Week 2: Therapy for Pediatric Clients With Mood Disorders

Mood disorders can impact every facet of a
child’s life, making the most basic activities difficult for clients and
their families. This was the case for 13-year-old Kara, who was
struggling at home and at school. For more than 8 years, Kara suffered
from temper tantrums, impulsiveness, inappropriate behavior, difficulty
in judgment, and sleep issues. As a psychiatric mental health nurse
practitioner working with pediatric clients, you must be able to assess
whether these symptoms are caused by psychological, social, or
underlying growth and development issues. You must then be able
recommend appropriate therapies.

This week,
as you examine antidepressant therapies, you explore the assessment and
treatment of pediatric clients with mood disorders. You also consider
ethical and legal implications of these therapies.

Assignment: 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.

Learning Objectives

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

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 this link provided.

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

Lorberg, B.,  Davico, C.,  Martsenkovskyi, D., & Vitiello, B. (2019).  Principles in using psychotropic medication in children and adolescents. In J. M. Rey & A. Martin (Eds.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from https://iacapap.org/content/uploads/A.7-Psychopharmacology-2019.1.pdf

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

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

Note: Retrieved from Walden Library databases.

Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787-791. doi:10.1002/da.22171

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 this Assignment:

• 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.

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.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
• Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:Week 2 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:Submit your Week 2 Assignment draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:Week 2 Assignment

Making Connections

Now that you have:

• 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
• Explored ethical and legal implications of prescribing antidepressant therapy to pediatric clients

Next week, you will build on your
assessment and treatment skills as you examine adult and geriatric
clients presenting for antidepressant therapy.
To go to the next week:Week 3

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