Initiation of Medication in Children and Adolescents Paper

Initiation of Medication in Children and Adolescents Paper

psychiatric diagnosis and management: Adults

Introduction.

Mental health disorders are very common among children and adolescents. It is estimated that about one in every six children is affected by a mental health disorder. The commonest disorders observed among children include depression and anxiety. The commonly observed mental health conditions among adolescents include anxiety, mood, attention, and behavior disorders with suicide being the second leading cause of mortality among individuals aged between fifteen years and twenty-four years (Bennett et al., 2019). Before initiating any medication among people in this age group, it is important to find out if thorough research has been done on the effectiveness and the effects of the drug in both children and adolescents. This paper highlights the baseline assessments that are important before the initiation of any medication among children and adolescents.

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Baseline Assessments.

During the assessment of both children and adolescents, they may find it difficult to clearly state both the duration and timing of their condition. They may also find it difficult to express various conditions that are embarrassing or that paint them in a bad light. Assessment of both children and adolescents, therefore, requires the health care practitioner to gather information from various sources including parents, teachers, and other caregivers (Abrahams et al., 2019). The information gathered from the various sources may vary but it is critical to ensure that neither the child nor the family is overwhelmed during the whole process. The information gathered should be shared among the various health care professionals involved in the whole care process keeping in mind that this information is critical during both diagnosis and management of the patient.

Clinical assessment is vital in coming up with a case formulation that is critical in guiding management decisions. Identifying signs and symptoms through a comprehensive history and examination is key in addressing various areas of concern including the presence or absence of a mental health disorder (Taylor et al., 2018). For a proper understanding of the condition, it is important to relate the current condition with the child’s psychosocial background and relate the current situation with various factors including treatment and the response to the treatment options used. Acquiring consistent and elaborate information from both the child and the family often poses a challenge. In instances where both the child and the family perceive a meaningful and useful relationship with the health care provider, the gathering of facts surrounding the condition is geared towards the formulation of intervention goals.

A clear and concise medical history is key before the initiation of medication in both children and adolescents. A detailed history coupled with other assessments is key in backing up or refuting the provisional diagnosis. It is vital to determine whether the mental health disorder is a result of a psychiatric disorder or a physical illness (Sharma et al., 2019). In instances where is it determined that the mental health disorder being observed is a result of a condition such as early-onset diabetes or Human Immunodeficiency Virus (HIV), appropriate action can be taken. Engaging a psychiatrist as part of the multidisciplinary team tasked with the responsibility of caring for such a child is important. An elaborate history is, therefore, key in guiding the way forward during the management of a patient and is critical during the determination of initiation of medication in this group of individuals.

Physical examination is also a very important assessment. Physical examination is guided by the patient’s presenting complaints, hypotheses, and differential diagnosis based on the history obtained by the health care professional from both the child and/ or family members. The physical examination is key in assessing key indicators of the overall well-being and development of both children and adolescents. A physical examination involves several key components. In this scenario, the health care professional should examine the overall state of the patient looking out for any signs of self-inflicted harm or physical abuse such as scars. A neurological examination is very important during the assessment of a patient with a mental health disorder (Ansary et al., 2019). A neurological examination focuses on the sensory and motor systems, cranial nerves, overall balance, coordination, and reflexes. A mental status examination identifies any emotional and cognitive alterations in the child and is key in the diagnosis of a mental health disorder. A comprehensive history and thorough examination paint a clear picture of the situation and are important before initiating treatment.

Laboratory investigations guided by the history obtained and the physical examination are also important. There are no standard laboratory investigations carried out in mental health disorders. In most scenarios, the child’s pediatrician is involved during the whole care delivery process. All investigations carried out should be in accordance with the overall health of the child. Renal function tests and thyroid function tests are often ordered. An electrocardiogram is often requested in instances where it is suspected that administered drugs may impact the functioning of the heart. An electroencephalogram is often not ordered but is requested in instances where seizures are suspected or in high-risk individuals such as children with intellectual disabilities (American Psychiatric Association, 2013). Laboratory investigations provide a comprehensive state of the situation and adequately guide patient management.

