PMHNP Care Across the Lifespan Week 1 Discussion Question

PMHNP Care Across the Lifespan Week 1 Discussion Question

Module 1: Special Considerations Related to Children and Adolescents; Ethical and Legal Issues

At this point in your program, you have completed specialization area courses on important individual components of PMHNP work: psychopharmacology, diagnostic reasoning and assessment, and psychotherapy.

While you hopefully have been able to see (and implement, in your practicums) the connections between these components, in this and the following course, NRNP 6675, you fully focus on this synthesis of knowledge as you begin the final bridge toward advanced practice nursing.

You begin this course in Module 1 with a review of two foundational areas of clinical knowledge, assessment and prescribing. Your assignments are focused on how these areas are impacted by age and developmental level for patients who are children and adolescents.

Additionally, you will delve into ethical and legal issues that may impact your clinical work with patients across the lifespan.

It will be important in this course to take a lifespan approach to your studies because, in your final two practicum experiences, you will be required to see at minimum 40 child/adolescent patients and 40 adult/older adult patients.

 

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BasWeek 1: Child and Adolescent Assessment

All diagnoses, from infancy to adulthood, begin with an examination. While an organic basis for most medical disorders can be determined through the use of diagnostic testing, the field of psychiatry is different in that patients cannot be sent to the lab for blood tests to determine the degree of depression. Similarly, patients cannot be sent to the radiology department for a “scan” to determine the severity of their bipolar disorder.

Instead, the field of psychiatry must use psychiatric assessments, such as the comprehensive integrated physical exam, diagnostic interviews, and questionnaires to make diagnoses. These tools must be specialized to address the needs of children and adolescents.

Diagnostic assessment of the child and adolescent is a specialized area of expertise. The PMHNP will often see children who have already been seen by a primary care provider. Many PCPs are comfortable handling attention-deficit/hyperactivity disorder (ADHD) and other straightforward childhood disorders.

That means that the PMHNP will often treat the more complicated patients. This week, you explore psychiatric assessment techniques and tools for children and adolescents. You also examine the role of the parent/guardian in the assessment process for this patient population.

Students will:

• Evaluate comprehensive integrated psychiatric assessment techniques for children and adolescents
• Recommend assessment questions for child and adolescent patients
• Explain the importance of thorough psychiatric assessment for children and adolescents
• Identify rating scales that are appropriate for child/adolescent psychiatric assessment
• Identify psychiatric treatments appropriate for children and adolescents
• Explain the role of the parent/guardian in child/adolescent psychiatric assessment

Based on the YMH Boston Vignette 5 video, post answers to the following questions:

• What did the practitioner do well? In what areas can the practitioner improve?
• At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
• What would be your next question, and why?

Then, address the following. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.

• Explain why a thorough psychiatric assessment of a child/adolescent is important.
• Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
• Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
• Explain the role parents/guardians play in assessment.
• Support your response with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.