What barriers to effective communication could occur with a health care professional colleague who is culturally diverse?

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arriers to Effective Communication

We face challenging barriers to effective communication in the healthcare field. As our world becomes smaller, we are in constant contact with patients, colleagues, or consumers from culturally diverse backgrounds and we need to develop our skills to improve effective communication.

Using the South University Online Library, search the following articles:

  • The Role of Nursing in Bridging the Gap between Managers and Physicians in Hospitals
  • Improving Communication in the Health Care Setting

Based on your research, answer the questions below writing at least five sentences per question in a Microsoft Word document. You need to think of a communication with a healthcare professional colleague to answer the following questions:

  • What barriers to effective communication could occur with a health care professional colleague who is culturally diverse? How can these barriers affect patient outcome when effective communication is essential?
  • What assumptions can you make about a healthcare professional colleague you do not know well? How can these assumptions impact your communication if your customs are different from your healthcare professional colleague’s customs and you do not understand their customs completely?
  • How can you overcome language barriers or make assumptions not based on facts to increase team unity and motivation? How important is it for you to take responsibility and improve your cultural competence?

Now you need to think of a communication with a patient or a consumer and answer the following questions:

  • What specific language barriers can result when you communicate with a patient or a consumer who speaks limited English? How can you gather information or educate when language barriers are present?
  • How do you adjust to conflicting values or traditions from patients in a specific religion or culture? For example, patients who are Jehovah’s Witness religion may refuse blood products or other religions may not eat pork. How do you adjust dietary restrictions communicating in a collaborative manner with the dietary department?
  • What are the benefits of a healthcare organization to provide cultural awareness and training for each employee to better understand and accept others? Does your current or past organization provide cultural awareness training? If not, what will be your recommendation to your management team?
  • Select one culture other than your own and describe how this culture may deal with death and mourning.

Support your responses with examples.

Cite any sources in APA format.

References:

Kaissi, A. (2008). The role of nursing in bridging the gap between managers and
physicians in hospitals. The Health Care Manager, 27(2), 113–117.

Ponte, C. D. (2011). Improving communication in the health care setting. American
Journal of Health-System Pharmacy, 68(8), 666–667.

Submission Details

Name your document SU_HSC4060_W1_A3_LastName_FirstInitial.doc.

Submit your document to the W1 Assignment 3 Dropbox by Tuesday, September 5, 2017.

Assignment 3 Grading Criteria
Maximum Points
Identified barriers to effective communication with a culturally diverse healthca

What alteration occurs in injured endothelial cells that contributes to atherosclerosis?

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Question

Question 1

2 / 2 pts

In hemolytic anemia, jaundice occurs only when

the patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT).

heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin.

the erythrocytes are coated with an immunoglobulin.

erythrocytes are destroyed in the spleen.

Question 2

2 / 2 pts

Symptoms of polycythemia vera are mainly the result of

destruction of erythrocytes.

neurologic involvement.

increased blood viscosity.

a decreased erythrocyte count.

Question 3

2 / 2 pts

The underlying disorder of _____ anemia is defective secretion of intrinsic factor, which is essential for the absorption of vitamin B12.

pernicious

microcytic

hypochromic

hemolytic

Question 4

2 / 2 pts

Pernicious anemia generally requires continued therapy lasting

8 to 12 months.

the rest of one’s life.

until the iron level is normal.

6 to 8 weeks.

Question 5

2 / 2 pts

In some anemias, the erythrocytes are present in various sizes, which is referred to as

microcytosis.

poikilocytosis.

isocytosis.

anisocytosis.

Question 6

2 / 2 pts

Untreated pernicious anemia is fatal, usually because of

renal failure.

heart failure.

brain hypoxia.

liver hypoxia.

Question 7

0 / 2 pts

Local signs and symptoms of Hodgkin disease–related lymphadenopathy are a result of

inflammation and ischemia.

obstruction and pressure.

ischemia and pressure.

pressure and obstruction.

