Therapy for pediatric clients with mood disorder
Therapy for Pediatric Clients with Mood Disorders
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· Mother reports that teacher said child is withdrawn from peers in class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 ( Depression is diagnosed).
The Assignment
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:
·
o 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.
Hint ( available on the required media on resource below)
Decision 1; begin Zoloft 25mg orally( Pt has no change)
Decision 2; increase dose to 37.5 mg orally ( Little effect of 20%)
Decision 3; increase dose to 75 mg orally ( pt feeling better. Will maintain this dose).
Other option, Begin paxil ( pt has N/V/D, refused meds), Begin Welbutrin( pt unable to sleep).
Resources for reference
Lorberg, B., Davico, C., Martsenkovskyi, D., & Vitiello, B. (2019). Principles in using psychotropic medication in children and adolescents. In J. M. Rey & A. Martin (Eds.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from https://iacapap.org/content/uploads/A.7-Psychopharmacology-2019.1.pdf
Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf
Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale--Revised. Los Angeles, CA: Western Psychological Services.
Note: Retrieved from Walden Library databases.
Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787-791. doi:10.1002/da.22171
Required Media
Laureate Education (2016e). Case study: An African American child suffering from depression [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
Ethical and Legal Implications of Prescribing Drugs
Explore the ethical and legal implications of scenarios and consider how to appropriately respond.
Scenarios: As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.
Consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
Review the scenario assigned by your Instructor for this Assignment.
Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario.
Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.
Write a 2- to 3-page paper that addresses the following:
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.
APA Citation 4 to 5 Reference within 5 years
Discussion
,Describe one innovative health care delivery model that incorporates an interdisciplinary care delivery team. Explain how this model is advantageous to patient outcomes.
Health Care Delivery Models and Nursing Practice
Examine changes introduced to reform or restructure the U.S. health care delivery system
Draft policy’s and procedures
You are the new office coordinator of a small multi-specialty group practice. You have been tasked with updating the office policies on medical records and confidentiality and training the employees on this important topic.
For this assignment you will:
Draft policies and procedures related to medical records and confidentiality in your group practice. This should include the following information in 3-5 pages, not including title page and reference page. You are expected to use a minimum of two references and utilize APA style:
Define medical records and confidentiality
Discuss legal standards and regulations related to medical records and confidentiality
Outline policies related to medical records requirements and standards
Outline policies and procedures related to confidentiality and access to records
Discuss how these policies and procedures will be communicated to employees
Discussion Reflection Response
Advanced Practice Nursing Model
Post your complete response to the discussion questions in the Discussion Area by the due date assigned.
This first week we are going to reflect on who we want to be and why. Why do you want to be an advanced practice nurse?
Please note:
Start with why you wanted to be a nurse originally; what does nursing mean to you? Describe the APN role that you are pursuing at South and why you chose this role—add a personal story to illustrate.
This is a reflection and therefore no references are needed nor expected.
There is only one (1) post for this discussion board.
There is no requirement to respond to any of your peers.
Your response should be 200-250 words in length.
Guidelines: In your discussion response, provide a substantive response that illustrates a well-reasoned and thoughtful response. Reflective posts provide you an opportunity to think back on the concepts and materials you reviewed for the week. A reflection is a method for personal growth. A reflection post can help answer questions, such as, ""How has my thinking changed this past week?"", ""How can I use the concepts or relationships from the course readings and course content in my practice?"" Reflection enhances personal and professional growth by making connections to previous course content and/or presenting novel ideas and insights
Project
: Community Blood Center of the Carolinas: Donations, Donations, Donations, Complete a full case analysis incorporating your work from your SWOT analysis this week. Use the following format to complete this assignment.
An introduction
Definition of the problem.
Identification of the stakeholders.
Identification of alternative solutions.
Evaluation of alternative solutions.
Solution chosen and how to implement it with the stakeholders.
Conclusion and reflection of this process
Poster creation
• Create a poster/powerpoint on: Crohn
• Include signs and symptoms
• What causes it
• Management of symptoms
• Medication that may be used
• Prevention
• Assessment findings
• What risk factors associated with disease process: (dehydration, electrolyte imbalance, . . .)
