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DEPRESSION
QUESTION
Natalee Williams, a 10-year-old African American girl, comes to your psychiatric nurse practitioner office for evaluation. She has been sad and withdrawn, complaining about headaches and “tummy aches.”
Her mother, Trina, accompanies her to the appointment. Trina notes that Natalee has seemed depressed and presents as irritable. The mother notes her daughter’s mood change occurred about two months ago. Natalee’s school performance has fallen, and she is now doing C work. Last term, she earned all As. She wants to sleep more, and her appetite has decreased. She rarely wants to play with friends and spends a lot of time in her room alone. Her height and weight are normal for her age, but she has lost 2 pounds over the last two months.
There is a history of depression in the family, as Natalee’s maternal grandmother and maternal aunt both have had major depression. Her maternal grandmother was hospitalized for psychiatric care 20 years ago for depression and a suicide attempt by an overdose of Tylenol.
Questions
From your perspective as Natalee’s psychiatric nurse practitioner, answer the following questions in a paper no longer than two double-spaced pages (not including the reference page and prescription) and in APA format. Include at least three peer-reviewed, evidence-based references.What are some differential diagnoses you would give – identify one medical differential diagnosis and two psychiatric differential diagnoses?
What diagnosis would you give Natalee? On what evidence/symptoms do you base your diagnosis?
What medication(s) would you prescribe for Natalee and why? Please note the medication, initial dose, and dosing schedule.
Fill out a prescription (PDF) (Links to an external site.) for this medication. Print the template, fill it out, and scan it or take a photo. Insert the image at the end of your Microsoft Word document.
How will you educate and inform Trina (Natalee’s mother) about how this medication will work?
How will you discuss with Trina the commonly expected side effects and potentially serious adverse effects and risks for a child of this age with taking this medication?
Subject | Psychology | Pages | 4 | Style | APA |
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Answer
Depression Case Analysis
Depression is one of the common mental health concerns, also known as an affective disorder. The depression case can range from mild to severe depending of the type of signs and symptoms depicted by the patient. Severe cases of depression are featured by symptoms such as hallucinations and delusions and can also result to death if not addressed in a timely manner (Bhowmik, Kumar, Srivastava, Paswan & Dutta, 2012). This primary focus of this paper is to explore a depression case study while outlining aspects such as differential diagnosis, medications and prescriptions.
Differential Diagnosis
Obstructive sleep apnea is one of the medical differential diagnoses which can be considered in this case. Two psychiatric disorders which can be considered in this case include anxiety disorder and manic disorder (Halverson, Bhalla, & Moraille-Bhalla, 2019).
Natalee’s Diagnosis
I would diagnose Natalee with depression. This is based on the fact that the patient represents several symptoms such as increased irritability, changes in mood, and increased isolation. According to Bhowmik et al. (2012) some of the common symptoms of depression include increased irritability or frustration even in the events of small issues. Additionally, excessive sleep or insomnia is a sign depicting depression alongside changes in appetite which can result to either weight gain or weight loss (Bhowmik et al., 2012).
Medications
Different medications can be described for a patient with depression. For instance, Prozac, also known by its generic name fluoxetine Prozac, can be administered to the patient to counteract the symptoms of depression (Yan & Goldman, 2019). Fluoxetine is known to have a high efficacy level in comparison to other selective serotonin reuptake inhibitors. The benefits of the intake of this medication will be seen after a period of 2 weeks of administration at the dose of 20mg daily for the next 8 weeks (Yan & Goldman, 2019). The proposed medication is focused on counteracting the symptoms of the patient such as the case of increased irritability.
Patient Education
The patient’s mother will be educated about medication effectiveness through a one-on-one interaction. In this case, the nurse will inform Natalee’s mother of the expected side-effects of the medication. Moreover, the patient’s mother will also be educated on the importance of following the proposed medication intake schedule for it to be effective in counteracting the depression symptoms (Bowen, Rotz, Patterson & Sen, 2017). After the short education process, I will encourage Natalie to ask question involving the use of the medication to ensure that she understood all the aspects taught about the medication’s effectiveness.
Expected Side Effects
Taking advantage of the training session, I will also educate Natalie of the expected side effects of the medications alongside the serious adverse effects, especially that the medicines will be administered to a 10 year old child. I will ensure that the mother is aware that the child is likely to experience diarrhea, dry mouth, indigestion, loss of appetite and strange dreams among others. Despite the fact that the patient’s mother will be informed of the fact that the side effects are common, she will also be informed that she should report back to the health care institution for advice if the patient should continue with the medication or have the current combination changed.
References
Bhowmik, D., Kumar, S., Srivastava, S., Paswan, S. & Dutta, A.S. (2012). Depression-symptoms, causes, medications and therapies. Pharma Innov. 1. 32-45. Bowen, J. F., Rotz, M. E., Patterson, B. J., & Sen, S. (2017). Nurses’ attitudes and behaviors on patient medication education. Pharmacy practice, 15(2), 930. https://doi.org/10.18549/PharmPract.2017.02.930 Halverson, J., Bhalla, R., & Moraille-Bhalla, P. (2019). Depression Differential Diagnoses. Medscape. Retrieved from https://emedicine.medscape.com/article/286759-differential Yan, T., & Goldman, R. D. (2019). Time-to-effect of fluoxetine in children with depression. Canadian family physician Medecin de famille canadien, 65(8), 549–551.
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