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NURS 6630 Week 2 Assignment: Assessing and Treating Pediatric Clients With Mood Disorders

NURS 6630 Week 2 Assignment : Assessing and Treating Pediatric Clients With Mood Disorders

When pediatric clients present with mood disorders, the process of assessing,
diagnosing, and treating them can be quite complex. Children not only present with
different signs and symptoms than adult clients with the same disorders, but they also
metabolize medications much differently. As a result, psychiatric mental health nurse
practitioners must exercise caution when prescribing psychotropic medications to these
clients. For this Assignment, as you examine the client case study in this week’s
Learning Resources, consider how you might assess and treat pediatric clients
presenting with mood disorders.
Note: This Assignment is the first of 10 assignments that are based on interactive client
case studies. For these assignments, you will be required to make decisions about how
to assess and treat clients. Each of your decisions will have a consequence. Some
consequences will be insignificant, and others may be life altering. You are not
expected to make the “right” decision every time; in fact, some scenarios may not have
a “right” decision. You are, however, expected to learn from each decision you make
and demonstrate the ability to weigh risks versus benefits to prescribe appropriate
treatments for clients.
Learning Objectives
Students will:
 Assess client factors and history to develop personalized plans of antidepressant therapy for
pediatric clients
 Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric
clients requiring antidepressant therapy
 Evaluate efficacy of treatment plans

 Analyze ethical and legal implications related to prescribing antidepressant therapy to pediatric
clients
Learning Resources
Note: To access this week’s required library resources, please click on the link to the
Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through this link provided.
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, 5th
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.

Review the following medications:
 amitriptyline
 bupropion
 citalopram
 clomipramine
 desipramine
 desvenlafaxine
 doxepin
 duloxetine
 escitalopram
 fluoxetine
 fluvoxamine
 imipramine
 ketamine
 mirtazapine
 nortriptyline
 paroxetine
 selegiline
 sertraline
 trazodone
 venlafaxine
 vilazodone
 vortioxetine

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.
Optional Resources
El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of
antidepressant or anxiolytic medication during pregnancy and childhood
neurodevelopmental outcomes: A systematic review. European Child & Adolescent
Psychiatry, 23(10), 973–992. doi:10.1007/s00787-014-0558-3
Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and
adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854.
doi:10.1111/jpc.12655
Seedat, S. (2014). Controversies in the use of antidepressants in children and
adolescents: A decade since the storm and where do we stand now? Journal of Child &
Adolescent Mental Health, 26(2), iii–v. doi:10.2989/17280583.2014.938497
To prepare for this Assignment:
 Review this week’s Learning Resources. Consider how to assess and treat pediatric clients
requiring antidepressant therapy.

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.
Note: Support your rationale with a minimum of three academic resources. While you
may use the course text to support your rationale, it will not count toward the resource
requirement.
By Day 7
Submit your Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
 Please save your Assignment using the naming convention “WK2Assgn+last name+first
initial.(extension)” as the name.
 Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
 Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria
from this area.
 Next, from the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
 If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my
paper(s) to the Global Reference Database.
 Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:
Week 2 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 2 Assignment draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 2 Assignment

Making Connections

Now that you have:
 Assessed pediatric clients presenting with mood disorders
 Developed personalized plans of antidepressant therapy for pediatric clients
 Examined factors that influence pharmacokinetic and pharmacodynamic processes in pediatric
clients requiring antidepressant therapy
 Explored ethical and legal implications of prescribing antidepressant therapy to pediatric clients
Next week, you will build on your assessment and treatment skills as you examine adult
and geriatric clients presenting for antidepressant therapy.
To go to the next week:
Week 3

