Advance Psych Pharm Decision Tree

click on the hyperlink // Pediatric Depression and this take you to the medications upon which pharmacology treatment decisions are based.

don’t forget to increase doses to optimal  therapeutic accepted level before switching to another medication in case the desired outcome is not reached.

do not abruptly switch medications , make sure you give the half life of minimum of two weeks from switching SSRI to MOAI etc…

Photo Credit: Getty Images/iStockphoto

Week 4: Therapy for Patients With Major Depressive Disorder (MDD)

Mood disorders can impact every facet of a human being’s life, making the most basic activities difficult for patients and their families. This was the case for 13-year-old Jeanette, who was struggling at home and at school. For more than 8 years, Jeanette suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues.

As a PNP working with pediatric patients, 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 three populations: pediatrics, adults, and geriatrics. The focus of your assessment tool, a decision tree, will specifically center on one of the most vulnerable populations, pediatrics. Please remember, you must also consider the ethical and legal implications of these therapies. You will also complete a Quiz on the concepts addressed throughout this module.

Learning Objectives

Students will:

· Assess patient factors and history to develop personalized plans of antidepressant therapy across the lifespan

· Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric, adult, and geriatric patients requiring antidepressant therapy

· Synthesize knowledge of providing care to pediatric, adult, and geriatric patients presenting for antidepressant therapy

· Analyze ethical and legal implications related to prescribing antidepressant therapy to patients across the lifespan

 

 

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.

 

 

 

// Pediatric depression 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

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

 

 

// Pediatric depression

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

 

 

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

 

  // Pediatric depression

Therapy for Pediatric Clients with Mood Disorders An African American Child Suffering From Depression

African American Child

 

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

 

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.

 

Decision Point One

Select what you should do:

 

Begin Zoloft 25 mg orally daily

 

Begin Paxil 10 mg orally daily

 

Begin Wellbutrin 75 mg orally BID