Details:
This assignment focuses on the importance of self-assessment and reflection.
Self-Assessment
Self-awareness is essential for developing leadership skills. Recognizing your own strengths, weaknesses, and values, and understanding emotional intelligence and learning styles can help you to be a more effective nurse leader.
For this assignment, you have the opportunity to take a variety of self-assessments to learn more about yourself and identify your assets and weaknesses as a leader. This will assist you in discovering how you can improve your own self-leadership skills. You will be asked to think critically about your results and submit a reflection as directed below.
Select three of the following self-assessments and complete them. Be sure to document the results of each assessment to assist you in completing the reflection portion of the assignment below.

Emotional Intelligence Assessment: “Emotional Intelligence Test”: https://www.psychologytoday.com/tests/personality/emotional-intelligence-test
Personality Assessment: “Free Personality Test”: https://www.16personalities.com/free-personality-test
Learning Styles Assessment: “Values Profile”: http://vark-learn.com/the-vark-questionnaire/
Values Assessment: “Values Profile”: https://www.psychologytoday.com/tests/personality/values-profile
Values Assessment: “Rokeach Values Survey”: http://faculty.wwu.edu/tyrank/Rokeach%20Value%20Survey.pdf
Diversity Assessment: “Cultural Competence Self-Test”: http://www.oregon.gov/DHS/SENIORS-DISABILITIES/DD/PROVIDERS-PARTNERS/SCPAconference/Cultural%20Competence%20Self-Test.pdf

Self-Assessment Reflection
Becoming self-aware is an ongoing process requiring introspection. The more often people practice self-reflection, the more opportunities they have to understand their own behaviors and adapt their approaches to working with other people, which can improve both your own and other’s abilities to meet their professional goals.
In a 750-1,000 word reflective essay, address the following:

Briefly summarize why you selected each self-assessment and the results you obtained on each assessment.
Identify the leadership style that closely aligns to your philosophy of care, and explain what appeals to you about that style.
Reflect on how you might incorporate elements of that particular style as you exercise leadership in a practice or health care organization setting.
Discuss any particular areas for improvement the assessments helped you identify and some steps for improving your leadership capabilities.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Please respond to your peerâ€s posts, from an FNP perspective. To ensure that your responses are substantive, use at least two of these prompts:

• Do you agree with your peers†assessment?
• Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
• Share your thoughts on how you support their opinion and explain why.
• Present new references that support your opinions.

Please be sure to validate your opinions and ideas with citations and references in APA format. Substantive means that you add something new to the discussion, you arenâ€t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.Be sure to review your APA errors in your reference list, specifically you have capitalization errors in some words of the titles. Also, be sure you are italicizing titles of online sources.

Question number one-

1. As a primary care provider working with children with mental health disorders you understand there are special health needs to be assessed and an increased frequency regarding health exams. What information do you want to assess in children who are diagnosed with ADHD and managed on stimulant medications? What is the frequency for evaluation?

Samantha B’s Response

Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children, and the prevalence is increasing (Felt, Christner, Kochhar, & Harrison, 2014). The practitioner should evaluate for ADHD in children with behavioral concerns such as inattention, hyperactivity, impulsivity, oppositionality or poor academic progress using validated assessment tools with observers from several settings and self-observation, if possible (Felt et al., 2014). Practitioners who inherit a patient with a previous ADHD diagnosis should review the diagnostic process, and current symptoms and treatment needs (Felt et al., 2014). The American Academy of Pediatrics provides the National Initiative for Children’s Healthcare Quality Vanderbilt Assessment Scale for free, and this should be used for assessment at home, school, and in the practitionerâ€s office (Felt et al., 2014).

Management for this condition include life style modification, behavioral treatment, and pharmacological treatment, ant the practitioner must manage this in addition to a psychiatrist. Behavioral treatments are recommended for preschool-aged children and may be helpful at older ages (Brahmbhatt et al., 2016). Effective behavioral therapies include parent training, classroom management, and peer interventions (Brahmbhatt et al., 2016). Medications are recommended as first-line therapy for older children (Brahmbhatt et al., 2016). Psychostimulants, such as methylphenidate and dextroamphetamine, are most effective for the treatment of core ADHD symptoms and have generally acceptable adverse effect profiles (Brahmbhatt et al., 2016).

