Prescribing for Children and Adolescents NRNP 6665

Prescribing for Children and Adolescents NRNP 6665

Prescribing For Children And Adolescents With Eating Disorders Example Approach

Eating disorders are psychological illnesses characterized by unusual feeding habits. Types of eating disorders include bulimia, anorexia nervosa, avoidant restrictive food eating disorder, and binge eating disorder. The management of eating disorders in children and adolescents can be pharmacological or non-pharmacological (Hay, 2020). Fluoxetine is an FDA-approved drug that is used in pharmacological management. An off-label drug that can be used is olanzapine. Additionally, cognitive behavioral therapy can be used in non-pharmacological management.

The risk score for eating disorders will inform my decision for treatment. Risk assessment for eating disorders can be done using the Sick, Control, One, Fat & Food (SCOFF) Questionnaire. This is a 5-item questionnaire that asks if an individual induces vomiting, loses control over the amount they eat, if they have lost more than 15 pounds in three months if they think they are fat, yet they are thin, and if food controls their life (Kutz et al., 2020). If two or more questions are answered positively, the patient is started on treatment.

According to Himmerich et al. (2021), fluoxetine is useful in managing eating disorders in that it alleviates anxiety or depression associated with the disease. The disadvantage of using fluoxetine is that it can cause insomnia, dry mouth, tremors, and weakness. Olanzapine also alleviates anxiety (Copur & Copur, 2020). However, it can cause respiratory depression, hyperglycemia, and anticholinergic effects like miosis.

The World Federation of Societies of Biological Psychiatry recommends antidepressants, antipsychotics, antiepileptics, and antihistamines to manage eating disorders. It also recommends combining pharmacological with non-pharmacological treatment. Fluoxetine is an antidepressant in the class of selective serotonin reuptake inhibitors. Olanzapine is a second-generation antipsychotic. These medications can be given along with psychotherapy.

References

 Çöpür, S., & Çöpür, M. (2020). Olanzapine in the treatment of anorexia nervosa: a systematic review. The Egyptian Journal of Neurology, Psychiatry, and Neurosurgery, 56(1), 1-7. https://doi.org/10.1186/s41983-020-00195-y

Hay, P. (2020). The current approach to eating disorders: a clinical update. Internal Medicine Journal, 50(1), 24–29. https://doi.org/10.1111/imj.14691

Himmerich, H., Kan, C., Au, K., & Treasure, J. (2021). Pharmacological treatment of eating disorders, comorbid mental health problems, malnutrition, and physical health consequences. Pharmacology & Therapeutics, 217, 107667. https://doi.org/10.1080/14740338.2018.1395854

Kutz, A. M., Marsh, A. G., Gunderson, C. G., Maguen, S., & Masheb, R. M. (2020). Eating disorder screening: a systematic review and meta-analysis of diagnostic test characteristics of the SCOFF. Journal Of General Internal Medicine, 35(3), 885–893. https://doi.org/10.1007/s11606-019-05478-6

Week 3: Assignment 1 PRESCRIBING FOR CHILDREN AND ADOLESCENTS INSTRUCTIONS

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

—Agency for Healthcare Research and Quality

Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients.

Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?

For this Prescribing for Children and Adolescents NRNP 6665 Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

Reference:

Agency for Healthcare Research and Quality. (2015). Off-label drugs: What you need to know. https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.htmlLinks to an external site.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCE

TO PREPARE

  • Your Instructor will assign a specific disorder for you to research for this Assignment.
  • Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.

THE ASSIGNMENT (1–2 PAGES)

  • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
  • Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
  • Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
  • Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

BY DAY 7 OF WEEK 3

Submit your Assignment.

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

  1. To submit your completed assignment, save your Assignment as WK3Assgn1+last name+first initial.
  2. Then, click on Start Assignmentnear the top of the page.
  3. Next, click on Upload Fileand select Submit Assignment for review.

Prescribing for Children and Adolescents NRNP 6665 Rubric

NRNP_6665_Week3_Assignment1_Rubric

NRNP_6665_Week3_Assignment1_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIn 1–2 pages, address the following: • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
25 to >22.0 pts

Excellent

The response accurately and concisely explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.

22 to >19.0 pts

Good

The response accurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.

19 to >17.0 pts

Fair

The response somewhat vaguely or inaccurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.

17 to >0 pts

Poor

The response vaguely or inaccurately explains interventions that would be appropriate for treating the assigned disorder in children and adolescents. Interventions may not represent the three types of interventions required, or response may be missing.

25 pts
This criterion is linked to a Learning Outcome• Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
25 to >22.0 pts

Excellent

The response accurately and concisely explains the risk assessment you would use to inform your treatment decision making. A concise and accurate explanation of the risks and benefits of each pharmacological intervention is provided.

22 to >19.0 pts

Good

The response accurately explains the risk assessment you would use to inform your treatment decision making. An adequate explanation of the risks and benefits of each pharmacological intervention is provided.

19 to >17.0 pts

Fair

The response somewhat vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The explanation of the risks and benefits of each pharmacological intervention is somewhat vague or inaccurate.

17 to >0 pts

Poor

The response vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The risks and benefits of each pharmacological intervention is vague or inaccurate. Or, the response is missing.

25 pts
This criterion is linked to a Learning Outcome• Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
25 to >22.0 pts

Excellent

The response accurately and concisely uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.

22 to >19.0 pts

Good

The response accurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.

19 to >17.0 pts

Fair

The response somewhat vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.

17 to >0 pts

Poor

The response vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations. Or, the response is missing.

25 pts
This criterion is linked to a Learning Outcome• Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Be sure they are current (no more than 5 years old). Attach the PDFs of your sources.
10 to >8.0 pts

Excellent

The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations. The resources reflect the latest clinical guidelines and provide strong justification for decision making.

