in the market.
We provide unique, original and plagiarism-free high quality academic, homework, assignments and essay submissions for all our clients. At our company, we capitalize on producing A+ Grades for all our clients and also ensure that you have smooth academic progress in all your school term and semesters.
High-quality academic submissions, A 100% plagiarism-free submission, Meet even the most urgent deadlines, Provide our services to you at the most competitive rates in the market, Give you free revisions until you meet your desired grades and Provide you with 24/7 customer support service via calls or live chats.