Prescribing for Children and Adolescents NRNP 6665
Beyond the legal aspects, it’s crucial to recognize the significant impact of cultural factors on the ethical dimensions surrounding informed consent within the realm of mental health settings. As observed by Thompson, H. (2020), cultural beliefs exert a substantial influence on how healthcare practitioners navigate the terrain of informed consent. This influence is particularly pronounced in regions where the field of bioethics may not have reached its full development, or in cultures where collective interests take precedence over individual autonomy. Negotiating this intricate landscape can present ethical challenges as clinicians strive to uphold fundamental principles while simultaneously honoring cultural norms and values.
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Cultural considerations become especially pertinent in scenarios where patients or their families harbor distinct attitudes toward mental health treatment or hail from cultures where the stigma associated with mental health issues is pervasive. In such instances, clinicians must exercise cultural sensitivity and adapt their approach to informed consent accordingly. Simultaneously, it’s paramount to ensure that patients receive comprehensive information about their treatment options, including the potential risks and benefits, enabling them to make informed decisions about their care.
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Consequently, it becomes imperative for Psychiatric-Mental Health Nurse Practitioners (PMHNPs) to not only possess a solid grounding in the legal and ethical dimensions of informed consent but also to exhibit a keen awareness of the cultural backdrop against which they provide care. Achieving this necessitates an ongoing commitment to education and training in the realm of cultural competence. It also involves an open-minded approach to learning from patients and their families about their cultural beliefs and values. By adopting a culturally sensitive perspective in the context of informed consent, clinicians can ensure the delivery of patient-centered care that upholds the principles of autonomy and preserves the dignity of each individual. This holistic approach acknowledges the interplay between law, ethics, and culture in the realm of mental health treatment, fostering a more inclusive and effective healthcare environment.
Assignment 1: Prescribing for Children and Adolescents
Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common.
In fact, one in five prescriptions written today are for off-label use.
—Agency for Healthcare Research and Quality
Photo Credit: Getty Images/Ingram Publishing
Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered
“off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in
order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from
research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint.
What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?
For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.
Reference:
Agency for Healthcare Research and Quality. (2015). Off-label drugs: What you need to know. https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.html
To Prepare
Your Instructor will assign a specific disorder for you to research for this Assignment.
Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.
The Assignment (1–2 pages)
Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off- label drug?
Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.
By Day 7 of Week 3
Submit your Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK3Assgn1+last name+first
initial.(extension)” as the name.
Click the Week 3 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 3 Assignment 1 link. You will also be able to “View Rubric” for grading criteria
from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK3Assgn1+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my
paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 3 Assignment 1 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 3 Assignment 1 draft and review the originality report.
Submit Your Assignment by Day 7 of Week 3
To participate in this Assignment:
Week 3 Assignment 1
Learning Resources
Required Readings (click to expand/reduce)
Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health.
American Psychiatric Association Publishing.
Chapter 14, “Psychosocial Interventions”
Chapter 15, “Psychotherapeutic Interventions”
Chapter 16, “Psychopharmacological Interventions”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and
adolescent psychiatry (6th ed.). Wiley Blackwell.
Chapter 43, “Pharmacological, Medically-Led and Related Treatments”
Walden University. (n.d.). Developing SMART goals.
https://academicguides.waldenu.edu/ld.php?content_id=51901492
Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.
Chapter 5, “Psychopharmacology”
Required Media (click to expand/reduce)
CriticalThinkRx. (2019, June 9). Module 5: Specific drug classes: Focus on adverse effects [Video].
YouTube. https://youtu.be/Gbq6RnOsGKQ
CriticalThinkRx. (2019, June 9). Module 2: Use of psychotropics with youth_prevalence and concerns
[Video]. YouTube. https://youtu.be/NRef-g4Ding
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