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(GRADED A) NURS 6630 Week 4 Assignment: Assessing and Treating Pediatric Patients With Mood Disorders; The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.

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(Solution) NURS 6630 Week 4 Assignment: Assessing and Treating Pediatric Patients With Mood Disorders The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression. Client complained of feeling “sad” Mother reports that teacher said child is withdrawn from peers in class Mother notes decreased appetite and occasional periods of irritation Client reached all developmental landmarks at appropriate ages Physical exam unremarkable Laboratory studies WNL Child referred to psychiatry for evaluation MENTAL STATUS EXAM Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead. You administer the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression) Decision Point One Begin Zoloft 25 mg orally dailyBegin Zoloft 25 mg orally daily RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks No change in depressive symptoms at all Decision Point Two Increase dose to 50 mg orally daily RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Depressive symptoms decrease by 50%. Cleint tolerating well Decision Point Three Maintain current DOSE Guidance to Student At this point, sufficient symptom reduction has been achieved. This is considered a “response” to therapy. Can continue with current dose for additional 4 week to see if any further reductions in depressive symptoms are noted. An increase in dose may be warranted since this is not “full” remission- Discuss pros/cons of increasing drug dose with client at this time and empower the client to be part of the decision. There is no indication that the drug therapy should be changed to an SNRI at this point as the client is clearly responding to this therapy. When pediatric patients present with mood disorders, the process of assessing, diagnosing, and treating them can be quite complex. Children not only present with different signs and symptoms than adult patients with the same disorders, they also metabolize medications much differently. Yet, there may be times when the same psychopharmacologic treatments may be used in both pediatric and adult cases with major depressive disorders. As a result, psychiatric nurse practitioners must exercise caution when prescribing psychotropic medications to these patients. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat pediatric patients presenting with mood disorders. To prepare for this Assignment: Review this week’s Learning Resources, including the Medication Resources indicated for this week. Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of pediatric patients requiring antidepressant therapy. The Assignment: 5 pages Examine Case Study: An African American Child Suffering From Depression. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. Decision #1 (1 page) Which decision did you select? Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #2 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #3 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Conclusion (1 page) Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature. Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements

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Assignment: Assessing and Treating Pediatric Patients with Mood Disorders

Walden University

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology

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Assignment : Assessing and Treating Pediatric Patients With Mood Disorders

In the given scenario, the client is an 8-year-old African American male who

arrives at the ER with his mother. He is exhibiting signs of depression. The patient complained of

feeling "sad", the mother reports that the teacher said the child is withdrawn from peers in class,

decreased appetite, and occasional irritation periods. The client reached all developmental

landmarks at appropriate ages. Laboratory studies are within the normal range. The child was

referred to psychiatry for evaluation.

The patient is alert, oriented x 3, clear, coherent, goal-directed, spontaneous. The self-

reported mood was "sad." Affect was somewhat blunted but smiled appropriately at various

points throughout the clinical interview. He denies visual and auditory hallucinations. No

delusional or paranoid thought processes were noted. Judgment and insight appear to be age-

appropriate. He is not endorsing active suicidal ideation but does admit that he often thinks about

himself being dead and what it would be like to be dead.

Which decision did you select?

The first selected treatment option is Zoloft 25 mg orally daily for depression.



Why did you select this decision? Be specific and support your response with clinically

relevant and patient-specific resources, including the primary literature

Major depressive disorder occurs in adults and children and adolescents (Gershon et al.,

1987). According to researchers, it is appropriate for clinicians to prescribe an SSRI for children

and adolescents experiencing persistent moderate to severe depression or anxiety symptoms with

clear evidence of functional impairment in addition to supportive treatment or a course of

psychotherapy (Garland et al., 2016). In the given scenario, the patient is exhibiting functional

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