8 to >7.0 pts

Good

The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations.

7 to >6.0 pts

Fair

Three evidence-based resources are provided to support the intervention recommendations, but they may only provide vague or weak justification.

6 to >0 pts

Poor

Two or fewer resources are provided to support the intervention recommendations. The resources may not be current or evidence based.

10 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.5 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3.5 to >3.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

3 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time. No purpose statement, introduction, or conclusion were provided.

5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors

4 to >3.5 pts

Good

Contains one or two grammar, spelling, and punctuation errors

3.5 to >3.0 pts

Fair

Contains several (three or four) grammar, spelling, and punctuation errors

3 to >0 pts

Poor

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/ narrative in-text citations, and reference list.
5 to >4.0 pts

Excellent

Uses correct APA format with no errors

4 to >3.5 pts

Good

Contains one or two APA format errors

3.5 to >3.0 pts

Fair

Contains several (three or four) APA format errors

3 to >0 pts

Poor

Contains many (five or more) APA format errors

5 pts
Total Points: 100

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LEARNING RESOURCES

Required Readings

Prescribing for Children and Adolescents NRNP 6665

  • Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental healthLinks to an external site.. American Psychiatric Association Publishing.
    • Chapter 14, “Psychosocial Interventions”
    • Chapter 15, “Psychotherapeutic Interventions”
    • Chapter 16, “Psychopharmacological Interventions”Links to an external site.
  • Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry(6th ed.). Wiley Blackwell.
    • Chapter 43, “Pharmacological, Medically-Led and Related Treatments”
  • Walden University. (n.d.). Developing SMART goalsLinks to an external site.. https://academicguides.waldenu.edu/ld.php?content_id=51901492Links to an external site.
  • Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.
    • Chapter 5, “Psychopharmacology”

Required Media

NRNP 6665 Week 3: Assignment 2 STUDY PLAN

Based on your practice exam question results from Week 2, identify strengths and areas of opportunity and create a tailored study plan to use throughout this course to help you prepare for the national certification exam. This will serve as an action plan to help you track your goals, tasks, and progress. You will revisit and update your study plan in NRNP 6675, and you may continue to refine and use it until you take the exam.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

TO PREPARE

  • Reflect on your practice exam question results from Week 2. Identify content-area strengths and opportunities for improvement.
  • Also reflect on your overall test taking. Was the length of time allotted comfortable, or did you run out of time? Did a particular question format prove difficult?

THE ASSIGNMENT

  • Based on your practice test question results, and considering the national certification exam, summarize your strengths and opportunities for improvement. Note:Your grade for this Assignment will not be derived from your test results but from your self-reflection and study plan.
  • Create a study plan for this quarter to prepare for the certification exam, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.
  • Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.

BY DAY 7 OF WEEK 3

Submit your study plan.

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

  1. To submit your completed assignment, save your Assignment as WK3Assgn2+last name+first initial.
  2. Then, click on Start Assignment near the top of the page.
  3. Next, click on Upload File and select Submit Assignment for review.

Rubric

NRNP_6665_Week3_Assignment2_Rubric

NRNP_6665_Week3_Assignment2_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeBased on your practice test question results and considering the national certification exam, summarize your strengths and opportunities for improvement.
25 to >22.0 pts

Excellent

The response provides an accurate, clear, and complete summary of both the strengths and opportunities for improvement.

22 to >19.0 pts

Good

The response provides an accurate summary of both the strengths and opportunities for improvement.

19 to >17.0 pts

Fair

The response provides a somewhat vague and/or inaccurate summary of both the strengths and opportunities for improvement.

17 to >0 pts

Poor

A summary of both the strengths and opportunities for improvement are incomplete or missing.

25 pts
This criterion is linked to a Learning OutcomeCreate a study plan, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.
30 to >26.0 pts

Excellent

The response provides three or four clear and appropriate SMART goals for the study plan, including tasks to complete to accomplish each goal. A clear timeline is provided for the study plan as well as a description of how progress toward goal completion will be measured.

26 to >23.0 pts

Good

The response provides three or four appropriate SMART goals and objectives for the practicum experience. Appropriate tasks, timeline, and description of how progress will be measured are provided.

23 to >20.0 pts

Fair

The response provides three or four somewhat vague or general goals for the study plan. Tasks, timeline, and description of how progress toward goals will be measured are vague or somewhat inappropriate.

20 to >0 pts

Poor

The response provides three or four unclear or inappropriate goals for the study plan, or goals are missing. Tasks, timeline, and a description for how progress will be measured are incomplete or missing.

30 pts
This criterion is linked to a Learning OutcomeDescribe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.
30 to >26.0 pts

Excellent

The response provides a clear description of appropriate resources to support the study plan that are tailored to individual need.

26 to >23.0 pts

Good

The response provides a description of appropriate resources to support the study plan that are somewhat tailored to individual need.

23 to >20.0 pts

Fair

The response provides a description of general resources that are not tailored to individual need.

20 to >0 pts

Poor

The response provides a description of inappropriate resources to support the study plan, or the description of resources is vague or missing.

30 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.5 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3.5 to >3.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

3 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time. Purpose statement, introduction, and conclusion were not provided.

5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors

4 to >3.5 pts

Good

Contains one or two grammar, spelling, and punctuation errors

3.5 to >3.0 pts

Fair

Contains several (three or four) grammar, spelling, and punctuation errors

3 to >0 pts

Poor

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference list.
5 to >4.0 pts

Excellent

Uses correct APA format with no errors

4 to >3.5 pts

Good

Contains one or two APA format errors

3.5 to >3.0 pts

Fair

Contains several (three or four) APA format errors

3 to >0 pts

Poor

Contains many (five or more) APA format errors

5 pts
Total Points: 100