• What questions the nurse should ask the patient/family presenting with this illness
• Education to family
Pediatric Discussion
Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.
JO Discussion:
What are the sources of pediatric primary care in the United States? Are these sources sufficient for providing health-care services to the pediatric population? Why or why not?
The pediatric population is offered several different resources of primary care. These resources include: community and school-based health centers, pediatricians, family practice/primary care clinicians, nurse practitioners, clinics, and the health department (Spencer et al, 2018). Various programs are available to assist families in gaining access to primary care, preventative care guidelines/schedules, insurance, supplemental nutrition, health care referrals, and nutritional education. State and federally funded programs/resources include: Medicaid, Women, Infants, and Children (WIC), Children’s Health Insurance Program (CHIP), and Bright Futures (Health Resources & Services Administration, 2021). Despite the number of resources made available for this population, some children’s health care needs are still not being met. The Children’s Health Fund estimates that nearly 28% of children in the United States still possess unmet healthcare needs, especially those requiring specialty care such as, pediatric endocrinology or pediatric cardiology (PNHP, 2016).
Are there certain pediatric populations that lack access to health-care services? Why?
The pediatric population residing in underserved, rural regions, tend to lack access to health-care services due to a limitation of services. Approximately 20 percent of Americans reside in rural areas, but hardly one-tenth of physicians practice in these areas (Nielsen et al., 2017). This ratio is projected to get worse as the federal government reports there will be an estimated deficiency of over 20,000 primary care providers in rural regions (Nielsen et al., 2017).
What are the barriers to children in accessing health-care services in the United States? Why do these barriers exist?
Sadly, many children are faced with numerous barriers in accessing health-care services in the United States. These barriers include financial and non-financial barriers. Financial barriers stem from high copays, high deductibles, high-priced prescription drugs, families reporting failure or difficulty to pay medical bills, and providers declining certain forms of insurance (PNHP, 2016). Non-financial barriers encompass informational and geographical barriers. Informational and geographical barriers are due to the complexity of information on accessing healthcare and obtaining coverage, parents’ limited proficiency in speaking English, health illiteracy, lack of transportation, and lack of healthcare providers per capita in rural and low-income regions (PNHP, 2016). These barriers can create a delay in seeking care, leading to more complex illnesses and decreased quality of life.
References
Health Resources & Services Administration. (2021). Maternal and child health. Retrieved from https://mchb.hrsa.gov/maternal-child-health-topics/child-health/bright-futures.html
Nielsen, M., D'Agostino, D., & Gregory, P. (2017). Addressing Rural Health Challenges Head On. Missouri medicine, 114(5), 363–366.
PNHP. (2016). Unfinished business: More than 20 million children in u.s. still lack sufficient access to essential health care. Retrieved from https://pnhp.org/news/20-million-children-lack-sufficient-access-to-health-care
Spencer, D. L., McManus, M., Call, K. T., Turner, J., Harwood, C., White, P., & Alarcon, G. (2018). Health Care Coverage and Access Among Children, Adolescents, and Young Adults, 2010-2016: Implications for Future Health Reforms. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 62(6), 667–673. https://doi.org/10.1016/j.jadohealth.2017.12.012
Nursing
Welcome to Samples page400-600 words APA 6 format, in-text citation, Use at least two (2) scholarly references to substantiate your work. Please provide a copy of all references used.
The links to the mentioned articles are provided below.
Assignment Details:
Nearly everyone in the United States—and the world as a whole—has now been impacted by the COVID-19 pandemic. Everything from schools, to hospitals, to workplaces have been affected. Among the greatest impact seen has been the impact to the various lines of supplies in the medical field. Please review this article.
Share how the pandemic has had an impact in both the demand for, and supply of healthcare goods and services.
Describe the impact the supply chain disruption had on healthcare organizations in your own community in terms of financial impact, patient access and treatment decisions, or shortages of personal protective equipment (PPE) for essential healthcare personnel.
Article:
https://emtemp.gcom.cloud/ngw/globalassets/en/doc/documents/720711-supply-chain-brief-coronavirus-stresses-global-healthcare-supply-chains.pdf
