apply knowledge gained

apply knowledge gained

Respond to at least two of your   colleagues who were assigned to a different case than you. Explain how   you might apply knowledge gained from your colleagues’ case studies to   you own practice in clinical settings.

NOTE: Positive comment

 Main Post

 

Case  Study: Volume 2, Case #21 focuses on the treatment of an adult client  diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).

Questions

Question 1: Are you having problems with your loved one’s due being “argumentative and temperamental”?

Rationale:  The client may have additional stress due to broken relationships and  this could be due to his disorder.  “Emotional dysregulation is  increasingly recognized as a core feature of ADHD” (Stralen, 2016).  Signs of ADHD include low frustration tolerance and explosive behavior  (Stralen, 2016).

Question 2:

What causes you the most anxiety?

It  is important to determine the triggers of the anxiety to help the  patient prepare for times when he is likely to be in high stress  situations. Planning a response when feeling overwhelmed can help the  patient remain in control of his emotions and allow the patient to  monitor his behavior.

Question 3:

You  stated that your father was abusive, was this physical or verbal abuse  or both? Do you contribute some of your anxiety from previous issues  with your father?

It  is important for the provider to understand the client’s point of view  in regards to his upbringing. He realizes it has affected in him in some  way, as he has obtained psychotherapy in the past. I would want to know  if he has ever spoken to his father about this and if his father has  ever apologized for his actions.

Questions for family

I  would want to talk with his mother to ask her how he did as a child in  school and at home in regards to schoolwork, chores and would want to  know if he had friends. Although  social problems are not part of the diagnostic criteria for ADHD, the  peer relationship difficulties faced by youth with this disorder are  profound (Hoza, 2007)

Diagnostics & Exams

A  full psychiatric evaluation which would include the Adult Self-Report  Scale (ASRS). ASRS was been developed by the World Health Organization  to determine if an individual (adult) may have ADHD. The scale is made  up of 6 questions, and if a client has at least 4 of 6 symptoms, there  may need to be a diagnosis of ADHD made by a professional (ADDA, 2018). Seay  et al. (2009) suggests the PMHNP should utilize intelligence test,  broad-spectrum scales, tests of specific abilities, and brain scans to  confirm the diagnosis and to rule out other disabilities, autism,  auditory processing disorders or mood disorders. In addition, a full medical work-up by a PCP in order to rule out other medical conditions that could present similarly to ADHD.

Differential DX

General Anxiety Disorder: The  patient exhibits symptoms of generalized anxiety disorder, DSM-5 300.02  (F14.1). He has had the symptoms for greater than six months with the  symptoms being severe enough to interfere with the patient’s daily  functioning. The patient complains of feels of worry that is difficult  to control, irritability, restlessness, difficulty concentrating and  feeling on edge. The patient symptoms have not been linked to a physical  condition or to substance use (Reynolds & Kamphaus,2013).

ADHD:  client consistently complains of feeling tense, irritable, and anxious  (Stahl Online, 2019).  Questions arise once the general anxiety symptoms  are resolved and the client is left feeling hyperactive, inattentive,  and the inability to focus (Stahl Online).

Post-Traumatic  Stress Disorder: The client’s diagnosis of anxiety may have been  related to underlying issues related to a traumatic event that he  experienced as a child. The client’s father was verbally abusive to him  and was an alcoholic. It is a possibility that the client’s issues could  have some relations to previous exposure as a child. Post-Traumatic  Stress Disorder is a serious condition that can occur in clients who  have experienced various incidents including abuse (PTSD, 2018).

Medications