Attention Deficit Hyperactivity Disorder
A Young Girl With ADHD
Begin Ritalin (methylphenidate) chewable tablets 10 mg orally in the MORNINGRESULTS OF DECISION POINT ONE
- Client returns to clinic in four weeks
- Katie’s parents report that they spoke with Katie’s teacher who notices that her symptoms are much better in the morning, which has resulted in improvement in her overall academic performance. However, by the afternoon, Katie is “staring off into space” and “daydreaming” again
- Katie’s parents are very concerned, however, because Katie reported that her “heart felt funny.” You obtain a pulse rate and find that Katie’s heart is beating about 130 beats per minute
- A Young Girl With ADHD Attention Deficit Hyperactivity Disorder
Decision Point Two
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Change to Ritalin LA 20 mg orally daily in the MORNINGRESULTS OF DECISION POINT TWO
- Client returns to clinic in four weeks
- Katie’s academic performance is still improved, and the switch to the LA preparation is lasting A Young Girl With ADHD Attention Deficit Hyperactivity Disorder Katie throughout the school day
- Katie’s reports of her heart feeling “funny” have gone away. Pulse was 92 during today’s office visit
Maintain current dose of Ritalin LA and reevaluate in 4 weeksGuidance to Student
At this point, A Young Girl With ADHD Attention Deficit Hyperactivity Disorder Katie’s symptoms are well controlled (her attention is sustained throughout the school day) and her side effects have gone away following change to a long-acting preparation. There is no indication at this point that the dose should be increased as it is always advisable to use the lowest effective dose of stimulant medication. Katie’s heart rate is appropriate for an 8 year old girl and an EKG would not be indicated based on her heart rate. A Young Girl With ADHD Attention Deficit Hyperactivity Disorder
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