Week 3: Adult and Geriatric Antidepressant

Therapy

The National Institute of Mental Health estimates that approximately 15.7 million adults
in the United States have depression (NIMH, 2014), making depression one of the most
common disorders you will treat in practice. Although this disorder is so prevalent,
antidepressant therapy must be as unique as each individual you treat. There are
dozens of antidepressant medications on the market, and you must be able to identify
which medication or combinations of medications will result in the best outcomes for
your clients.
This week, as you study antidepressant therapies, you examine the assessment and
treatment of clients with mood disorders. You also explore ethical and legal implications
of these therapies.
Learning Objectives
Students will:
 Assess client factors and history to develop personalized plans of antidepressant therapy for
adult and geriatric clients
 Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and
geriatric clients requiring antidepressant therapy
 Analyze the impact of ethnicity on antidepressant therapy
 Evaluate efficacy of treatment plans
 Apply knowledge of providing care to adult and geriatric clients presenting for antidepressant
therapy
Learning Resources
Note: To access this week’s required library resources, please click on the link to the
Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through this link provided.
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”
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, 5th
ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

 amitriptyline
 bupropion
 citalopram
 clomipramine
 desipramine
 desvenlafaxine
 doxepin
 duloxetine
 escitalopram
 fluoxetine
 fluvoxamine
 imipramine
 ketamine
 mirtazapine
 nortriptyline
 paroxetine
 selegiline
 sertraline
 trazodone
 venlafaxine
 vilazodone
 vortioxetine

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). Washington, DC: Author.

Howland, R. H. (2008). Sequenced Treatment Alternatives to Relieve Depression
(STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health
Services, 46(9), 21-24. doi:02793695-20081001-0510.3928/02793695-20080901-06

Howland, R. H. (2008). Sequenced Treatment Alternatives to Relieve Depression
(STAR*D). Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health
Services, 46(10), 21-24. doi:02793695-20081001-0510.3928/02793695-20080901-06

NURS 6630 Week 2 Assignment Assessing and Treating Pediatric Clients With Mood Disorders

NURS 6630 Week 2 Assignment Assessing and Treating Pediatric Clients With Mood Disorders

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Yasuda, S.U., Zhang, L. & Huang, S.-M. (2008). The role of ethnicity in variability in
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Therapeutics, 84(3), 417–423. Retrieved from
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Exit

 Grid View
 List View
Excellent
Point range: 90–100

Good
Point range: 80–89

Fair
Point range: 70–79

Poor
Point range: 0–69

Introduction to the case (1
page)
Briefly explain and summarize
the case for this Assignment.
Be sure to include the specific
patient factors that may impact
your decision making when

prescribing medication for this
patient.

9 (9%) – 10 (10%)
The response accurately, clearly,
and fully summarizes in detail the
case for the Assignment.
The response accurately and
clearly explains in detail the
specific patient factors that
impact decision making when
prescribing medication for this
patient.

8 (8%) – 8 (8%)
The response accurately
summarizes the case for the
Assignment.
The response accurately explains
the specific patient factors that
impact decision making with
prescribing medication for this
patient.

7 (7%) – 7 (7%)
The response inaccurately or
vaguely summarizes the case for
the Assignment.
The response inaccurately or

vaguely explains the specific
patient factors that impact
decision making with prescribing
medication for this patient.

0 (0%) – 6 (6%)
The response inaccurately and
vaguely summarizes the case for
the Assignment, or is missing.
The response inaccurately and
vaguely explains the specific
patient factors that impact
decision making with prescribing
medication for this patient.

Decision #1 (1–2 pages)
• Which decision did you
select?
• Why did you select this
decision? Be specific and
support your response with
clinically relevant and patient-
specific resources, including
the primary literature.
• Why did you not select the

18 (18%) – 20 (20%)
The response accurately and
clearly explains in detail the

decision selected.
The response accurately and
clearly explains in detail why the
decision was selected, with
specific clinically relevant
resources that fully support the
decision selected.

