Attention, Deficit Hyperactivity Disorder, is a mental health condition that affects mostly children and teens. The condition is characterized by symptoms such as hyperactivity and inability to control impulses as well as having trouble to pay attention ( Charach et al., 2011). The client, in this case, is a young Caucasian girl with eight years of age who is accompanied by her parents. She is diagnosed with ADHD where she is easily distracted, is inattentive in class, often forgets things learned in class and lacks interest in school work. At the same time, she has a short attention span and seldom finishes her school work which affects her performance in exams. However, she has a clear and coherent speech for her age and does not develop any noteworthy gestures or mannerism. The paper discusses the best possible treatment options that can be used in treating clients with ADHD.
Decision point 1
The first decision is to begin Ritalin (methylphenidate) chewable tablets 10 mg orally to be taken daily in the morning. Ritalin is a central nervous system stimulant agent that is used in helping children with focus and concentration. The medication targets chemicals in the brain that contribute to hyperactivity an impulse control, therefore making it appropriate for treating ADHD in the client ( Biederman et al., 2003) . It is advisable to start with the lowest dosage of the medication to allow for monitoring of the patient condition before adjusting to higher levels. Therefore the decision is to begin Ritalin chewable tablets at 10 mg.
Delegate your assignment to our experts and they will do the rest.
The expected result for this decision point is that the patient will return with an improvement in the symptoms of ADHD and show differences in mood and concentration. For example, the decision anticipates that Katie will show improvements in her attention span, more focus in class and an increased interest in school work. As such, there should be differences between the symptoms reported before the medication and after the drug.
After four weeks of treatment, the client reported an improvement in her symptoms especially in the morning, which led to an increase in her academic performance. She started feeling more alert in class that allowed her a longer attention span and less distracted. However, the client reported experiencing symptoms of ADHD in the afternoons, where she could be seen daydreaming and staring in space for more extended periods. At the same time, the client reported experiencing specific side effects such as problems with her heart which raised concerns, showing a pulse rate of about 130 beats per minute.
Decision point 2
The second decision is to change the dosage to Ritalin LA 20 mg orally daily in the morning. The decision to increase the dosage is because the client has reported minimal improvements in the symptoms of ADHD where she could return to lousy state after a few hours of attention. As such, increasing the dosage can increase the effectiveness of the drug and ensure the client achieves full recovery from the condition ( Stahl, 2017). However, there is no need to change the medication since the client has shown a positive response to the drug and the improvements in the symptoms.
The expected result for this medication is a further improvement in the symptoms of ADHD in the patient such as achieving a full day of attention in class and an increase in attitudes. The client should be able to finish her school work on time and does not experience daydreaming due to inattention. At the same time, introducing long-acting preparation and increasing the dosage to 20 mg seeks to counter the side effects that the patient experiences and anticipates that there will be an increase in the efficiency of the drug ( Stahl & Stahl, 2013) .
After four weeks of treatment, the client reported further improvement in ADHD symptoms that also corresponded with an improvement in academic performance. She says having longer attention spans and concentration in class which has increased her interest. Switching the medication to Long-acting preparation also worked as Katie was able to last through the school day without daydreaming. At the same time, changing the dosage helped in doing away with the side effects as the client reported feeling better. Her pulse rate after four weeks of treatment was 92 beats per minute from 130 in the previous visit.
Decision point 3
The third decision for this medication is to maintain the current dose of Ritalin LA on a daily basis and reevaluate the decision in four weeks. The decision to continue the dosage and medication is because the client is showing an excellent response to the drug with almost full recovery from the symptoms of ADHD. The decision to maintain the medication is to allow for full recovery from the symptoms of ADHD. However, it is not appropriate to change the drug or increase the dosage since Katie’s symptoms are already well controlled as seen with sustained attention throughout her school day. At this stage, there is a need to increase the dosage since it is always advisable to use the lowest effective dose when dealing with stimulant medication ( Stahl & Mignon, 2009) . At the same time, most of the side effects have gone away after she changed to the long-acting preparation.
The expected results for the decision are that the client reports full recovery from the symptoms of ADHD and can achieve normal functioning and higher quality of life. The patient should take the drug for an extended period of 12 weeks while monitoring the symptoms and ensure no further issues arises from the continued use of the drug.
Ethical consideration
Ethical consideration of this medication is to ensure the drug is appropriate for a child of fewer than ten years. There is also need to understand the side effects of the drug before prescribing it to the patient, especially since methylphenidate is a stimulant and therefore can result in heart problems when the client has a family history of heart disease. Therefore conducting a family history and administering dosage in the right dosage is crucial in ensuring no harm is posed to the client.
Conclusion
Treating ADHD in children requires assessing the state of the client during her admission and remission before planning for the appropriate medication. A good option is one that effectively contains the symptoms and brings full recovery to the client within the specified period. This paper focused on using Ritalin (methylphenidate) chewable tablets since it is an appropriate medication to reduce symptoms of ADHD without any risk of side effects ( Biederman et al., 2003) .
References
Biederman, J., Quinn, D., Weiss, M., Markabi, S., Weidenman, M., Edson, K., ... & Wigal, S. (2003). Efficacy and safety of Ritalin® LA™, a new, once daily, extended-release dosage form of methylphenidate, in children with attention deficit hyperactivity disorder. Pediatric Drugs , 5 (12), 833-841.
Charach, A., Dashti, B., Carson, P., Booker, L., Lim, C. G., Lillie, E., ... & Schachar, R. (2011). Attention deficit hyperactivity disorder.
Stahl, S. M. (2017). Prescriber's Guide: Stahl's Essential Psychopharmacology . Cambridge university press.
Stahl, S. M., & Mignon, L. (2009). Stahl's illustrated attention deficit hyperactivity disorder . Cambridge University Press.
Stahl, S. M., & Stahl, S. M. (2013). Stahl's essential psychopharmacology: neuroscientific basis and practical applications . Cambridge university press.
