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NURS 6630 Assignment Assessing And Treating Pediatric Patients With Mood Disorders
NURS 6630 Assignment Assessing And Treating Pediatric Patients With Mood Disorders
NURS 6630 Assignment Assessing And Treating Pediatric Patients With Mood Disorders
Depression is a mental disease that affects young people frequently and is associated with illiteracy. Additionally connected to this condition are self-harm and an elevated risk of suicidal ideation. Teenage depression is a regular occurrence, and it causes additional issues that have an impact on adolescents’ physical and mental health.
Additionally, children’s academic performance is being impacted by depression. The American Psychiatric Association divides child depression into two categories. The first kind of depression, known as a severe depression, often strikes youngsters for little longer than one month, but it can occasionally recur as these children grow older. Another type is known as dysthymia, a less form of severe depression which is lasting for two years (Mitchell, Davies, Cassesse, & Curran, 2014.
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This paper is aimed at studying the case presented in an African American child who is suffering from depression. It is based on making decisions about the medication to be prescribed to the client with the consideration of the factors that are likely to affect the patient’s pharmacokinetic and the pharmacodynamics processes.
Decision #1
The first decision, in this case, is starting the client on the medication of Zoloft 25 mg. Reason for selecting this decision
Zoloft 25 mg is recommended by the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) due to its safety and effectiveness for the treatment of the mood disorders in children of this group.
The anticipated outcome
Within the first 7 days of the therapy, it is expected that there will be some improvement in the health status of the client. The client is expected to have an increased appetite and sleep a lot. The child will concentrate more within a month of the therapy process and have an improvement in the level of the interactions with the peers.
The differences between what was expected to be achieved with this decision and the outcomes of the decision
The differences between the two are that the patient will be back for the assessment for the effectiveness of the prescribed drugs as opposed to the previously presented symptoms. However, in case the objective of the drug prescription is achieved with no side effects reported, then the dosage of the prescribed drug will be constant for the rest of the duration until the client made another visit again. In case the expected outcome from the drug therapy is not attained and there are no side effects, then the medication has to be increased to 50 mg. the differences between the expected outcomes expected to be achieved and the outcome of the decision are based on whether the prescription is on lower or higher dosage (Stahl, 2013).
Decision #2
Prescription of Paxil 10 mg orally daily Reason for the Decision
Usually depressed mood is associated with suicidal thoughts; therefore, the prescription of this drug is helping in reducing the possibility of suicide on the patient. Paxil or the paroxetine is helping in the treatment of the generalized anxiety disorder.
The anticipated outcome
The expected results from the prescription are the improvement in the mood stability, reduction in the possibility of the suicidal thoughts in case the situation becomes worse, and the reduction in the fear or phobia in his daily life which makes him to occasionally think about himself being dead or how he would be like when dead.
The differences between what was expected to be achieved with this decision and the outcomes of the decision
It is expected that there will be a positive change upon the prescription of Paxil 10 mg for example increase in the stability of the patient mood, reduction in the chances of the suicidal thoughts in case the condition become worse, and reduction in the fear or phobias. The outcome following the prescription of Paxil will not be the same to the expected when the Zoloft is prescribed i.e. the previous prescription leads to the improvement in the patient mood, active participation in t he classroom activities and interaction with the peers in the classroom, and the reduction in the irritation (Chien, Leung, Yeung, & Wong, 2013.
Decision #3
Prescription of Wellbutrin 75 mg orally BID Reason for the decision
The drug is working through restoring the balance of some natural chemical i.e. the neurotransmitters in the brain. This therefore results in the improvement of the mood thus helping in the removal of the sad feeling of the patient (Mitchell, Davies, Cassesse, & Curran, 2014).
The anticipated outcome
The expected outcome from the prescription of this drug is the reduction in the sad feeling of the patient. It is expected that there will be improvement in the mood of the patient thus helping in the reduction of the frequent irritation. The patient will gain more interest in interacting with the peers in the class.
The differences from what was expected to be achieved and the outcome of the decision
The actual outcome from the treatment is the process of attaining the medication therapeutic impact that is required by the patient to overcome the depressive symptoms.
The ethical considerations
The child requires close monitoring process due to the symptoms associated with the depression. Depression on children increases their risk of suicidal thoughts, therefore they require close monitoring. To prevent suicidal thoughts, children are also supposed to be given antidepressant medication.
However, the prescription of the antidepressant medication must be based on the consideration of the balance existing in the risk of suicidality with the client clinical needs of the antidepressant medication. According to the FDA regulation, a child whose age is below 18 years should not be allowed to take depression medication without the approval of the parents of the child diagnosed with the disease (Stahl, The prescriber’s guide, 2014b).