Question 8

2 / 2 pts

What is the most common cause of vitamin K deficiency?

An IgG-mediated autoimmune disorder

Liver failure

Total parenteral nutrition (TPN) with antibiotic therapy

Administration of warfarin (Coumadin)

Question 9

2 / 2 pts

Heparin-induced thrombocytopenia (HIT) is described as a(n)

IgG immune-mediated adverse drug reaction that reduces circulating platelets.

hematologic reaction to heparin in which the bone marrow is unable to produce sufficient platelets to meet the body’s needs.

cell-mediated drug reaction in which macrophages process the heparin and platelet complexes that are then destroyed by activated cytotoxic T cells.

IgE-mediated allergic drug reaction that reduces circulating platelets.

Question 10

2 / 2 pts

Which proinflammatory cytokines are responsible for the development and maintenance of DIC?

Tumor necrosis factor-alpha (TNF-a); IL-1, IL-6, and IL-8; and platelet-activatingfactor (PAF)

Granulocyte-macrophage colony-stimulating factor (GM-CSF); IL-3, IL-5, and IL-9, and IFN-?

Granulocyte colony-stimulating factor (G-CSF); IL-2, IL-4, and IL-10; and IFN-?

Macrophage colony-stimulating factor (M-CSF); IL-7, IL-11, and IL-14; and PAF

Question 11

2 / 2 pts

G6PD and sickle cell disease are

diagnosed equally in men and women.

inherited autosomal recessive disorders.

inherited X-linked recessive disorders.

disorders initiated by hypoxemia and acidosis.

Question 12

2 / 2 pts

The sickle cell trait differs from sickle cell disease in that the child with sickle cell trait

has the mildest form of the disease with normal hemoglobin and hemoglobin F, which prevents sickling.

has a mild form of sickle cell disease that causes sickling during fever and infection, but not during acidosis or hypoxia, whereas the child with sickle cells disease develops sickling during each of these conditions.

has a milder form of the disease that is characterized by vaso-occlusive crises and is believed to result from higher hemoglobin values and viscosity.

inherited normal hemoglobin A from one parent and Hb S from the other parent, whereas the child with sickle cell disease has Hb S from both parents.

Question 13

2 / 2 pts

Hemolytic disease of the newborn can occur if the mother is

type AB blood and the fetus has type B.

Rh-positive and the fetus is Rh-negative.

Rh-negative and the fetus is Rh-positive.

type A blood and the fetus has type O.

Question 14

2 / 2 pts

What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain?

Icterus gravis neonatorum

Jaundice

Kernicterus

Icterus neonatorum

Question 15

2 / 2 pts

In a full-term infant, the normal erythrocyte life span is _____ days, whereas the adult is _____ days.

30 to 50; 80

60 to 80; 120

120 to 130; 150

90 to 110; 140

Question 16

0 / 2 pts

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune process involving antibodies against

eosinophils.

basophils.

neutrophils.

platelets.

Question 17

2 / 2 pts

Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes?

15

10

25

20

Question 18

0 / 2 pts

The risk of developing coronary artery disease is increased up to threefold by

obesity.

hypertension.

high alcohol consumption.

diabetes mellitus.

Question 19

0 / 2 pts

What alteration occurs in injured endothelial cells that contributes to atherosclerosis?

They are unable to make the normal amount of vasodilating cytokines.

They produce an increased amount of antithrombotic cytokines.

They develop a hypersensitivity to homocysteine and lipids.

They release toxic oxygen radicals that oxidize low-density lipoproteins (LDLs).

Question 20

2 / 2 pts

In systolic heart failure, what effect does angiotensin II have on stroke volume?

Increases preload and decreases afterload

Increases preload and increases afterload

Decreases preload and decreases afterload

Decreases preload and increases afterload

Question 21

2 / 2 pts

What is the most important clinical manifestation of aortic coarctation in the neonate?

