NURSING

Nursing: Assessing and Treating Patients with ADHD

Case Introduction

An 8-year-old Caucasian girl named Katie is believed to suffer from attention deficit hyperactivity disorder (ADHD). Her teacher generated the statement as she showed symptoms within the class that led to such an observation. The signs included the girls inattentiveness, easy distraction, forgetfulness, focus loss after a short period, poor spelling and grammar, and reading and mathematics learning. Moreover, the girl only pays attention to things that she finds interesting.

The teacher also believes that when the girl starts a task, she cannot finish it. She is distracted and does not find the focus to complete her assignments. School work is no more fascinating to her, so she does not follow the instructions.

All of the above details are mentioned in Conners Teacher Rating Scale-Revise, which was forwarded to PMHNP for further scrutinizing of Katies condition. The symptoms must be prudently reviewed before the diagnosis is made and relevant treatment is suggested.

Katies parents totally deny her condition since her father said he never witnessed any temper issues. Her mother cited the same response by saying that she would have been found running around the house wildly if she suffered from any such state; however, this was never observed.

When asked by Katie, her subjective responses included that her school is okay, she likes art and recess the most, the rest of the subjects are boring for her, and she is usually lost in class. She is aware of the fact about herself that she feels lost during her lectures. The teacher has to call out her name to bring her back from her thoughts. Upon asking, she is entirely clueless about what is being discussed on the topic.

The mental examination reveals that her psychological state is normal, active, clear, and coherent. Her dress is appropriate according to the weather, and she shows accurate mannerisms in front of the physician. She does not show mood disturbances, and visual and auditory signs are fine. She does not mention any intention felt ever for suicide or ever experienced hallucinations. During her clinical interview, her attention was completely intact with the standard in sight, judgment, and backward counting from 100.

Decision 1

The first decision is discontinuing Wellbutrin and beginning Strattera 10mg daily for oral intake. The reason for selecting this option is that it might be difficult for the parents to understand that Katies thought of hurting herself is a mere side effect. Since parents are usually concerned about their childs safety first, it would be hard to persuade them to continue Wellbutrin (Abar et al., 2021). It even seemed they were petrified enough to call the police as they did not want to call and wake the doctor up at night.

The other two options were not selected since continuing the existing medicine might raise further concerns for the parents. Opting to begin with Adderall would have the same side effects as Strattera. Hence, one of them had to be selected. It would not have made much difference if Adderall was preferred over Strattera, as the side effects of both are the same among children with ADHD (Cleveland Clinic, 2021; Llamas, 2022).

It was hoped to achieve that Katie would be able to more focused and calm rather than thinking about suicide. Research has corroborated the effectiveness of atomoxetine. The drug has...…homework time for her.

Ethical considerations remain the same in this decision, as the doctor would be more concerned with producing maximum benefit for the patients health and wellbeing. Belonging to a different ethnic might create worries for the parents regarding health treatment equity, which would be addressed with better patient and parents education and awareness about medication adherence. Fairness would be practiced so that health resource scarcity should not cause problems for health outcomes for Katie. Again, autonomy would allow the parent to decide whether a change of medicine should be accepted or rejected for their childs best health interests.

Conclusion

The above three decisions are based on the notion that the child should be prevented from maximum adverse drug effects that might cause cultural concerns amidst the pharmacological treatment for Katie. The physician needs to be culturally component to know about the parents fears as treating a child is riskier for each of the recommended medical interventions.

The side effects have to be weighed against other options left out in each decision so that lesser harm is predicted for the patient. Not only the childs health but the apprehensions of her surrounding people, such as Katies parents and the teacher, would be modified with the medication change at each step.

Certain commonly reported side effects such as loss of appetite and sleep disturbances should be kept in line with the medication use and adherence among children. The frequent or quick response of the medication, such as in the case of Adderall vs. Ritalin, should be carefully analyzed before prescribing to children like Katie, as morning and afternoon effects could bring massive changes in their physical and psychological functioning on the…