Feb 23, 2024 Discussion: NURS 6521 Decision Making When Treating Psychological Disorders
Discussion: NURS 6521 Decision Making When Treating Psychological Disorders
A Sample Answer For the Assignment: Discussion: NURS 6521 Decision Making When Treating Psychological Disorders
This week I chose ADHD Attention-Deficit/Hyperactivity Disorder; both my children suffer from this disease, and I do not fully understand it. I do not feel they have ever gotten adequate treatment for it, and I have seen them struggle throughout childhood into adolescence with all aspects of life due to this partially understood disease.
ADHD affects 5% to 11% of school-aged children being the most common neuropsychiatric disorder of childhood (Rosenthal & Burchum, 2021, p. 251). This disorder affects boys more than girls by two-thirds (Rosenthal & Burchum, 2021). This disease is not well understood but is thought to have a genetic component related to a mutation of the dopamine D4 receptor gene (DRD4) or a variation of the catechol-O-methyltransferase gene (COMT) (Block et al., 2021). Clinical manifestations include inattention, hyperactivity, and impulsivity (Rosenthal & Burchum, 2021).
These individuals are frequently late, have forgetfulness in daily activities, distractibility, hyperactivity, and forgetfulness (Block et al., 2021). Not all these people will be hyperactive. Symptoms must be present before age twelve to be diagnosed (Block et al., 2021). These children cannot separate important stimuli from unimportant stimuli, which leads to difficulty staying on task and maintaining focus (Block et al., 2021).
This disease may be related to brain development, including abnormalities in the “dopaminergic and noradrenergic neurotransmission system” (Block et al., 2021). Several other factors have been suggested to be a possible association with this disease that I will not be listed for this discussion.
Discussion: Decision Making When Treating Psychological Disorders NURS 6521
The pharmacotherapeutics I chose for this patient’s pathophysiology started with Ritalin (methylphenidate) chewable tablet 10 mg orally in the morning. Eight-year-old female with a new diagnosis of ADHD and had not been on any medications in the past. On her first follow-up appointment four weeks after starting medication, her parents reported improvement in symptoms in the morning; however, the medication seems to be wearing off by the afternoon.
Parents were concerned that the patient had reported her “heart felt funny” and noted a heart rate of 130 bpm in the clinic. During this visit, the medication was changed to Ritalin LA 20mg orally daily in the morning. This change will offer medication to be spread out over the day with a peak onset of four to seven hours and a duration of up to twelve hours (Davis’s Drug Guide, 2018).
After the patient returns for a follow-up visit in four weeks, the parents state improvement in the patients’ schoolwork and states medication is lasting throughout the day. The patient report that the heart feeling has gone away. This dose would be maintained for an additional four weeks with a medication check-up in the clinic.
Ritalin is the drug of choice for ADHD for the start of care and has proven efficacy (Rosenthal & Burchum, 2021). No studies suggest one drug over another, and therefore if the first drug seems ineffective, the clinician should start considering second-line medications (Rosenthal & Burchum, 2021). Stimulants have possible adverse effects such as insomnia and growth suppression (Rosenthal & Burchum, 2021).
Extended-release medications should be given as close to when the child wakes up to prevent insomnia as it will last up to twelve hours. If the child is experiencing decreased appetite, give medication after or during meals (Rosenthal & Burchum, 2021). Some providers recommend taking “drug holidays” where the child would not take medication on weekends; this is not recommended for all children (Rosenthal & Burchum, 2021).
References
Block, R., Macdonald, N. P., & Piotrowski, N. A. (2021). Attention deficit hyperactivity disorder (ADHD). Magill’s Medical Guide (Online Edition).
Davis’s Drug Guide. (2018). Davis’s drug guide for nurses (16th ed. ed.). F.A. Davis Company. Retrieved from Www.drugguide.com.: https://www.drugguide.com/ddo/mobile
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants (2nd Edition ed.). St. Louis, MO: Elsevier. Retrieved from vbk://9780323554954
NURS6 521 Advanced Pharmacology
Week 8 Forum Decision Making When Treating Psychological Disorders
Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.Photo Credit: Getty Images/iStockphoto
For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeuticson a patient’s pathophysiology.
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Discussion: NURS 6521 Decision Making When Treating Psychological DisordersReflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.
By Day 3 of Week 8
Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.
By Day 6 of Week 8
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology.
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