Congestive heart failure (CHF)

Cor pulmonale

Cerebral hypertension

Pulmonary hypertension

Question 22

2 / 2 pts

When does most cardiovascular development occur?

Between the 12th and 14th weeks of gestation

Between the eighth and 10th weeks of gestation

By the 28th day of gestation

Between the fourth and seventh weeks of gestation

Question 23

2 / 2 pts

Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click?

Pulmonic stenosis

Hypoplastic left heart syndrome

Aortic stenosis

Coarctation of the aorta

Question 24

2 / 2 pts

Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?

Coarctation of the aorta and pulmonary stenosis

Tetralogy of Fallot and persistent truncus arteriosus

Atrial septal defect and dextrocardia

Ventricular septal defect and patent ductus arteriosus

Question 25

2 / 2 pts

The foramen ovale is covered by a flap that creates a check valve allowing blood to flow unidirectionally from the _____ to the _____.

right atrium; left atrium

right atrium; right ventricle

right ventricle; left ventricle

left atrium; left ventricle

What are the implications of TB for critical care and advanced practice nurses?

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1. Conduct an evidence-based literature search to identify the most recent standards of care/treatment modalities from peer-reviewed articles and professional association guidelines (www.guideline.gov).

Cite a minimum of three resources.

Answer the following questions:

  1. What is the transmission and pathophysiology of TB?
  2. What are the clinical manifestations?
  3. After considering this scenario, what are the primary identified medical concerns for this patient?
  4. What are the primary psychosocial concerns?
  5. What are the implications of the treatment regimen, as far as likelihood of compliance and outcomes? Search the Internet to research rates of patient compliance in treatment of TB, as well as drug resistant TB.
  6. Identify the role of the community clinic in assisting patients, particularly undocumented patients, in covering the cost of TB treatment. What resources exist for TB treatment in community health centers around the United States? Compare the cost for treatment between, subsidized as it would be for a community health center, and unsubsidized.
  7. What are the implications of TB for critical care and advanced practice nurses?

 

Your paper should be 4 pages, (excluding cover page and reference page).

Your resources must include research articles as well as reference to non-research evidence-based guidelines.

Use APA format to style your paper and to cite your sources.

Discuss the use of a medication such as Adderall and its evidence for treating ADHD

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  // Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder A Young Girl With ADHD

A Young Girl With ADHD

 

Decision Point One Begin Wellbutrin (bupropion) XL 150 mg orally daily

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Katie’s parents inform you that they stopped giving Katie the medication because about 2 weeks into the prescription, Katie told her parents that she was thinking about hurting herself. This scared the parents, but they didn’t want to “bother you” by calling the office, so they felt that it would be best to just stop the medication as they would be seeing you in two weeks

Decision Point Two

Select what the PMHNP should do next:

Educate the parents that Bupropion sometimes causes suicidal ideation in children and that this is normal, and re-start the drug at the previous dose

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Katie’s parents again report that after about a week of treatment with the Bupropion, Katie began telling her parents that she wanted to hurt herself and began having dreams about being dead. This scared her parents and they stopped giving her the medication
  • At this point, they are quite upset with the results of their daughter’s treatment and are convinced that medication is not the answer

Decision Point Three

Select what the PMHNP should do next:

Refer the parents to a pediatric psychologist who can use behavioral therapy to treat Katie’s ADHD

Guidance to StudentBupropion is used off-label for ADHD and is used more commonly in adults. It’s mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex, (which largely lacks dopamine transporters) bupropion can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Bupropion as well as other antidepressants have been linked to suicidal ideation in children and adolescents- despite the fact that it was being used initially to treat ADHD, it is still an antidepressant.

At this point, the parents are probably quite frustrated as no parent wants to hear their child talking about hurting themselves or having dreams about being dead. If the parents are adamant about no more medications, referral to a pediatric psychologist or similar therapist skilled in the use of behavioral therapies to treat ADHD in children. However, it should be noted that behavioral therapies work best when combined with medication, however, if the parents are insistent, then behavioral therapy may be the only alternative left in the treatment of Katie.

