approach to treatment

  
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 client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
· 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?
o 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?
o 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.

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Resources
Therapy for Pediatric Clients with Mood Disorders An African American Child SufferingBACKGROUND 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Mother      reports that teacher said child is withdrawn from peers in class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.  

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