The Assignment Examine Case Study: A Young Caucasian Girl with ADHD You will be asked to make three decisions concerning the medication to prescribe... Unlock Solution The Assignment 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 there will be three decisions. I will choose one out of the three and give the outcome. At each decision point these are the thoughts to ponder: 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? *** Also include how ethical considerations might impact your treatment plan and communication with clients.*** Finally: 1. Complete the decision tree (keep track of what you selected. come up with a rational reason why you chose it. Come up with patient specific rational reason behind not choosing the other two options not chosen). 2. Write paper addressing all section listed based on the decision tree. Case Study: A Caucasian Man with Hip Pain 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.

1. The Assignment Examine Case Study: A Young Caucasian Girl
with ADHD You will be asked to make three decisions
concerning the medication to prescribe...
Unlock
Solution
The Assignment
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 there will be three decisions. I will
choose one out of the three and give the outcome. At each
decision point these are the thoughts to ponder:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with

2. 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

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?
***
Also include how ethical considerations might impact your
treatment plan and communication with clients.***
Finally: 1. Complete the decision tree (keep track of what you
selected. come up with a rational reason why you chose it.
Come up with patient specific rational reason behind not
choosing the other two options not chosen).
2. Write paper addressing all section listed based on the
decision tree.

4. Case Study: A Caucasian Man with Hip Pain
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

5. 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.

6. 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
Decisions Made and Outcomes (Needed to formulate the paper)

7. (Must use and formulate paper based off of the chosen decision.
Then tell why the other two decision were not a good choice
with in-text citations noted for each.)
Choices for Decision 1: Select what the PMHNP should do:
1.
Begin Wellbutrin (bupropion) XL 150 mg orally daily
2.
Begin Intuniv extended release 1 mg orally at BEDTIME
3.
Begin Ritalin (methylphenidate) chewable tablets 10 mg orally
in the MORNING
4.
Decision Choice Chosen:
Begin Ritalin (methylphenidate) chewable tablets 10 mg orally
in the MORNING

8. ***Explain why other two choice were rejected (not adequate
choices)***
Outcome: 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
Choices for Decision 2: Select what the PMHNP should do:
1.

9. Continue same dose of Ritalin and re-evaluate in 4 weeks
2.
Change to Ritalin LA 20 mg orally daily in the MORNING
3.
Discontinue Ritalin and begin Adderall XR 15 mg orally daily
4.
Decision Choice Chosen:
Change to Ritalin LA 20 mg orally daily in the MORNING
***Explain why other two choice were rejected (not adequate
choices)***
Outcome: RESULTS OF DECISION POINT TWO:
·
Client returns to clinic in four weeks
·

10. 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
·
Choices for Decision 3: Decision Point Three Select what the
PMHNP should do next:
1.
Maintain current dose of Ritalin LA and reevaluate in 4 weeks
2.
Increase Ritalin LA to 30 mg orally daily
3.
Obtain EKG based on current heart rate
4.
Decision Choice Chosen:

11. Maintain current dose of Ritalin LA and reevaluate in 4 weeks
***Explain why other two choice were rejected (not adequate
choices)***
Outcome: Guidance to Student
RESULT FROM CHOOSING TO MAINTAIN CURRENT DOES
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.
***Write on each decision. Make sure that in each decision

12. choice that you explain why the other two decisions were not
good choices. Use cited sources to validate points. Make sure
that this paper has at least
7 References
.
Please use in-text citations for each section of each decision.
Don't forget the ethical considerations for this assignment.
Make it a section by itself.***
***Also please make sure when looking at the ethical
consideration for this assignment that you look at how the
Caucasian (male) ethnicity and pain medications interact.***
Please use the following format when formulating the
paragraphs for each section. Don’t forget the intext citations.
Remember to use at least 7 references.
Introduction
Decision #1
Reasons for Choosing the Decision (Why is it the best choice
out of the 3 choices)
Anticipated Results (of Chosen Decision)
Difference in Results (Anticipated VS Actual)
Decision #2
Reasons for Choosing the Decision (Why is it the best choice

13. out of the 3 choices)
Anticipated Results (of Chosen Decision)
Difference in Results (Anticipated VS Actual)
Decision #3
Reasons for Choosing the Decision (Why is it the best choice
out of the 3 choices)
Anticipated Results (of Chosen Decision)
Difference in Results (Anticipated VS Actual)
Ethical Considerations
Conclusion
References
PLEASE REMEMBER TO INCLUDE INTRODUCTION AND
CONCLUSION