In terms of the pathophysiology of ADHD, whereas it may be true that increasing age may demonstrate some improvement in symptoms (some people will actually experience complete resolution of symptoms by adulthood), it is not helping Katie in the here and now. Katie still needs help with her symptoms which are causing academic issues.

The PMHNP should attempt to repair the rupture in the therapeutic alliance (the parents now believe that medications are not the answer) by explaining rationale for the use of Bupropion (many people like to start with Bupropion because it has a low-risk for addiction). The family should be encouraged to allow the PMHNP to initiate Adderall as it has a very good track record in terms of its efficacy in treating ADHD.

Start Over

Do nothing, and explain to the parents that Katie’s ADHD will most likely improve with age as her prefrontal cortex grows and matures

Guidance to StudentBupropion is used off-label for ADHD and is used more commonly in adults. It’s mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex, (which largely lacks dopamine transporters) bupropion can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Bupropion as well as other antidepressants have been linked to suicidal ideation in children and adolescents- despite the fact that it was being used initially to treat ADHD, it is still an antidepressant.

At this point, the parents are probably quite frustrated as no parent wants to hear their child talking about hurting themselves or having dreams about being dead. If the parents are adamant about no more medications, referral to a pediatric psychologist or similar therapist skilled in the use of behavioral therapies to treat ADHD in children. However, it should be noted that behavioral therapies work best when combined with medication, however, if the parents are insistent, then behavioral therapy may be the only alternative left in the treatment of Katie.

In terms of the pathophysiology of ADHD, whereas it may be true that increasing age may demonstrate some improvement in symptoms (some people will actually experience complete resolution of symptoms by adulthood), it is not helping Katie in the here and now. Katie still needs help with her symptoms which are causing academic issues.

The PMHNP should attempt to repair the rupture in the therapeutic alliance (the parents now believe that medications are not the answer) by explaining rationale for the use of Bupropion (many people like to start with Bupropion because it has a low-risk for addiction). The family should be encouraged to allow the PMHNP to initiate Adderall as it has a very good track record in terms of its efficacy in treating ADHD.

Start Over

Discuss the use of a medication such as Adderall and its evidence for treating ADHD

Guidance to StudentBupropion is used off-label for ADHD and is used more commonly in adults. It’s mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex, (which largely lacks dopamine transporters) bupropion can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Bupropion as well as other antidepressants have been linked to suicidal ideation in children and adolescents- despite the fact that it was being used initially to treat ADHD, it is still an antidepressant.

At this point, the parents are probably quite frustrated as no parent wants to hear their child talking about hurting themselves or having dreams about being dead. If the parents are adamant about no more medications, referral to a pediatric psychologist or similar therapist skilled in the use of behavioral therapies to treat ADHD in children. However, it should be noted that behavioral therapies work best when combined with medication, however, if the parents are insistent, then behavioral therapy may be the only alternative left in the treatment of Katie.

In terms of the pathophysiology of ADHD, whereas it may be true that increasing age may demonstrate some improvement in symptoms (some people will actually experience complete resolution of symptoms by adulthood), it is not helping Katie in the here and now. Katie still needs help with her symptoms which are causing academic issues.

The PMHNP should attempt to repair the rupture in the therapeutic alliance (the parents now believe that medications are not the answer) by explaining rationale for the use of Bupropion (many people like to start with Bupropion because it has a low-risk for addiction). The family should be encouraged to allow the PMHNP to initiate Adderall as it has a very good track record in terms of its efficacy in treating ADHD.

