Week 7 Case Study 2 CrabTree Amy

Week 7 Case Study 2026: Addressing Attention-Deficit/Hyperactivity Disorder (ADHD) in Pediatric Populations

Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity. In pediatric populations, ADHD significantly impacts academic performance, social interactions, and overall well-being. This case study examines the pharmacological management of ADHD in children, focusing on the selection and administration of stimulant medications, with a particular emphasis on Methylphenidate.

Clinical Presentation

A 7-year-old male patient, referred to as Patient A, presents with symptoms indicative of ADHD. His parents report difficulties in maintaining attention during class, frequent interruptions during conversations, and an inability to remain seated during lessons. These behaviors have led to academic underachievement and strained peer relationships.

Diagnostic Evaluation

The diagnostic process for ADHD involves a comprehensive assessment, including:

• Clinical Interviews: Engaging with the patient and caregivers to gather detailed behavioral histories.

• Behavioral Rating Scales: Utilizing standardized tools such as the Conners' Rating Scales to quantify symptom severity.

• Observational Assessments: Monitoring the patient's behavior in structured settings to observe manifestations of inattention and hyperactivity.

These evaluations collectively inform the diagnostic decision-making process.

Pharmacological Intervention

Stimulant medications are considered first-line pharmacological treatments for ADHD due to their efficacy in enhancing attention and reducing hyperactive behaviors. Among these, Methylphenidate is widely prescribed.

Methylphenidate Overview

Methylphenidate is a central nervous system stimulant that functions as a dopamine and norepinephrine reuptake inhibitor and releaser. By increasing the concentrations of these neurotransmitters in the brain, Methylphenidate enhances attention and reduces impulsivity and hyperactivity.

Dosage and Administration

For children under 6 years of age, the recommended starting dose of Methylphenidate Immediate Release (IR) is 5 mg taken orally twice daily with food, typically at breakfast and lunch. Dosage can be titrated weekly in 5 mg to 10 mg increments, with a maximum daily dose of 60 mg.

Prescription Example

A sample prescription for Patient A is as follows:

Adverse Effects and Monitoring

Common adverse effects of Methylphenidate include:

• Central Nervous System: Insomnia, headache, nervousness, and dizziness.

• Gastrointestinal: Anorexia, nausea, and abdominal discomfort.

• Cardiovascular: Elevated blood pressure and heart rate.

Monitoring should encompass regular assessments of height and weight to detect potential growth suppression, as well as periodic evaluations of blood pressure and heart rate. Additionally, monitoring for the emergence of tics or exacerbation of pre-existing tics is recommended.

Patient and Family Education

Effective management of ADHD with Methylphenidate necessitates comprehensive education for both the patient and their family:

• Medication Adherence: Emphasize the importance of consistent medication intake as prescribed.

• Side Effect Awareness: Inform about potential side effects and the importance of reporting any adverse reactions.

• Lifestyle Considerations: Discuss the role of structured routines, balanced nutrition, and adequate sleep in conjunction with pharmacological treatment.

Conclusion

The management of ADHD in pediatric patients requires a multifaceted approach, with pharmacological intervention serving as a cornerstone. Methylphenidate, when prescribed and monitored appropriately, can significantly ameliorate symptoms and enhance quality of life. Ongoing collaboration between healthcare providers, patients, and families is essential to optimize treatment outcomes.

Below are sample Questions and Answers:

Part 1: Case 3
A 45-year-old woman is complaining of urgency and dysuria for the past two days.
Yesterday, she started getting chills, feels she is getting a fever, and her back hurts.
Past medical history: UTI one year ago.
Medications: none.
Allergies: no known drug allergy (NKDA).
Physical examination: temperature 100°F, pulse 86 beats per minute; respirations 18 per minute;
blood pressure 110/70 mmHg; positive costovertebral angle and suprapubic tenderness,
otherwise unremarkable; urine dipstick reveals positive leukocytes but negative for nitrites and
blood.
What is the most likely diagnosis and pathogen causing this disorder and mode of
transmission?
The patient’s UTI symptoms (urgency and dysuria) along with fever, chills and
costovertebral angle tenderness determine that pyelonephritis is the appropriate diagnosis
(Dlugasch & Story, 2019). It is an upper urinary traction infection (UTI) that involves the kidney,
usually caused by Escherichia coli (E. coli) (Dlugasch & Story, 2019). E. coli can easily be
transferred to the urinary tract due to the proximity of the anus to the urinary meatus (Dlugasch
& Story, 2019). Women are more likely to develop UTIs due to the position in which they
urinate, perineal irritation, personal hygiene habits and clothing choices (Dlugasch & Story,
2019).