16 (16%) – 17 (17%)
The response accurately explains
the decision selected.
The response explains why the
decision was selected, with
specific clinically relevant
resources that support the
decision selected.
The response accurately explains

14 (14%) – 15 (15%)
The response inaccurately or
vaguely explains the decision
selected.
The response inaccurately or
vaguely explains why the
decision was selected, with
specific clinically relevant
resources that inaccurately or
vaguely support the decision

0 (0%) – 13 (13%)
The response inaccurately and
vaguely explains the decision
selected.
The response inaccurately and
vaguely explains why the
decision was selected, with
specific clinically relevant
resources that do not support the
decision selected, or is missing.

other two options provided in
the exercise? Be specific and
support your response with
clinically relevant and patient-
specific resources, including
the primary literature.
• What were you hoping to
achieve by making this
decision? Support your
response with evidence and
references to the Learning
Resources (including the
primary literature).
• Explain how ethical
considerations may impact
your treatment plan and
communication with patients.
Be specific and provide

examples.

The response accurately and
clearly explains in detail why the
other two responses were not
selected, with specific clinically
relevant resources that fully
support the response.
The response accurately and
clearly explains in detail the
outcome the student was hoping
to achieve with the selected
decision, with specific clinically
relevant resources that fully
support the response.
The response accurately and
clearly explains in detail how
ethical considerations impact the
treatment plan and
communication with patients.
Examples provided fully support
the decisions and responses
provided.

why the other two responses
were not selected, with specific
clinically relevant resources that
support the response.
The response accurately explains

the outcome the student was
hoping to achieve with the
selected decision, with specific
clinically relevant resources that
support the response.
The response accurately explains
how ethical considerations
impact the treatment plan and
communication with patients.
Examples provided support the
decisions and responses
provided.

selected.
The response inaccurately or
vaguely explains why the other
two responses were not selected,
with specific clinically relevant
resources that inaccurately or
vaguely support the response.
The response inaccurately or
vaguely explains the outcome the
student was hoping to achieve
with the selected decision, with
specific clinically relevant
resources that inaccurately or
vaguely support the response.
The response inaccurately or
vaguely explains how ethical

considerations impact the
treatment plan and
communication with patients.
Examples provided may support
the decisions and responses
provided.

The response inaccurately and
vaguely explains why the other
two responses were not selected,
with specific clinically relevant
resources that do not support the
decision selected, or is missing.
The response inaccurately and
vaguely explains the outcome the
student was hoping to achieve
with the selected decision, with
specific clinically relevant
resources that do not support the
response, or is missing.
The response inaccurately and
vaguely explains how ethical
considerations impact the
treatment plan and
communication with patients, or
is missing.
Examples provided do not
support the decisions and
responses provided, or is

missing.

Decision #2 (1–2 pages)
• Which decision did you
select?
• Why did you select this
decision? Be specific and
support your response with
clinically relevant and patient-
specific resources, including
the primary literature.
• Why did you not select the
other two options provided in
the exercise? Be specific and
support your response with
clinically relevant and patient-
specific resources, including
the primary literature.
• What were you hoping to

18 (18%) – 20 (20%)
The response accurately and
clearly explains in detail the
decision selected.
The response accurately and
clearly explains in detail why the
decision was selected, with
specific clinically relevant
resources that fully support the

decision selected.
The response accurately and
clearly explains in detail why the
other two responses were not
selected, with specific clinically
relevant resources that fully
support the response.

16 (16%) – 17 (17%)
The response accurately explains
the decision selected.
The response explains why the
decision was selected, with
specific clinically relevant
resources that support the
decision selected.
The response accurately explains
why the other two responses
were not selected, with specific
clinically relevant resources that
support the response.
The response accurately explains
the outcome the student was

14 (14%) – 15 (15%)
The response inaccurately or
vaguely explains the decision
selected.
The response inaccurately or

vaguely explains why the
decision was selected, with
specific clinically relevant
resources that inaccurately or
vaguely support the decision
selected.
The response inaccurately or
vaguely explains why the other
two responses were not selected,
with specific clinically relevant
resources that inaccurately or

0 (0%) – 13 (13%)
The response inaccurately and
vaguely explains in detail the
decision selected.
The response inaccurately and
vaguely explains why the
decision was selected, with
specific clinically relevant
resources that do not support the
decision selected, or is missing.
The response inaccurately and
vaguely explains why the other
two responses were not selected,
with specific clinically relevant
resources that do not support the
decision selected, or is missing.

achieve by making this
decision? Support your
response with evidence and
references to the Learning
Resources (including the
primary literature).
• Explain how ethical
considerations may impact
your treatment plan and
communication with patients.
Be specific and provide
examples.