Start Over

Discontinue Wellbutrin and begin Strattera (atomoxetine) 10 mg orally daily

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Katie’s parents report that they spoke with Katie’s teacher who notices that her symptoms are getting a bit better
  • They are very concerned, however, about Katie’s decreased appetite. They say that Katie was never a “big eater” but have become concerned that her appetite has worsened

Decision Point Three

Select what the PMHNP should do next:

Maintain current dose of Strattera and reevaluate side effects at next office visit in 4 weeks

Guidance to StudentWellbutrin is used off-label for ADHD but is used more commonly in adults. Its mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex (which largely lacks dopamine transporters), Wellbutrin can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Wellbutrin, as well as other antidepressants, has been linked to suicidal ideation in children and adolescents. Despite the fact that it is being used to treat ADHD, it is still an antidepressant.

After discontinuing the Wellbutrin and beginning Strattera (atomoxetine), a decrease in symptoms was noted by Katie’s teacher. This indicates that the drug is working. However, the parents are concerned about Katie’s decreased appetite. This side effect may improve with the passage of time, but the PMHNP will need to monitor it. Keep in mind that if the PMHNP decides to increase the dose at this point, the side effects may worsen. Additionally, Strattera can take up to 8 to 12 weeks to demonstrate the full therapeutic actions of the drug; therefore, it may be prudent at this point to maintain the current dose.

The development of common side effects are not an indication to discontinue one drug and begin a different medication unless they are severe enough to warrant intervention (i.e., they are severe or incapacity for the individual); therefore, it would not be appropriate to discontinue Strattera and begin Intuniv.

Start Over

Discontinue Strattera and begin Intuniv extended release, 1 mg orally daily

Guidance to StudentWellbutrin is used off-label for ADHD but is used more commonly in adults. Its mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex (which largely lacks dopamine transporters), Wellbutrin can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Wellbutrin, as well as other antidepressants, has been linked to suicidal ideation in children and adolescents. Despite the fact that it is being used to treat ADHD, it is still an antidepressant.

After discontinuing the Wellbutrin and beginning Strattera (atomoxetine), a decrease in symptoms was noted by Katie’s teacher. This indicates that the drug is working. However, the parents are concerned about Katie’s decreased appetite. This side effect may improve with the passage of time, but the PMHNP will need to monitor it. Keep in mind that if the PMHNP decides to increase the dose at this point, the side effects may worsen. Additionally, Strattera can take up to 8 to 12 weeks to demonstrate the full therapeutic actions of the drug; therefore, it may be prudent at this point to maintain the current dose.

The development of common side effects are not an indication to discontinue one drug and begin a different medication unless they are severe enough to warrant intervention (i.e., they are severe or incapacity for the individual); therefore, it would not be appropriate to discontinue Strattera and begin Intuniv.

Start Over

Increase Strattera to 25 mg orally daily and reevaluate at next office visit in 4 weeks

Guidance to StudentWellbutrin is used off-label for ADHD but is used more commonly in adults. Its mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex (which largely lacks dopamine transporters), Wellbutrin can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Wellbutrin, as well as other antidepressants, has been linked to suicidal ideation in children and adolescents. Despite the fact that it is being used to treat ADHD, it is still an antidepressant.

After discontinuing the Wellbutrin and beginning Strattera (atomoxetine), a decrease in symptoms was noted by Katie’s teacher. This indicates that the drug is working. However, the parents are concerned about Katie’s decreased appetite. This side effect may improve with the passage of time, but the PMHNP will need to monitor it. Keep in mind that if the PMHNP decides to increase the dose at this point, the side effects may worsen. Additionally, Strattera can take up to 8 to 12 weeks to demonstrate the full therapeutic actions of the drug; therefore, it may be prudent at this point to maintain the current dose.

The development of common side effects are not an indication to discontinue one drug and begin a different medication unless they are severe enough to warrant intervention (i.e., they are severe or incapacity for the individual); therefore, it would not be appropriate to discontinue Strattera and begin Intuniv.

