Assignment: decision tree | Nursing homework help

Don't use plagiarized sources. Get Your Assignment on
Assignment: decision tree | Nursing homework help
Just from $13/Page
Order Now


For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.

The Assignment:

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

  • Decision #1: Differential Diagnosis
    • Which Decision did you select?
    • Why did you select this Decision? Support your  response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. 
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
  • Decision #2: Treatment Plan for Psychotherapy
  •       Why did you select this Decision? Support your response with evidence and references to the Learning Resources.    
  •       What were you hoping to achieve by making this Decision? Support your response with evidence and references to  
  •       the Learning Resources. 
  •       Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why   
  •       were they different?
  • Decision #3: Treatment Plan for Psychopharmacology
    • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. 
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
  • Also include how ethical considerations might impact   your treatment plan and communication with clients and their families.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. 

                                                                  Case #2
                              Anxiety disorder, OCD, or something else? 

8-year-old black male


Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well cared for. 

Shaquana reports that Tyrel is irritable at times and has also had some sleep disturbances (which she reports as “trouble staying asleep”). She reports that he has been more and more difficult to get to school as he has become nervous around his classmates. He has missed about 8 days over the course of the last 3 weeks. He has also stopped playing with his best friend from across the street. 

His mother reports that she feels “responsible” for his current symptoms. She explains that after he was sick with strep throat a few weeks ago, she encouraged him to be more careful about washing his hands after playing with other children, handling things that did not belong to him, and especially before eating. She continues by saying “maybe if I didn’t make such a big deal about it, he would not be obsessed with germs.” 

Per Shaquana, her pregnancy with Tyrel was uncomplicated, and Tyrel has met all developmental milestones on time. He has had an uneventful medical history and is current on all immunizations. 


During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders. 

When you discuss his handwashing with him, he tells you that “handwashing is the best way to keep from getting sick.” When you question him how many times a day he washes his hands, he again shrugs his shoulders. You can see that his bilateral hands are dry. Throughout your assessment, Tyrel reveals that he has been thinking of how dirty his hands are; and no matter how hard he tries to stop thinking about his “dirty” hands, he is unable to do so. He reports that he gets “really nervous” and “scared” that he will get sick, and that the only way to make himself feel better is to wash his hands. He reports that it does work for a while and that he feels “better” after he washes his hands, but then a little while later, he will begin thinking “did I wash my hands well enough? What if I missed an area?” He reports that he can feel himself getting more and more “scared” until he washes his hands again. 


Tyrel is alert and oriented to all spheres. Eye contact varies throughout the clinical interview. He reports his mood as “good,” admits to anxiety. Affect consistent to self-reported mood. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes were apparent. He denies suicidal ideation. 

Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters. 

                                                         Decision Point One


In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.


                                 Generalized Anxiety Disorder (GAD)

                                 Obsessive Compulsive Disorder

                                 Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (“PANDAS”)

 ANSWER CHOSEN: Obsessive Compulsive Disorder 

                                                               Decision Point Two



https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-red.pngBegin Zoloft 50 mg orally daily

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-blue.pngBegin Fluvoxamine immediate release 25 mg orally at bedtime

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-yellow.pngBegin Fluvoxamine controlled release 100 mg orally in the morning


ANSWER CHOSENhttps://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-blue.pngBegin Fluvoxamine immediate release 25  

                                                  mg orally at bedtime 



·  Client returns to clinic in four weeks

· Upon return to the clinic, Tyrel’s mother reported that he has had some  

  decrease in his symptoms. She states that the frequency of the handwashing 

  has decreased, and Tyrel seems a bit more “relaxed” overall.

·  She also reports that Tyrel has not fully embraced returning to school, but that  

  his attendance has improved. She reported that over this past weekend, Tyrel    

  went outside to play with his friend from across the street, which he has not  

 done in a while.


                                                          Decision Point Three



https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-red.pngIncrease Fluvoxamine to 50 mg orally at bedtime

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-blue.pngAugment with an atypical antipsychotic such as Abilify

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-yellow.pngAugment treatment with cognitive behavioral therapy

ANSWER CHOSEN:  https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-red.pngIncrease Fluvoxamine to 50 mg orally at 


Guidance to Student 

In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this.

