Assignment: Assessing and Treating Pediatric Patients With Mood Disorders NURS 4430

Assignment: Assessing and Treating Pediatric Patients With Mood Disorders NURS 4430

Assignment: Assessing and Treating Pediatric Patients With Mood Disorders NURS 4430

Decision Point 2

The second decision is Sertraline 50 mg by mouth daily. This treatment option was selected following the ineffectiveness of Zoloft 25 mg orally in improving the client’s symptoms. The client did not report a change in the initial symptoms after taking Zoloft 25 mg orally for 4 weeks. According to Tini et al. (2022), Sertraline’s dosage for treating depression in children can be titrated upwards to 250 mg to enhance its effectiveness. Hence, increasing the client’s dosage to 50 mg by mouth daily would strengthen the effectiveness of Sertraline in improving initial depression symptoms.

Other alternatives include Prozac 10 mg by mouth daily and Sertraline 37.5 mg by mouth daily. Prozac 10 mg by mouth daily was rejected due to its inefficacy in treating significant depressive symptoms in children. Zhou et al. (2022) reported that Prozac 10 mg is effective for treating acute depressive symptoms in children. Hence, this option is inappropriate for this client since he was diagnosed with significant depression. Additionally, Sertraline 37.5 mg by mouth daily was rejected since the client did not report improvement in depressive symptoms after taking Zoloft 25 mg orally for four weeks. Similarly, Sertraline 37.5 mg by mouth daily would not result in the desired improvement in depressive symptoms.

Sertraline of 50% mg by mouth daily was expected to reduce the client’s depressive symptoms by 50%. According to Tini et al. (2022), the effectiveness of Sertraline in treating depression in children increase with dosage. The client reported a 50% decrease in initial symptoms upon returning to the clinic after 4 weeks.

While developing this treatment plan, the PMNHP adhered to the ethical principles of beneficence. The most beneficial option, Sertraline 50 mg by mouth daily, was prescribed to the patients. The PMHNP dismissed other options, including Prozac 10 mg by mouth daily and Sertraline 37.5 mg daily, due to their inefficacy in treating the client’s depressive symptoms.

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 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 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/general#s-lg-box-20293632).All
papers submitted must use this formatting.

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 “WK4Assgn+last name+first
initial.(extension)” as the name.
 Click the Week 4 Assignment Rubric to review the Grading Criteria for the
Assignment.
 Click the Week 4 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 “WK4Assgn+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 4 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:
Submit your Week 4 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 4

To participate in this Assignment:
Week 4 Assignment

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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.), 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.gov/downloads/Dr
ugs/ScienceResearch/…/UCM085502.pdf

Medication Resources (click to expand/reduce)

IBM Corporation. (2020). IBM Micromedex.
https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkaccess?source=deepLink
&institution=SZMC%5ESZMC%5ET43537

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
 ketamine
 mirtazapine
 nortriptyline
 paroxetine
 selegiline
 sertraline
 trazodone
 venlafaxine
 vilazodone
 vortioxetine

Required Media (click to expand/reduce)

Case Study: An African American Child Suffering from Depression
Note: This case study will serve as the foundation for this week’s Assignment.

Optional Resources (click to expand/reduce)

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. https://doi.org/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.
https://doi.org/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. https://doi.org/10.2989/17280583.2014.938497