Assignment: practicum: decision tree (due in week 4) | NURS 6660 – Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent | Walden University

  

The Assignment:

Examine Contingency 1. You accomplish be beseeched to restraintm three determinations abextinguished the individuality and matter restraint this client. Be assured to deem co-morbid substantial as courteous as hyperphysical occurrenceors that restraintce collision the client’s individuality and matter.

At each Determination Point, plug to adequate the following:

· Determination #1: Incongruousial Individuality

o Which Determination did you pickeded?

o Why did you pickededed this Determination? Support your solution with testimony 

and references to the Learning Resources.

o What were you hoping to seal by making this Determination? Support your solution with testimony and references to the Learning Resources.

o Explain any destruction among what you expected to seal with 

o Determination #1 and the results of the Determination. Why were they incongruous?

· Determination #2: Matter Artfulness restraint Psychotherapy

o Why did you pickededed this Determination? Support your solution with testimony and references to the Learning Resources.

o What were you hoping to seal by making this Determination? Support your solution with testimony and references to the Learning Resources.

o Explain any destruction among what you expected to seal with 

o Determination #2 and the results of the Determination. Why were they incongruous?

· Determination #3: Matter Artfulness restraint Psychopharmacology

o Why did you pickededed this Determination? Support your solution with testimony and references to the Learning Resources.

o What were you hoping to seal by making this Determination? Support your solution with testimony and references to the Learning Resources.

o Explain any destruction among what you expected to seal with 

Determination #3 and the results of the determination. Why were they incongruous?

· Too conceive how immaterial deemations restraintce collision your matter artfulness and messsenility with clients and their families.

· Note: In APA Restraintmat and fit extract, Support your rationale with a insufficiency of three academic resources/references no over than five years senilityd. Conceive initiative and omission.

Contingency #1

A immature maid with unmanageableies in instruct

BACKGROUND

In psychopharmacology you inspiration Katie, an 8-year-aged Caucasian feminine, who was brought to your station by her dowager (senility 47) and senior (senility 49). You worked through the contingency by recommending practicconducive ADHD medications. As you advance in your PMHNP program, the contingencys accomplish mingle over advice restraint you to condition through.

Restraint this contingency, you conceive Katie and her parents again. The parents enjoy reputed that the medication abandoned to Katie does referconducive conceivem to be subsidiary. This has prompted you to redeem the individuality of ADHD. You accomplish deem other incongruousial diagnoses and state what advice you deficiency to correspondently assess the DSM-5 criteria to restraintm the individuality of ADHD or another experimentation with common indication features.

When parents procure their branch to your station, they may enjoy discover symptoms on the internet or they may enjoy been taged by the instruct “your branch has ADHD”. Your individuality accomplish either ratify or repel that individuality.

Katie’s parents reputed that their PCP felt that she should be evaluated by psychiatry to state a incongruousial individuality and to initiate medication, if involved. The PMHNP restraintms this indication determination naturalized on conferences and observations of the branch, her parents, and the rate of the parents and professor.

To set-on-foot, deem what rate besidesls you restraintce deficiency to evaluate Katie.

· Branch Behavior Check List

· Conners’ Professor Rating Lamina

The parents present the PMHNP a portraiture of a restraintm titled “Conner’s Professor Rating Lamina-Revised” (Availconducive at: https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000099.1 ). This lamina was employed extinguished by Katie’s professor and sent residence to the parents so that they could portion-out it with their provider. According to the scoring granted by her professor, Katie is opinionless, abundantly bewildered, restraintms incorrect mistakes in her instructwork, restraintgets things she already scholarly, is unsatisfactory in spelling, discovering, and arithmetic. Her consideration two is scanty, and she is referableed to singly unswerving consideration to things she is ardent in. She has inaptitude interacting with peers in the arrangeroom and likes to play by herself at withdrawal.

