Assessing and Treating Pediatric Clients With Mood Disorders

BACKGROUND INFORMATION:

An African American Child Suffering from Depression

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• Mother reports that teacher said child is withdrawn from peers in class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)

RESOURCES

§ Poznanski, E., & Mokros, H. (1996). Child Depression Rating
Scale–Revised. Los Angeles, CA: Western Psychological Services.

Decision Point One

Select what the PMHNP should do:

Begin Zoloft 25 mg orally dailyBegin Paxil 10 mg orally dailyBegin Wellbutrin 75 mg orally BID 

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.

Note:Support your rationale
with a minimum of three academic resources no more than give years old.
While you may use the course text to support your rationale, it will not
count toward the resource requirement.

“