Start Over

Discontinue Wellbutrin and begin Adderall (amphetamine d, l) extended release 5 mg orally daily

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Katie’s parents report that they spoke with Katie’s teacher who notices that her symptoms are getting a bit better
  • They are very concerned, however, about Katie’s decreased appetite. They say that Katie was never a “big eater” but have become concerned that her appetite has worsened

Decision Point Three

Select what the PMHNP should do next:

Maintain current dose of Adderall and re-evaluate side effects at next office visit in 4 weeks

Guidance to StudentWellbutrin is used off-label for ADHD but is used more commonly in adults. Its mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex (which largely lacks dopamine transporters), Wellbutrin can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Wellbutrin, as well as other antidepressants, has been linked to suicidal ideation in children and adolescents. Despite the fact that it is being used to treat ADHD, it is still an antidepressant.

After discontinuing the Wellbutrin and beginning Adderall, a decrease in symptoms was noted by Katie’s teacher. This indicates that the drug is working. However, the parents are concerned about Katie’s decreased appetite. This side effect may improve with the passage of time, but the PMHNP will need to monitor it.

Increasing the dose of Adderall may worsen this side effect; however, if symptoms are still severe enough, an increase in dose may be warranted. At this point, the PMHNP needs to know what symptoms have improved and—based on overall functioning—must then determine whether or not there is an indication to increase the current dose of the medication.

The development of common side effects are not an indication to discontinue one drug and begin a different medication unless they are severe enough to warrant intervention (i.e., they are severe or incapacity for the individual); therefore, it would not be appropriate to discontinue Strattera and begin Intuniv.

Start Over

Discontinue Adderall and begin Intuniv extended release, 1 mg orally daily

Guidance to StudentWellbutrin is used off-label for ADHD but is used more commonly in adults. Its mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex (which largely lacks dopamine transporters), Wellbutrin can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Wellbutrin, as well as other antidepressants, has been linked to suicidal ideation in children and adolescents. Despite the fact that it is being used to treat ADHD, it is still an antidepressant.

After discontinuing the Wellbutrin and beginning Adderall, a decrease in symptoms was noted by Katie’s teacher. This indicates that the drug is working. However, the parents are concerned about Katie’s decreased appetite. This side effect may improve with the passage of time, but the PMHNP will need to monitor it.

Increasing the dose of Adderall may worsen this side effect; however, if symptoms are still severe enough, an increase in dose may be warranted. At this point, the PMHNP needs to know what symptoms have improved and—based on overall functioning—must then determine whether or not there is an indication to increase the current dose of the medication.

The development of common side effects are not an indication to discontinue one drug and begin a different medication unless they are severe enough to warrant intervention (i.e., they are severe or incapacity for the individual); therefore, it would not be appropriate to discontinue Strattera and begin Intuniv.

Start Over

Adderall to 10 mg extended release daily and reevaluate at next office visit in 4 weeks

Guidance to StudentWellbutrin is used off-label for ADHD but is used more commonly in adults. Its mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex (which largely lacks dopamine transporters), Wellbutrin can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Wellbutrin, as well as other antidepressants, has been linked to suicidal ideation in children and adolescents. Despite the fact that it is being used to treat ADHD, it is still an antidepressant.

After discontinuing the Wellbutrin and beginning Adderall, a decrease in symptoms was noted by Katie’s teacher. This indicates that the drug is working. However, the parents are concerned about Katie’s decreased appetite. This side effect may improve with the passage of time, but the PMHNP will need to monitor it.

Increasing the dose of Adderall may worsen this side effect; however, if symptoms are still severe enough, an increase in dose may be warranted. At this point, the PMHNP needs to know what symptoms have improved and—based on overall functioning—must then determine whether or not there is an indication to increase the current dose of the medication.

The development of common side effects are not an indication to discontinue one drug and begin a different medication unless they are severe enough to warrant intervention (i.e., they are severe or incapacity for the individual); therefore, it would not be appropriate to discontinue Strattera and begin Intuniv.

Start Over