As an adult gerontology nurse practitioner you are working in a rural health clinic. You are evaluating a 16-year-old adolescent patient who comes in complaining of having a difficulty concentrating in school. On exam you also note that the patient is very thin and frail in appearance and is asking you for diet pills.
What are some initial areas for concern? What screening tools can help lead you closer to your diagnosis?
Describe 1 health promotion strategy you can discuss with the patient.
Be sure to address the following in your plan of care: pharmacological and non-pharmacological (OTC) interventions, labs, follow-up, teaching, and referral/s.
Your work should integrate course resources (text/s) as well as a minimum of two (2) other evidence-based guidelines and/or articles published within 3-5 years.
Please used evidence based guideline to formula the answer. Remember to not use any references older than 5years old, and use APA format
Reference:
Centers for Disease Control and Prevention. (2013). Youth risk behavior surveillance
system (YRBSS). Retrieved from
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Answer question based on scenario given Nursing Assignment Help
Introduction: In this assignment, we will be addressing the concerns and challenges faced by a medical professional who is evaluating a 16-year-old adolescent patient in a rural health clinic. The patient presents with difficulties in concentration at school, accompanied by physical indicators such as being thin and frail, and a request for diet pills. We will explore the initial areas for concern, screening tools for diagnosis, and the development of a comprehensive plan of care that incorporates both pharmacological and non-pharmacological interventions, as well as health promotion strategies.
1. Initial Areas for Concern:
In evaluating the 16-year-old adolescent patient, several initial areas for concern can be identified. Firstly, the reported difficulty in concentration at school could be indicative of an underlying cognitive or psychiatric condition. It is crucial to assess whether this issue is impacting the patient’s academic performance and overall well-being. Secondly, the patient’s physical appearance of being thin and frail raises concerns about possible nutritional deficiencies and/or an eating disorder. Lastly, the patient’s request for diet pills suggests a potential unhealthy approach towards weight management and the presence of body image concerns.
2. Screening Tools for Diagnosis:
To further investigate the concerns mentioned above, several screening tools can be utilized to aid in the diagnosis. Firstly, a comprehensive psychiatric evaluation should be conducted to assess the patient’s cognitive abilities, mood, and overall mental health. Standardized tools such as the Child Behavior Checklist (CBCL) or the Behavior Assessment System for Children (BASC) can be employed to assess emotional and behavioral functioning. Additionally, the Patient Health Questionnaire for Adolescents (PHQ-A) can help assess the presence of any depressive symptoms. In terms of nutritional assessment, the use of tools such as the Eating Attitudes Test (EAT-26) or the ChEAT Questionnaire can assist in identifying potential eating disorders or disordered eating behaviors.
3. Health Promotion Strategy:
A suitable health promotion strategy to discuss with the patient is the importance of a balanced and nutritious diet. Educating the patient about the benefits of consuming a variety of nutrient-rich foods, such as fruits, vegetables, whole grains, and lean proteins, can be emphasized. Encouraging the patient to develop a positive relationship with food and promoting the concept of intuitive eating can also be valuable. Emphasizing the importance of regular physical activity as part of a healthy lifestyle can be incorporated into the discussion, ensuring that the patient understands the benefits of exercise for both physical and mental well-being.
Plan of Care:
– Pharmacological Interventions: Based on the findings from the evaluation, if an underlying psychiatric condition such as attention-deficit/hyperactivity disorder (ADHD) or depression is identified, pharmacological interventions such as stimulant medications or selective serotonin reuptake inhibitors (SSRIs) may be considered, in consultation with a psychiatrist.
– Non-Pharmacological (OTC) Interventions: In terms of non-pharmacological interventions, the patient could be referred to a registered dietitian to develop a personalized nutrition plan that addresses any existing nutritional deficiencies or imbalances. Psychosocial interventions such as individual therapy, cognitive-behavioral therapy (CBT), or family therapy may also be recommended depending on the specific diagnosis.
– Labs: Laboratory tests can be ordered to assess the patient’s nutritional status, including a complete blood count (CBC), comprehensive metabolic panel (CMP), and a nutritional assessment panel.
– Follow-up: Regular follow-up appointments should be scheduled to monitor the patient’s progress, reassess symptoms, adjust treatment plans as necessary, and ensure compliance with prescribed interventions.
– Teaching: Patient education should focus on providing information about the diagnosed condition, recommended treatments, and strategies for self-management. This can involve explaining the mechanisms of any prescribed medications, potential side effects, and the importance of adhering to the treatment regimen. In terms of nutrition education, guidance on portion control, meal planning, and debunking common myths surrounding weight and body image can be provided.
– Referral/s: Depending on the specific diagnosis, referrals may be made to interdisciplinary healthcare professionals such as psychiatrists, registered dietitians, therapists, or support groups specializing in adolescent mental health and eating disorders.
In developing this plan of care, it is essential to rely on evidence-based guidelines and current research. The Centers for Disease Control and Prevention (CDC) offers valuable resources, such as the Youth Risk Behavior Surveillance System (YRBSS), which can inform clinical decision-making and assist in tailoring interventions to address the adolescent patient’s specific needs.
Reference:
Centers for Disease Control and Prevention. (2013). Youth risk behavior surveillance system (YRBSS). Retrieved from