Adverse effects of stimulant medication are generally dose dependent and include reduced appetite, abdominal discomfort, headache, irritability, anxiousness, sleep problems, and a small reduction in height velocity that may attenuate with time and/or reverse after discontinuation of treatment (Storebo, 2018). National guidelines recommend that practitioners consider electrocardiography and/or cardiology referral before initiating psychostimulants in patients with a history of heart disease, palpitations, syncope, or seizures, or with a family history of sudden cardiac death, Wolff-Parkinson-White syndrome, hypertrophic cardiomyopathy, or long QT syndrome. Height, weight, heart rate, blood pressure, symptoms, mood, and treatment adherence should be recorded at follow-up visits (Storebo, 2018). Monthly visits may be required until medication dosing and timing are optimized (Storebo, 2018). When an acceptable regimen is determined, follow-up is recommended at least every three months during the first year, and two or three times per year thereafter to assess control of symptoms, treatment adherence, and the presence of comorbid conditions (Storebo, 2018).

Brahmbhatt, K., Hilty, D. M., Hah, M., Han, J., Angkustsiri, K., & Schweitzer, J. B. (2016). Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder During Adolescence in the Primary Care Setting: A Concise Review. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 59(2), 135–143. doi:10.1016/j.jadohealth.2016.03.025

Felt, B., Christner, J., Kochhar, P., & Harrison, R. (2014). Diagnosis and management of ADHD in children. American Family Physician . Retrieved from https://www.aafp.org/afp/2014/1001/p456.html

Storebø, O. J., Pedersen, N., Ramstad, E., Kielsholm, M. L., Nielsen, S. S., Krogh, H. B., Gluud, C. (2018). Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents – assessment of adverse events in non-randomised studies. The Cochrane database of systematic reviews, 5(5), CD012069. doi:10.1002/14651858.CD012069.pub2

Question #2-

Amanda D’s response

You have just finished seeing a 10-year-old girl for complaints of somatic pains, refusal to engage in activities, mood swings, and sleep disturbances. You perform a depression screening which reveals a high score for depression. You diagnose her with Depression NOS and initiate monotherapy with sertraline.

What are your recommendations for her parents?

Successful management of childhood depression involves participation from the childâ€s parents (Steele, & Doey, 2007). The parents should be educated regarding the childâ€s medication regimen, possible medication side effects, and medication schedule (Gordon, & Melvin, 2014). Depression is commonly triggered by stressful life events such as; divorce of parents, difficulty at school, social dysfunction, and family conflict (Pinfield, 2017). I would recommend that they work to develop a daily routine for the patient and limit exposure to stressful events. I would recommend that the parents develop a nightly bedtime routine to foster an appropriate sleep schedule. Insomnia has been identified as a risk factor for the development of depression (Boysan, 2016). Bedtime has been recognized as a time of increased anxiety for children that suffer from insomnia (Boysan, 2016). I would encourage the parents to limit “screen time” at least 1 hour before bedtime to reduce stimulus.

When will you have her return to clinic?

Reviewed literature suggests that pediatric patients which are placed on a selective serotonin reuptake inhibitor (SSRI) should be monitored weekly for the first 4 weeks of therapy, then biweekly for 2 months, and monthly until stable (Scahill, Hamrin, & Pachler, 2005). I would have this patient return to the clinic weekly for four weeks to monitor the efficacy of the medication, potential medication side effects, and assess her overall wellness.

What is your plan if she discloses suicidal ideation?

My first priority is the safety of the patient and her family. If this patient were to disclose suicidal ideation I would gather more information. I would assess the patients†level of suicide risk. I would ask if she has attempted suicide in the past. If so, how? I would ask if she has a plan to end her life, if so how? I would inquire if she had the means to carry out her plan. For example, if she stated she had the intent to shoot herself, I would ask if she had access to a firearm. Risk of suicide is increased when the patient begins to exhibit characteristics such as giving away possessions, has a mental health history, has a family member that has committed suicide, and the patient exhibits psychotic thinking (Steele, & Doey, 2007). If after further assessment I felt that this patient was a danger to herself or others, I would facilitate her transport to an inpatient facility for close observation and management. It has been my experience (although quite limited) that pediatric patients do not distinguish thoughts of suicide from thoughts of self-harm. The difference between suicide and self-harm is intent. Often, suicidal patients feel that there is “no way out” and want to end their life. Patients with thoughts of self-harm view harming themselves as a coping mechanism.

References

Boysan, M. (2016). Developmental implications of sleep. Sleep and Hypnosis (Online), 18(2), 44-52.

Gordon, M., & Melvin, G. (2014). Risk assessment and initial management of suicidal adolescents. Australian Family Physician, 43(6), 367-72.

Pinfield, J. (2017). Recognizing and diagnosing depression in children and young people. Nursing Standard (2014), 31(48), 51.

Scahill, L., Hamrin, V., & Pachler, M. E. (2005). The use of selective serotonin reuptake inhibitors in children and adolescents with major depression. Journal of Child and Adolescent Psychiatric Nursing, 18(2), 86-9.

Steele, M. M., & Doey, T. (2007). Suicidal behavior in children and adolescents. Treatment and prevention. Canadian Journal of Psychiatry, 52(6), 35S-45S.

 

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