Answer

Assessing and Treating Pediatric Clients with Mood Disorders

Background

The patient is an 8-year-old African American male who arrives at the hospital with his mother. He has signs of depressions.

The patient complained of feeling “sad”.

The mother says that teachers are reporting of withdrawal from his peers.

The mother mentions occasional irritation and decreased appetite.

According to the mother, the patient reached all developmental landmarks at the correct age

Laboratory studies WNL

Physical examination unremarkable

The patient is referred to the psychiatry for evaluation

The patient is seen by psychiatric nurse practitioner

Mental Status Exam.

The client is alert and oriented, coherent, speech clear, spontaneous, and goal oriented. He reports a sad mood. Although somehow blunted, he smiles appropriately at several occasions throughout the clinical review. The child denies auditory and visual hallucinations. No paranoid or delusional thought processes observed. Insights and judgment are age-appropriate.  He does not endorse an active suicidal ideation, but in some instances, thinks of himself dead and imagine what happens when one is dead and the consequences.

The PMHNP puts her under the children depression rating scale that obtained a score of 30 which indicates a significant depression.

Decision One

I selected Zoloft 25 mg orally daily. This is because the drug is used to treat depression, panic disorder, obsessive-compulsive disorder, anxiety disorders, and post-traumatic stress disorder (Wehry et al., 2015). I was expecting to see improvement as far as depression is concerned at the same time see a reduction of on the scale to anything below 25. There was no difference between the expected and the actual results. This is because the indication was still 30 and the signs of the disorder did not change.

Decision Two

Increase Zoloft prescription to 50mg orally daily. Since the drug is used to treat depression, panic disorder, obsessive-compulsive disorder, anxiety disorders, and post-traumatic stress disorder, there could be possibility of poor reaction of the drug as a result of low dosage. According to Linehan (2018), by increasing the dosage of a particular drug, there is possibility they will react more compared to the low dosage.  I was expecting to see a reduction reduction of on the scale to anything below 25 and also elimination of some of the signs and symptoms. The expected result was achieved as certain symptoms such as low appetite and reduced interaction with peers disappeared. Indicator also fell to 24.

Decision Three

Maintain Zoloft to 50mg orally daily. This is because the drug proved that is working as was observed in decision two. Nathan and Gorman (2015) say that depression disorder are complex diseases which require patience hence after realizing that certain drug can treat particular diseases, it of impotent to be given more time. The expected results are elimination of the remaining signs and symptoms and reduction of indicator to below 25 after two weeks.