It is, however, important to consider the ethical aspects of these situations using various ethical reasoning about the well-being of the client. This, therefore, implies that it is crucial to educate the parent child’s parents about the treatment prescribed to the child and seeking their consent. The drugs such as Zoloft is off-label medications that must be prescribed with a lot of carefulness as well as approval from the parents before the dispensation of the drug (Stahl, 2013).
Conclusion
The Zoloft medication proves to be effective when it comes to dealing with the depression among children and helping in the reduction of suicidal thoughts. Based on the regulation set by the FDA, it is important to put a lot of considerations when prescribing such medications. Zoloft is considered to be off-label drugs, therefore, the prescription of such medications to the children below 18 years needs the approval of the parents.
References
Chien, W. T., Leung, S. F., Yeung, F. K., & Wong, W. K. (2013). Current approaches to treatments for schizophrenia spectrum disorders, part II: Psychosocial interventions and patient-focused perspectives in psychiatric care. Neuropsychiatric Disease and Treatment, 10, 1463. https://doi.org/10.2147%2FNDT.S49263
Mitchell, A., Davies, M. A., Cassesse, C., & Curran, R. (2014). 5 Antidepressant Use in Children, Adolescents, and Young Adults: 10 Years After the Food and Drug Administration Black Box Warning. The Journal for Nurse Practitioners, 10 (3), 149- 156.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4 ed.). New York, NY: Cambridge University Press.
Stahl, S. M. (2014b). The prescriber’s guide (5 ed.). New York, NY: Cambridge University Press.
NURS 6630 Assignment Assessing And Treating Pediatric Patients With Mood Disorders Instructions
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.
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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.
Learning Objectives for NURS 6630 Assignment Assessing And Treating Pediatric Patients With Mood Disorders
Students will:
- Assess client factors and history to develop personalized plans of antidepressant therapy for pediatric clients
- Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric clients requiring antidepressant therapy
- Evaluate efficacy of treatment plans
- Analyze ethical and legal implications related to prescribing antidepressant therapy to pediatric clients
Learning Resources for NURS 6630 Assignment Assessing And Treating Pediatric Patients With Mood Disorders
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Chapter 7, “Antidepressants”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Review the following medications:
- amitriptyline
- bupropion
- citalopram
- clomipramine
- desipramine
- desvenlafaxine
- doxepin
- duloxetine
- escitalopram
- fluoxetine
- fluvoxamine
- imipramine
- ketamine
- mirtazapine
- nortriptyline
- paroxetine
- selegiline
- sertraline
- trazodone
- venlafaxine
- vilazodone
- vortioxetine
Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf
Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. doi:10.1002/da.22171
Note: Retrieved from Walden Library databases. NURS 6630 All Week Assignments latest
Vitiello, B. (2012). Principles in using psychotropic medication in children and adolescents. In J. M. Rey (Ed.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf
Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education (2016e). Case study: An African American child suffering from depression [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992. doi:10.1007/s00787-014-0558-3
Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854. doi:10.1111/jpc.12655
Seedat, S. (2014). Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2), iii–v. doi:10.2989/17280583.2014.938497
To prepare for NURS 6630 Assignment Assessing And Treating Pediatric Patients With Mood Disorders
Review this week’s Learning Resources. Consider how to assess and treat pediatric clients requiring antidepressant therapy.
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?
- Also include how ethical considerations might impact your treatment plan and communication with clients.
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NURS 6630 Assignment Assessing And Treating Pediatric Patients With Mood Disorders
Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders.
Learning Objectives
Students will:
- Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients
- Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy
- Evaluate efficacy of treatment plans
- Analyze ethical and legal implications related to prescribing antidepressant therapy to adult and geriatric clients
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
- amitriptyline
- bupropion
- citalopram
- clomipramine
- desipramine
- desvenlafaxine
- doxepin
- duloxetine
- escitalopram
- fluoxetine
- fluvoxamine
- imipramine
- ketamine
- mirtazapine
- nortriptyline
- paroxetine
- selegiline
- sertraline
- trazodone
- venlafaxine
- vilazodone
- vortioxetine
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389. Retrieved from https://www.researchgate.net/profile/Marie_Asberg/publication/22697065_A_New_Depression_Scale_Designed_to_be_Sensitive_to_Change/links/09e41513f85c708fee000000.pdf
Required Media
Laureate Education. (2016g). Case study: An elderly Hispanic man with major depressive disorder [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat adult and geriatric clients requiring antidepressant therapy.
The Assignment
Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. 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?
- Also include how ethical considerations might impact your treatment plan and communication with clients.
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