Assignment: Assessing and Treating Pediatric Patients With Mood Disorders
When pediatric patients 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 patients with the same disorders, they also metabolize medications much differently. Yet, there may be times when the same psychopharmacologic treatments may be used in both pediatric and adult cases with major depressive disorders. As a result, psychiatric nurse practitioners must exercise caution when prescribing psychotropic medications to these patients. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat pediatric patients presenting with mood disorders.
To prepare for this Assignment:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of pediatric patients requiring antidepressant therapy.
The Assignment: 5 pages
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 patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response wi.
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Assignment Assessing and Treating Pediatric Patients With Mood Diso.docx
1. Assignment: Assessing and Treating Pediatric Patients With
Mood Disorders
When pediatric patients 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 patients with the same disorders, they also
metabolize medications much differently. Yet, there may be
times when the same psychopharmacologic treatments may be
used in both pediatric and adult cases with major depressive
disorders. As a result, psychiatric nurse practitioners must
exercise caution when prescribing psychotropic medications to
these patients. For this Assignment, as you examine the patient
case study in this week’s Learning Resources, consider how you
might assess and treat pediatric patients presenting with mood
disorders.
To prepare for this Assignment:
Review this week’s Learning Resources, including the
Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might
recommend for the assessment and treatment of pediatric
patients requiring antidepressant therapy.
The Assignment: 5 pages
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 patient. Be sure to consider
2. factors that might impact the patient’s pharmacokinetic and
pharmacodynamic processes.
At each decision point, you should evaluate all options before
selecting your decision and moving throughout the exercise.
Before you make your decision, make sure that you have
researched each option and that you evaluate the decision that
you will select. Be sure to research each option using the
primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be
sure to include the specific patient factors that may impact your
decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your
response with clinically relevant and patient-specific resources,
including the primary literature.
Why did you not select the other two options provided in the
exercise? Be specific and support your response with clinically
relevant and patient-specific resources, including the primary
literature.
What were you hoping to achieve by making this decision?
Support your response with evidence and references to the
Learning Resources (including the primary literature).
3. Explain how ethical considerations may impact your treatment
plan and communication with patients. Be specific and provide
examples.
Decision #2 (1 page)
Why did you select this decision? Be specific and support your
response with clinically relevant and patient-specific resources,
including the primary literature.
Why did you not select the other two options provided in the
exercise? Be specific and support your response with clinically
relevant and patient-specific resources, including the primary
literature.
What were you hoping to achieve by making this decision?
Support your response with evidence and references to the
Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment
plan and communication with patients. Be specific and provide
examples.
Decision #3 (1 page)
Why did you select this decision? Be specific and support your
response with clinically relevant and patient-specific resources,
including the primary literature.
Why did you not select the other two options provided in the
exercise? Be specific and support your response with clinically
4. relevant and patient-specific resources, including the primary
literature.
What were you hoping to achieve by making this decision?
Support your response with evidence and references to the
Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment
plan and communication with patients. Be specific and provide
examples.
Conclusion (1 page)
Summarize your recommendations on the treatment options you
selected for this patient. Be sure to justify your
recommendations and support your response with clinically
relevant and patient-specific resources, including the primary
literature.
Note:
Support your rationale with a minimum of five academic
resources. While you may use the course text to support your
rationale, it will not count toward the resource requirement.
You should be utilizing the primary and secondary literature.
Reminder
: The College of Nursing requires that all papers submitted
include a title page, introduction, summary, and references. The
Sample Paper provided at the Walden Writing Center provides
an example of those required elements (available at
https://academicguides.waldenu.edu/writingcenter/templates/gen
eral#s-lg-box-20293632).All papers submitted must use this
formatting.
5. Learning Resources
Required Readings
(click to expand/reduce)
Baek, J. H., Nierenberg, A. A., & Fava, M. (2016).
Pharmacological approaches to treatment-resistant depression.
In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum.
(Eds.),
Massachusetts General Hospital psychopharmacology and
neurotherapeutics
(pp. 44–47). Elsevier.
Fava, M., & Papakostas, G. I. (2016). Antidepressants. In T. A.
Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.),
Massachusetts General Hospital psychopharmacology and
neurotherapeutics
(pp. 27–43). Elsevier.
American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental disorders (5th ed.).
https://doi.org/10.1176/appi.books.9780890425596
Howland, R. H. (2008a). Sequenced Treatment Alternatives to
Relieve Depression (STAR*D). Part 1: Study design.
Journal of Psychosocial Nursing and Mental Health Services, 46
(9), 21–24. https://doi.org/10.3928/02793695-20080901-06
Howland, R. H. (2008b). Sequenced Treatment Alternatives to
Relieve Depression (STAR*D). Part 2: Study outcomes.
Journal of Psychosocial Nursing and Mental Health Services, 46
(10), 21–24. https://doi.org/10.3928/02793695-20081001-05
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
6. .), IACAPAP e-textbook of child and adolescent mental health
. https://iacapap.org/content/uploads/A.7-Psychopharmacology-
2019.1.pdf
Magellan Health. (2013).
Appropriate use of psychotropic drugs in children and
adolescents: A clinical monograph
. http://www.magellanhealth.com/media/445492/magellan-
psychotropicdrugs-0203141.pdf
Poznanski, E. O., & Mokros, H. B. (1996).
Child depression rating scale—Revised
. Western Psychological Services.
Rao, U. (2013). Biomarkers in pediatric depression.
Depression & Anxiety, 30
(9), 787–791. https://doi.org/10.1002/da.22171
Yasuda, S. U., Zhang, L. & Huang, S.-M. (2008). The role of
ethnicity in variability in response to drugs: Focus on clinical
pharmacology studies.
Clinical Pharmacology & Therapeutics, 84
(3), 417–423.
https://web.archive.org/web/20170809004704/https://www.fda.g
ov/downloads/Drugs/ScienceResearch/.../UCM085502.pdf
Medication Resources
(click to expand/reduce)
IBM Corporation. (2020).
IBM Micromedex
.
https://www.micromedexsolutions.com/micromedex2/librarian/d
eeplinkaccess?source=deepLink&institution=SZMC%5ESZMC
%5ET43537
7. Note:
To access the following medications, use the IBM Micromedex
resource. Type the name of each medication in the keyword
search bar. Be sure to read all sections on the left navigation
bar related to each medication’s result page, as this information
will be helpful for your review in preparation for your
Assignments.
Review the following medications:
amitriptyline
bupropion
citalopram
clomipramine
desipramine
desvenlafaxine
doxepin
duloxetine
escitalopram
fluoxetine
fluvoxamine
imipramine
9. 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
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.
You administer 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.
