Assessing and Treating Pediatric Clients With Mood Disorders
When pediatric clients 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 clients with the same disorders, but they also metabolize medications much differently. As a result, psychiatric mental health nurse practitioners must exercise caution when prescribing psychotropic medications to these clients. 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 with mood disorders.
Note: This Assignment is the first of 10 assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients.
The Assignment
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 client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
- At each decision point stop to complete the following:
- Decision #1
- 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
- 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
- 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?
- Decision #1
- Also include how ethical considerations might impact your treatment plan and communication with clients.
zero plagiarism
four references
Decision Tree Assignments Please read these instructions VERY carefully…please ask questions if you have any difficulties understanding the information below. My goal is to provide you with very detailed instructions so you understand the assignment instructions. You will have your first interactive case study assignment (decision tree) in week 2 A case study is included in the reading assignment and you will face three different decision points. There may not be a “right” answer and you are not expected to answer with the “right” answer at each scenario. You will need to describe your answer and provide your rationale and evidence supporting your decision at each decision point. Please review the information below. I feel like it is important to share with you exactly what I am looking for in the assignments. You will find the case studies listed in the course reading list under “required media” each week you have a decision tree assignment.
Here is a general framework for what I am looking for on the decision tree assignments. Provide an introduction to the disease state discussed in the case. I am looking for a high-level summary that briefly describes the key aspects of that disease state. I do not want several pages of information related to the diagnosis of the disease state. Provide a high-level summary of the important pieces of information from the case-study that is presented. I do not want the entire case study presented. The goal is that you would be able to give your essay to someone that does not know anything about the assignment and for that individual to be able to understand the purpose of your essay. Again….focus on the important pieces of information that will help you make your decision. You also want to mention the purpose of the assignment. This can be brief. Decision Point 1, 2, and 3. At each decision point, list the options that are presented and describe your rationale for choosing the option you chose. I do not want general answers….”I chose sertraline because sertraline is an SSRI and SSRIs are approved for depression/anxiety”. I want VERY SPECIFIC reasons you chose the option you chose. These reasons must be backed by good evidence. Feel free to include studies comparing
agents, side effects, dosing, patient considerations, therapeutic practice guidelines, comorbid conditions, etc…. You will also need to explain your rationale for not choosing the other two options. This is very important in your learning. Please remember that you will have MANY more medications to choose from than three in clinical practice. When you make your choice, you also need to describe your goals of treatment. What do you want to achieve by initiating the therapy you picked. Again….be specific. Defend your choices like you are in a courtroom. After each decision, you will be presented with the outcome of that decision. You need to discuss how that outcome was what you expected or if it was different than what you expected and why. You will do the above for all three decision points. You need to use evidence to support your rationale. [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. Credible reference material only will be accepted. Sites such as WebMD and drugs.com (among others) will not be counted.] How to move through the case study….. You will be presented with three options at the bottom of the case for decision point one. You must click on one of these options to move to decision point 2.
You will then be presented with the outcome of the decision you chose for decision point 1. The outcome is different for each of the three options (see below).
You will then choose the option for decision point 2 which will take you to the outcome of the decision you made for decision point 2. You will then be presented with decision point 3. Analogy: Where would you like to go on vacation? You would want to describe WHY you would want to go to the location of your choosing and NOT the other two. You do not need to describe what the beach, theme park, and mountains are. Decision 1: Beach Theme Park Mountains Let’s assume you choose beach….. What will you do at the beach once you get there? Again….describe why you picked the option you did and NOT the other two. Decision 2: Build a sandcastle Swim in the ocean Play frisbee
Let’s assume you chose to build a sandcastle… What type of sandcastle will you build? Decision 3: A large sculpture A small sandcastle with a moat A detailed sand castle decorated with seashells Note about providing evidence…….. Please note that you need to be VERY SPECIFIC when describing the reason you chose the decision you made for each decision point. I cannot stress this enough. Here are some examples of what I do NOT want:
• I chose sertraline (ZOLOFT) because it is an SSRI that treats depression.
• Paroxetine (PAXIL) was chosen because paroxetine increases the levels of serotonin in the brain.
• I decided to prescribe bupropion (Wellbutrin) because data supports the use of bupropion in…… • Think about the patient you are treating. I have had students discuss concerns with erectile dysfunction in pediatric patients and female patients on multiple occasions. You want to consider the patient you are treating.
Here are some examples of what I DO want:
• “As the PMHNP caring for this client, Zoloft 25 mg daily would be the first choice of therapy for this patient. Selective Serotonin Reuptake Inhibitors (SSRIs) are known to be the first line of treatment for children with depression (DeFilippis & Wagner, 2014). While sertraline and paroxetine are both SSRIs, sertraline is FDA approved when treating children whereas paroxetine has been found to be affective when treating children with depression, it is not specifically approved by the FDA at this point in time (Stahl, 2014b).” • “Paroxetine is not recommended in use for children due to its short half-life which can lead to withdrawal when the medication is stopped abruptly (Nathan & Gorman, 2015).” • Evidence supporting the effectiveness of one agent over another. How did one agent perform when compared to another medication in clinical trials. I really like seeing these types of comparisons.
• What do the guidelines recommend? You can typically find the reason for their recommendation in the body of the guidelines. • What side effects are the most concerning for the patient case study? For example: you wouldn’t want to prescribe a medication that causes excessive sedation in a patient that operates heavy machinery or drives transport trucks across the country. • Consider genetics and the role genetics have in drug metabolism. • Evaluate for the potential for drug-drug interactions.
The main point is to be very specific regarding the reason you made your choice. I have posted the essay requirements as a checklist. I would strongly recommend using the…