The response accurately and
clearly explains in detail the
outcome the student was hoping
to achieve with the selected
decision, with specific clinically
relevant resources that fully
support the response.
The response accurately and
clearly explains in detail how
ethical considerations impact the
treatment plan and
communication with patients.
Examples provided fully support
the decisions and responses
provided.

hoping to achieve with the
selected decision, with specific
clinically relevant resources that
support the response.
The response accurately explains
how ethical considerations
impact the treatment plan and
communication with patients.
Examples provided support the
decisions and responses
provided.

vaguely support the response.
The response inaccurately or
vaguely explains the outcome the
student was hoping to achieve
with the selected decision, with
specific clinically relevant
resources that inaccurately or
vaguely support the response.
The response inaccurately or
vaguely explains how ethical
considerations impact the
treatment plan and
communication with patients.
Examples provided may support
the decisions and responses
provided.

The response inaccurately and
vaguely explains the outcome the
student was hoping to achieve
with the selected decision, with
specific clinically relevant
resources that do not support the
response, or is missing.
The response inaccurately and
vaguely explains how ethical
considerations impact the
treatment plan and
communication with patients, or
is missing.
Examples provided do not
support the decisions and
responses provided, or is
missing.

Decision #3 (1–2 pages)
• Which decision did you
select?
• Why did you select this
decision? Be specific and
support your response with
clinically relevant and patient-
specific resources, including
the primary literature.
• Why did you not select the
other two options provided in

the exercise? Be specific and
support your response with
clinically relevant and patient-
specific resources, including
the primary literature.
• What were you hoping to
achieve by making this
decision? Support your
response with evidence and
references to the Learning
Resources (including the
primary literature).
• Explain how ethical

18 (18%) – 20 (20%)
The response accurately and
clearly explains in detail the
decision selected.
The response accurately and
clearly explains in detail why the
decision was selected, with
specific clinically relevant
resources that fully support the
decision selected.
The response accurately and
clearly explains in detail why the
other two responses were not
selected, with specific clinically
relevant resources that fully

support the response.
The response accurately and
clearly explains in detail the
outcome the student was hoping
to achieve with the selected
decision, with specific clinically
relevant resources that fully

16 (16%) – 17 (17%)
The response accurately explains
the decision selected.
The response explains why the
decision was selected, with
specific clinically relevant
resources that support the
decision selected.
The response accurately explains
why the other two responses
were not selected, with specific
clinically relevant resources that
support the response.
The response accurately explains
the outcome the student was
hoping to achieve with the
selected decision, with specific
clinically relevant resources that
support the response.
The response accurately explains
how ethical considerations

14 (14%) – 15 (15%)
The response inaccurately or
vaguely explains the decision
selected.
The response inaccurately or
vaguely explains why the
decision was selected, with
specific clinically relevant
resources that inaccurately or
vaguely support the decision
selected.
The response inaccurately or
vaguely explains why the other
two responses were not selected,
with specific clinically relevant
resources that inaccurately or
vaguely support the response.
The response inaccurately or
vaguely explains the outcome the
student was hoping to achieve
with the selected decision, with
specific clinically relevant

0 (0%) – 13 (13%)
The response inaccurately and
vaguely explains in detail the
decision selected.
The response inaccurately and

vaguely explains why the
decision was selected, with
specific clinically relevant
resources that do not support the
decision selected, or is missing.
The response inaccurately and
vaguely explains why the other
two responses were not selected,
with specific clinically relevant
resources that do not support the
decision selected, or is missing.
The response inaccurately and
vaguely explains the outcome the
student was hoping to achieve
with the selected decision, with
specific clinically relevant
resources that do not support the

considerations may impact
your treatment plan and
communication with patients.
Be specific and provide
examples.

support the response.
The response accurately and
clearly explains in detail how
ethical considerations impact the
treatment plan and

communication with patients.
Examples provided fully support
the decisions and responses
provided.

impact the treatment plan and
communication with patients.
Examples provided support the
decisions and responses
provided.

resources that inaccurately or
vaguely support the response.
The response inaccurately or
vaguely explains how ethical
considerations impact the
treatment plan and
communication with patients.
Examples provided may support
the decisions and responses
provided.

response, or is missing.
The response inaccurately and
vaguely explains how ethical
considerations impact the
treatment plan and
communication with patients, or
is missing.

