Mental Health

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.
Therapy for Pediatric Clients with Mood Disorders
An African American Child Suffering From Depression
BACKGROUND INFORMATION
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Mother reports that teacher said child is withdrawn from peers in class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
Client seen by Psychiatric Nurse Practitioner
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.
The PMHNP administers the Children’s Depression Rating Scale, obtaining a score of 30
(indicating significant depression)
Select what the PMHNP should do:
Begin Zoloft 25 mg orally daily
Begin Paxil 10 mg orally daily
Begin Wellbutrin 75 mg orally BID
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At each decision point stop to complete the following:
o 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?
o 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?
o 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.
Note: 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.
Making Connections
Now that you have:
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Assessed pediatric clients presenting with mood disorders
Developed personalized plans of antidepressant therapy for pediatric clients
Examined factors that influence pharmacokinetic and pharmacodynamic processes in
pediatric clients requiring antidepressant therapy
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Explored ethical and legal implications of prescribing antidepressant therapy to pediatric
clients
Review the following medications:
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amitriptyline
bupropion
citalopram
clomipramine
desipramine
desvenlafaxine
doxepin
duloxetine
escitalopram
fluoxetine
fluvoxamine
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imipramine
ketamine
mirtazapine
nortriptyline
paroxetine
selegiline
sertraline
trazodone
venlafaxine
vilazodone
vortioxetine
RESOURCES
§ Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles,
CA: Western Psychological Services.
http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf
https://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf
http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

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