iHuman Case Study – Adolescent Risk Behaviors

iHuman Case Study – Adolescent Risk Behaviors

iHuman Case Study – Adolescent Risk Behaviors

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered. For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned.

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To support your work, use your course textbook readings and the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible.

Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content. iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning. Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.
Click here for information on how to access and navigate iHuman.

This week, complete the iHuman case titled ”Angela Cotez V3.1 PC”.

Apply information from the iHuman Case Study to answer the following questions:

Describe the evaluation tool and explain why this tool is essential in the care of the adolescent patient population.

Apply the findings of the scholarly research articles to the use of this evaluation tool and describe its validity and reliability.

Apply this evaluation tool to a patient situation and summarize your opinion of the results.

Describe a plan of care for the patient, depending upon the results.

Submission Details:

Post your initial response to the Discussion Area by Saturday. Respond to at least two posts by the end of the week, Wednesday. Week starts on Thursday and ends on the following Wednesday.

Your initial post is due on Saturday.

Your two peer responses are due no later than Wednesday. The expectation is that you reply to your peers on more than 2 days before Wednesday to receive full credit.

Please make sure you are using scholarly references and should not be older than 5 years. Your posts/references must be in

Please follow the discussion rubric to make sure you have addressed the discussion criteria.

Example of  Information needed..

Angela Cortez is a 17-year-old female who presents with a history of fatigue and lack of energy for the past two months; associated with irritability and weight gain. Her symptoms have led to a decline in her school performance and lack of participation in her usual activities. She has been crying on a near daily basis over the past month. On physical exam, she has an elevated BMI, is tearful, and is noted to have acne, striae, and acanthosis. She denies any active suicidal thoughts (i-Human).

Describe the evaluation tool and explain why this tool is essential in the care of the adolescent patient population.

Patient Health Questionnaire (PHQ-9) Modified for Adolescents (PHQ-A) is a self-administered instrument that assesses anxiety, eating, mood and substance use disorders among adolescent primary care patients. It is essential in this population due to the high risks of this age group and the need to assess for and manage/treat mental health disorders.

Apply the findings of the scholarly research articles to the use of this evaluation tool and describe its validity and reliability.

According to the Journal of Adolescent Health findings support the diagnostic validity of the PHQ-A. The PHQ-A and the clinical interview produced similar estimates of the prevalence rates of anxiety, eating, mood, and substance use disorders. The PHQ-A demonstrated satisfactory sensitivity, specificity, diagnostic agreement, and overall diagnostic accuracy, compared with the clinical interview.  The PHQ-A may be used to assist primary care practitioners in identifying psychiatric disorders among their adolescent patients. The PHQ-A is the first such tool to be tested for use in adolescents and offers an acceptable and efficient tool for early detection and recognition of mental disorders in this high-risk group.

iHuman Case Study – Adolescent Risk Behaviors

Apply this evaluation tool to a patient situation and summarize your opinion of the results

The PHQ-9 Modified for Adolescents PHQ-A was used to evaluate Angela regarding her current symptoms and changes in mood and behavior. Based on responses to the questionnaire and patient interview it is established that she has Depressive Disorder; scoring 19 on the PQH-9. More than half of her responses received a score of 3 in the nearly every day category for feelings, appetite, interests and concentration; for the past two weeks.

Describe a plan of care for the patient, depending upon the results

According to the American Family Physician the following is the client plan. Angela will be referred to a psychiatrist for initiation of both psychotherapy and pharmacotherapy in treatment of adolescent depression. As a first line agent she will be started on a selective serotonin reuptake inhibitor (SSRI); with titration over the course of several weeks. SSRIs plus cognitive-behavioral therapy (CBT) have been demonstrated to be effective in treating adolescent depression. The American Family Physician also takes this stance in regard to the PHQ-A; stating that this 9 item screening tool is more sensitive in adolescents than adults.

The initial management plan also includes the following actions:

  • Review common side effects of medication with the client and family; especially black box warnings and risk of suicide.
  • Assess patient’s suicide risk. Establish a no-suicide contract. Inquire about firearms in the home and accessibility.
  • Provide education and information depression.
  • Nutritionist referral for regarding healthy eating/choices and physical activity.
  • Follow-up with PCP to assess management / therapy.

iHuman Case Study – Adolescent Risk Behaviors

References

Gardner, W. (2014). Screening for Mental Health Problems: Does It Work? Journal of Adolescent Health,55(1), 1-2. doi:10.1016/j.jadohealth.2014.04.019

Ham, P., MD, & Allen, C., PhD. (n.d.). Adolescent Health Screening and Counseling. American Family Physician,86(12), 1109-1116.

Johnson, J. G., PhD, Harris, E. S., MD, & Williams, J. B., DSW. (n.d.). The patient health questionnaire for adolescents: Validation of an instrument for the assessment of mental disorders among adolescent primary care patients. Journal of Adolescent Health,30(3), 196-204.

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