Fluvoxamine immediate release is FDA-approved for the treatment of OCD in children aged 8 years and older. Fluvoxamine’s sigma-1 antagonist properties may cause sedation and as such, it should be dosed in the evening/bedtime.

At this point, it would be appropriate to consider increasing the bedtime dose, especially since the child is responding to the medication and there are no negative side effects.

Atypical antipsychotics are typically not used in the treatment of OCD. There is also nothing to tell us that an atypical antipsychotic would be necessary (e.g., no psychotic symptoms). Additionally, the child seems to be responding to the medication, so there is no rationale as to why an atypical antipsychotic would be added to the current regimen.

Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. The PMHNP should augment medication therapy with CBT. If further assessment determines that Tyrel has social anxiety disorder, CBT is effective in treating this condition as well.

Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.  Chapter      31, “Child Psychiatry” (pp. 1253–1268)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author  “Anxiety Disorders”

American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 51(1), 98–113. Retrieved from http://www.jaacap.com/article/S0890-8567(11)00882-3/pdf 

McClelland, M., Crombez, M-M., Crombez, C., Wenz, C., Lisius, M., Mattia, A., & Marku, S. (2015). Implications for advanced practice nurses when pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is suspected: A qualitative study. Journal of Pediatric Health Care, 29(5), 442–452. doi:10.1016/j.pedhc.2015.03.005

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press. 

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.



Calculate your paper price

Pages(550 words)

Approximate price:-

Why Choose Our Assignment Writing Services

Quality Assignment Papers

We aim at 100% customer satisfaction. As such, we never compromise on the quality of our assignment services. Our homework helpers craft each paper carefully to match the requirements on the instruction form.

Professional Homework Helpers

We receive many applications from writers around the world daily. Nevertheless, we only choose the cream of the crop to tackle your “help with homework” requests. Hence, our homework helpers are highly-qualified individuals who maintain our quality policy.

Affordable Homework Help

We maintain a fair pricing policy for all our homework help services. Our pricing system generates quotations based on the requirements of each paper.

On-Time Assignment Delivery

At My Homework Writers, we guarantee all students swift delivery of their assignments. We understand that time is an essential factor in the academic world. We, therefore, ensure that all assignments are delivered on or before the agreed deadline.

100% Original Assignment Papers

We maintain a zero-plagiarism policy in all our essay papers. Our assignment writers stick to the students’ instructions to deliver plagiarism-free papers. We are also keen to avoid any chance of similarities with previously written papers.

24/7 Customer Support

We understand that you might run into trouble once in a while when working with our system. In the event that you do run into trouble, please get in touch with our support agents and they will immediately provide you with assistance.

Feel free to contact us via the Chat window or email: support@myhomeworkwriters.com.

How myhomeworkwriters works?

Follow these simple steps to get your homework done

1). Place your order

Fill in the order form and provide all details of your assignment.

2). Proceed with the payment

Choose the payment system that suits you most.

3). Track Progress

You will be able to track the progress of your paper from our system.

4). Receive the final file

Once your paper is ready, we will email it to you.

Calculate the price of your order

You will get a personal manager and a discount.
We'll send you the first draft for approval by at
Total price:

Our Assignment Writing Services

Myhomeworkwriters website holds a reputation for providing high-quality assignment writing services. You only need to give us all the requirements for your “do my homework” order, and our homework paper writers will give you the best results.

Essay Writing Services

We have highly qualified essay writers to assist you whenever you place in "help with my homework" order. Our essay writing service is designed to help students get good grades.

Admission Essay Writing service

Our admission essay writing help will assist you to secure a position at your desired learning institution. We will help you craft a top-notch personal statement paper. Our writers who know how to write a college admission essay will help you get the college admission you are longing for.

Editing and Proofreading

Our team of professional editors will help you organize your paper, paraphrase it, and eliminate any possible mistakes. Also, we will help you check on plagiarism to ensure that your final paper possesses quality and originality.

Technical papers

My homeworkwriters harbors specialists who can handle your technical papers order. Our “write my homework” services cover all academic areas you can think of. The simplicity or complexity of the paper does not affect the quality of assignment writing services.