When conferenceing Katie’s parents, you beseech abextinguished pre- and post-natal occurrence and you referablee that Katie is the pristine born with parents who were seal to 40 years senilityd when she was born. She had a subsided 5 detailed Apgar charges. The parents repeat that she inspiration regular develophyperphysical milestones and perhaps had some inaptitude with slumber during the pre-instruct years. They referableice that Katie has inaptitude gregariousizing with peers, she is hush at residence and spends a doom of season tending TV.

SUBJECTIVE

You remark Katie in the station and she is referconducive conducive to sit calm?} during the conference. She is incessantly interrupting twain you and her parents. Katie fames that instruct is “OK”- her cosset subjects are “art” and “recess.” She states that she finds some subjects boring or besides unmanageable, and sometimes solid owing she reachs “lost”. She furthers that her purpose does desert during arrange. “Sometimes” Katie fames “I accomplish equitable be thinking abextinguished referable attributable attributableability else and referconducive looking at the professor or other students in the arrange.”

Katie fames that her residence morals is equitable subtle. She fames that she loves her parents and that they are very cheerful and peel to her. Denies any abuse, denies open at instruct. She offers no other concerns at this season.

Katie’s parents show slightly disturbed abextinguished their daughter’s problems. You referableice the dowager is fidgeting with her rings and tend spaceliness you are talking. The senior is tapping his floor. Other than that, they conceivem serene and unswerving restraintward in the conference system.

MENTAL STATUS EXAM

The client is an 8-year-aged Caucasian feminine who shows right familiar restraint her senility. Her address is serene, compact, and argumentative. She is right oriented to special, assign, season, and issue. She is healed right restraint the weather and season of year. She demonstrates no referableeworthy mannerisms, gestures, or tics. Self-reputed disposition is euthymic. Affect is unavowed. Katie repeats that she doesn’t hearkenken any ‘voices’ in her source still does further to having an unreal acquaintance, ‘Audrey’. No fames of delusional or paranoid opinion systemes. Consideration and strain are slightly poor naturalized on Katie’s scanty answers to your questions.

Determination Point One:

299.00 Autism Spectrum Experimentation (ASD), calm and co-occurring; 300.23 Gregarious Diffidence Experimentation

RESULTS OF DECISION POINT ONE

· Client avail to clinic in lewd weeks

· You enjoy pickededed Autism Spectrum Experimentation concurrently with co-occurring Gregarious Diffidence Experimentation. Naturalized on this excellent, extinguishedline the balance of the indication evaluation that you accomplish precede on this branch and their parents. Be assured to conceive standardized rate instruments that you would administer

Determination Point two:

Naturalized on your individuality and the parent’s concerns, your determined to initiate Risperal 0.5mg po BID

RESULTS OF DECISION POINT TWO

Client avail to clinic in lewd weeks

Upon her reappear to the clinic in 4 weeks, Katie’s parents reach that Katie is calmer, still no changes in her instruct enterprise enjoy been referableed. Additionally, her parents enjoy referableiced that she conceivems over “tired” than regular, and fame that she conceivems to ‘space extinguished’ over repeatedly. They further fame that she has been escheatment aslumber during her regular television shows.

Determination Point Three:

Increase Risperdal to 1mg po BID

Guidance to Student

The advice granted in the scenario is referconducive entreative of the indication criteria restraint autism spectrum experimentation (ASD) or co-occurring gregarious diffidence experimentation. Even if it were, Risperdal is referconducive routinely used to entertain autism-spectrum experimentation- in occurrence, there are no FDA general drugs restraint matter of this experimentation. Antipsychotics are singly used to entertain restraintcible or self-injurious behaviors in ASD, and in those contingencys, used off-label. Antipsychotics did ssubsided Katie down, still too gave her a other verge effects, and did referablehing to entertain the principal presenting problems of neglect.

Timeliness CBT has testimony of productiveness in twain autism spectrum experimentation and gregarious diffidence experimentation, and spaceliness video modeling and video-self modeling therapy has some testimony restraint productiveness in ASD, these therapies accomplish referable, in and of themselves, acceleration Katie as she does referconducive enjoy ASD with co-occurring gregarious diffidence experimentation.

 
 

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