The patient’s past medical history is important in aiding the health care professional to better understand the patient’s condition. The child’s parent or caregiver is tasked with the responsibility of sharing the child’s pregnancy, perinatal, and early developmental history. A clear association has been identified between these factors and behavioral outcomes and tendencies observed during both childhood and adolescence. These variables often go a long way in guiding follow-up evaluation. They also inform the health care provider of the family’s current situation and any risks that the child was or is exposed to. A child’s developmental history provides a background on which it is easier to comprehend the current behavioral concerns and adequately plan pharmacological and psychotherapeutic management. Focusing on other elements such as the child’s temperament, schooling interests, skills, and interests also provides an avenue for the health care practitioner to better understand the child. This understanding is key in understanding the child’s condition, formulating an intervention plan, and initiating the necessary medication.

Conclusion.

In conclusion, mental health disorders are quite rampant among children and adolescents. Health care professionals have a huge role to play in identifying these disorders and initiating the required management plans. Before initiating medication in a child or an adolescent, it is important to carry out a comprehensive assessment. A thorough history, physical examination, laboratory investigations, and understanding the patient’s history are key in establishing a diagnosis. This diagnosis consequently guides the management plan. Health care professionals should therefore carry out a comprehensive assessment of any child or adolescent where they are suspecting psychiatric disorders before initiating medication.

References.

Abrahams, L., Pancorbo, G., Primi, R., Santos, D., Kyllonen, P., John, O. P., & De Fruyt, F. (2019). Social-Emotional Skill Assessment in children and adolescents: Advances and challenges in personality, clinical, and educational contexts. Psychological Assessment, 31(4), 460–473. https://doi.org/10.1037/pas0000591

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. https://doi.org/10.1176/appi.books.9780890425596

Ansary, A. M., Martinez, J. N., & Scott, J. D. (2019). The virtual physical exam in the 21st Century. Journal of Telemedicine and Telecare, 27(6), 382–392. https://doi.org/10.1177/1357633×19878330

Bennett, S. D., Cuijpers, P., Ebert, D. D., McKenzie Smith, M., Coughtrey, A. E., Heyman, I., Manzotti, G., & Shafran, R. (2019). Practitioner review: Unguided and guided self-help interventions for common mental health disorders in children and adolescents: A systematic review and meta-analysis. Journal of Child Psychology and Psychiatry, 60(8), 828–847. https://doi.org/10.1111/jcpp.13010

Sharma, E., Srinath, S., Jacob, P., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(8), 158. https://doi.org/10.4103/psychiatry.indianjpsychiatry_580_18

Taylor, D. M., Barnes, T. R., & Young, A. H. (2021). The Maudsley prescribing guidelines in psychiatry. https://doi.org/10.1002/9781119870203

 

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Discussion Question: Discuss all of the baseline assessments necessary before initiation of medication in children and adolescents

Please use at least two required text book

Discussion Board question rubrics

Application of Course Knowledge

1. Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding
2. All 4 critical elements are present:

Support from Evidence-Based Practice (EBP)

1. Discussion Answers are supported with a minimal of One (3) appropriate, scholarly source;.
2. Sources are published within the last 5 years
3. Reference list is provided and in-text citations match.
4. Includes support from textbook(s]
5. All 4 critical elements are present:

REQUIRED TEXTS

1.American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association Publishing, Inc.

2.American Psychiatric Nurses Association, International Society of Psychiatric-Mental Health Nursing, & American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Nursebooks.org.

3.American Psychological Association. (2019). Publication manual of the American Psychological Association (7th ed.). American Psychological Association.

4.Perese, E. (2012). Psychiatric advance practice nursing: A biopsychosocial foundation for practice. F.A. Davis Company.

5.Taylor, D. M., Barnes, T. R. E., & Young, A. H. (2018). The Maudsley prescribing guidelines in psychiatry (13th ed.). John Wiley & Sons, Inc.

OPTIONAL MATERIALS

1.Boyd, M. A. & Lubbert, R. A. (2019). Essentials of psychiatric nursing (2nd ed.). Wolters Kluwer/Lippincott Williams & Wilkins Co. Leahy, L. G., & Kohler, C. G. (2013).

2.Clinical manual of psychopharmacology for nurses. American Psychiatric Association Publishing.

3. Stahl, S. M. (2017). Prescriber’s guide: Stahl’s essential psychopharmacology (6th ed.). Cambridge University Press.