Examples provided do not
support the decisions and
responses provided, or is
missing.

Conclusion (1 page)
• Summarize your
recommendations on the
treatment options you selected
for this patient. Be sure to
justify your recommendations
and support your response
with clinically relevant and
patient-specific resources,
including the primary literature.

14 (14%) – 15 (15%)
The response accurately and
clearly summarizes in detail the
recommendations on the
treatment options selected for
this patient.
The response accurately and
clearly explains a justification for
the recommendations provided,
including clinically relevant
resources that fully support the
recommendations provided.

12 (12%) – 13 (13%)
The response accurately
summarizes the
recommendations on the
treatment options selected for
this patient.
The response accurately explains
a justification for the
recommendation provided,
including clinically relevant
resources that support the
recommendations provided.

11 (11%) – 11 (11%)
The response inaccurately or
vaguely summarizes the
recommendations on the
treatment options selected for
this patient.
The response inaccurately or
vaguely explains a justification for
the recommendations provided,
including clinically relevant
resources that inaccurately or
vaguely support the
recommendations provided.

0 (0%) – 10 (10%)
The response inaccurately and

vaguely summarizes the
recommendations on the
treatment options selected for
this patient, or is missing.
The response inaccurately and
vaguely explains a justification for
the recommendations provided,
including clinically relevant
resources that do not support the
recommendations provided, or is
missing.

Written Expression and
Formatting – Paragraph
Development and Organization:
Paragraphs make clear points
that support well-developed
ideas, flow logically, and
demonstrate continuity of
ideas. Sentences are carefully
focused—neither long and
rambling nor short and lacking
substance. A clear and
comprehensive purpose
statement and introduction are
provided that delineate all
required criteria.

5 (5%) – 5 (5%)

Paragraphs and sentences follow
writing standards for flow,
continuity, and clarity.
A clear and comprehensive
purpose statement, introduction,
and conclusion are provided that
delineate all required criteria.

4 (4%) – 4 (4%)
Paragraphs and sentences follow
writing standards for flow,
continuity, and clarity 80% of the
time.
Purpose, introduction, and
conclusion of the assignment are
stated, yet they are brief and not
descriptive.

3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow
writing standards for flow,
continuity, and clarity 60%–79%
of the time.
Purpose, introduction, and
conclusion of the assignment is
vague or off topic.

0 (0%) – 3 (3%)
Paragraphs and sentences follow

writing standards for flow,
continuity, and clarity < 60% of
the time.
No purpose statement,
introduction, or conclusion were
provided.

Written Expression and
Formatting – English writing
standards:
Correct grammar, mechanics,
and proper punctuation

5 (5%) – 5 (5%)
Uses correct grammar, spelling,
and punctuation with no errors.

4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar,
spelling, and punctuation errors.

3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4)
grammar, spelling, and
punctuation errors.

0 (0%) – 3 (3%)
Contains many (≥ 5) grammar,
spelling, and punctuation errors

that interfere with the reader’s
understanding.

Written Expression and
Formatting – The paper follows
correct APA format for title
page, headings, font,
spacing, margins, indentations,
page numbers, parenthetical/in-
text citations, and reference
list.

5 (5%) – 5 (5%)
Uses correct APA format with no
errors.

4 (4%) – 4 (4%)
Contains a few (1 or 2) APA
format errors.

3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) APA
format errors.

0 (0%) – 3 (3%)
Contains many (≥ 5) APA format
errors.

Total Points: 100

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