What decisions would influence the medication prescribed to a child with depression?

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.

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,
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Mother reports that teacher said child is withdrawn from peers in class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
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:

I already made the selection, so gave rationale

Answer preview :

depression

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