response to VIDA

docx

School

Kenyatta University *

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Course

101

Subject

Nursing

Date

Nov 24, 2024

Type

docx

Pages

Uploaded by E_l_i_j_a_h_IX94

Hi Vida, I am going to comment on the following aspects of your presentation. Diagnosis The diagnostic impressions of Attention Deficit Hyperactivity Disorder (ADHD) and Generalized Anxiety Disorder (GAD) appear well-founded based on the patient's presentation and reported symptoms. The patient's history of childhood speech delay, ongoing difficulties with concentration, focus, and learning aligns with ADHD, a neurodevelopmental disorder that can persist into adulthood. His expression of excessive worry about upcoming responsibilities and an inability to alleviate this anxiety is indicative of GAD. The assessments seem to adequately cover these diagnostic considerations. Pharmacological Therapy The choice of Strattera (atomoxetine) for treating ADHD is reasonable, especially considering its status as a non-stimulant medication suitable for adults. Atomoxetine has shown efficacy in improving attention and impulse control in individuals with ADHD (Fu et al., 2022). It's crucial to educate the patient about the medication's mechanism of action, potential side effects, and the importance of adherence. Monitoring for side effects and efficacy should be a routine part of the follow-up process. However, a discussion about potential interactions with atomoxetine and hypothyroidism should occur since the patient reports having hypothyroidism Psychotherapy The inclusion of cognitive-behavioral therapy (CBT) is appropriate to address both ADHD and anxiety symptoms. CBT has a strong evidence base for managing anxiety disorders and can also be adapted to address attention and concentration challenges (Curtiss et al., 2021). It is essential to monitor the patient's active participation in therapy sessions and assess treatment progress.

Techniques for enhancing focus, managing anxiety, and improving study routines should be a key focus of CBT. Non-Pharmacological Therapy Incorporating time management strategies, mindfulness exercises, relaxation techniques, and potentially alternative therapies like yoga can provide valuable non-pharmacological support. These interventions can help the patient better manage anxiety, improve concentration, and enhance overall well-being. Encouraging regular physical exercise and a balanced diet aligns with the promotion of holistic health and well-being. Patient Education Educating the patient about ADHD and GAD, their symptoms, and the role of medication and therapy in treatment is essential (Fawns, 2021). The patient should fully understand what to expect from their medication, the potential benefits, and the importance of adherence. Additionally, providing information about the positive impact of exercise and nutrition on mental health supports the patient's overall well-being. Social Determinant of Health The patient's lack of previous access to mental health services highlights a critical social determinant of health. Ensuring access to necessary healthcare and mental health services is crucial for addressing the patient's well-being and can positively impact their life and functioning. Follow-Up Parameters

A follow-up visit after 4 weeks is appropriate to assess the patient's response to treatment, monitor for side effects, and adjust treatment strategies if necessary. Consistent evaluation of both medication and psychotherapy progress is vital for optimizing the patient's outcomes. Overall, the diagnostic considerations, treatment plan, and non-pharmacological interventions appear comprehensive and tailored to address the patient's unique challenges and needs. Continual monitoring and collaboration with the patient will be key to achieving successful outcomes. References Curtiss, J. E., Levine, D. S., Ander, I., & Baker, A. W. (2021). Cognitive-behavioral treatments for anxiety and stress-related disorders. Focus , 19 (2), 184-189. Fawns, T. (2021). Attention deficit and hyperactivity disorder. Primary Care: Clinics in Office Practice , 48 (3), 475-491. Fu, D., Wu, D. D., Guo, H. L., Hu, Y. H., Xia, Y., Ji, X., ... & Liu, Q. Q. (2022). The mechanism, clinical efficacy, safety, and dosage regimen of atomoxetine for ADHD therapy in children: a narrative review. Frontiers in Psychiatry , 12 , 780921.

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