NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders
Sample Answer for NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders Included After Question
When pediatric patients 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 patients with the same disorders, they also metabolize medications much differently. Yet, there may be times when the same psychopharmacologic treatments may be used in both pediatric and adult cases with major depressive disorders. As a result, psychiatric nurse practitioners must exercise caution when prescribing psychotropic medications to these patients. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat pediatric patients presenting with mood disorders.
To prepare for this Assignment:
- Review this week’s Learning Resources, including the Medication Resources indicated for this week.
- Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of pediatric patients requiring antidepressant therapy.The Assignment: 5 pages
For this assignment, you will write a 5–6-page paper on the topic of bipolar and bipolar and
related disorders. You will create this guide as an assignment; therefore, a title page,
introduction, conclusion, and reference page are required. You must include a minimum of 3
scholarly supporting resources outside of your course provided resources.
In your paper, you will choose one of the following diagnoses: Bipolar I, Bipolar II, Cyclothymic
Disorder, Substance/Medication-Induced Bipolar and Related Disorder, Bipolar and Related
Disorder Due to Another Medical Condition. Your paper will include discussion for your chosen
diagnosis of bipolar and related disorder on the following:
Prevalence and Neurobiology of your chosen disorder
Discuss the differences between your chosen disorder and one other bipolar and related
disorders in relation to the diagnostic criteria including presentation of symptoms
according to DSM 5 TR criteria Discuss special populations and considerations (children, adolescents, pregnancy/post-
partum, older adult, emergency care) for your chosen bipolar and related disorder;
demonstrating critical thinking beyond basics of HIPPA and informed consent with
discussion of at least one for EACH category: legal considerations, ethical
considerations, cultural considerations, social determinants of health
NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders Discuss FDA and/or clinical practice guidelines approved pharmacological treatment
options in relation to acute and mixed episodes vs maintenance pharmacological
treatment for your chosen bipolar and related disorder
Of the medication treatment options for your chosen disorder discuss side effects, FDA
approvals and warnings. What is important to monitor in terms of labs, comorbid
medical issues with why important for monitoring
Provide 3 examples of how to write a proper prescription that you would provide to the
patient or transmit to the pharmacy.
Note: Support your rationale with a minimum of five academic resources. While you may use the
course text to support your rationale, it will not count toward the resource requirement. You
should be utilizing the primary and secondary literature.
Reminder: The College of Nursing requires that all papers submitted include a title page,
introduction, summary, and references. The Sample Paper provided at the Walden Writing
Center
Links to an external site. provides an example of those required elements (available at
https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All
papers submitted must use this formatting.
By Day 7
Submit your Assignment.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check
your draft, access the Turnitin Drafts from the Start Here area.
1. To submit your completed assignment, save your Assignment as
WK5Assgn_LastName_Firstinitial
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.
The Assignment: 5 pages
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 patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
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.
Decision #1 (1 page)
- 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 considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
- 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 considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)
- 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 considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
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.
Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.
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 “WK4Assgn+last name+first initial.(extension)” as the name.
- Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 4 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 “WK4Assgn+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 4 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 4 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 4
To participate in this Assignment:
Week 4 Assignment
What’s Coming Up in Week 5?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Next week, you will build on your assessment and treatment skills as you examine patients presenting with bipolar disorders.
Next Week
NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders Rubric Detail
Select Grid View or List View to change the rubric’s layout.
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders
Title: NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders
Bipolar disorder is one of the most common mental illnesses characterized by drastic shifts in the patient’s mood, activity, and energy levels, affecting their ability to conduct daily tasks (Marzani, & Neff, 2021). Such drastic changes in the patient’s energy levels and mood are more severe, unlike the normal ups and downs experienced by most people. The National Institute of Mental Health (NIH) reported that approximately 2.8% of adults in the United States were diagnosed with bipolar disorder last year (Citrome, 2020). Bipolar disorders are associated with severe morbidity and mortality rates. However, through evidence-based practice, several treatment options have been proposed with proven effectiveness in the management of patients with bipolar disorder. In this discussion, the choices of medication used to manage a young Asian adult diagnosed with bipolar type 1 have been discussed in addition to the reasons behind the choice of psychotropic agent and the expected outcome and legal and ethical considerations encountered by the PMHNP. The choices of medications used are based on both pharmacodynamic and pharmacokinetic factors.
The case study provided described a 26 years old Asian woman who presented to the clinic with a primary diagnosis of bipolar type 1. The patient was previously hospitalized for 21 days as a result of the onset of acute mania. The patient is in good health with a stable mood at the moment but claims to hate sleeping. She is however underweight with a BMI of 18.3. Genetic testing reveals that the patient is positive for the CYP2D6*10 allele. She has been taking lithium to manage her mental condition during the hospitalization period, which she stopped talking when she was discharged. Mental examination results reveal that the patient is oddly groomed, but displays perfect orientation in person, time, and place. She is however rapid and pressured. Upon administration of the Young Mania Rating Scale (YMRS), the patient revealed a score of 22, which indicated mild mania. She however denies suicidal ideation and auditory or visual hallucination.
Decision #1
Begin Seroquel XR 100 mg orally at HS
Reason Behind Decision 1:
Seroquel (Quetiapine) is recommended by most study guidelines for the management of bipolar disorder as monotherapy. The mood-stabilizing effects of Seroquel are associated with its antagonistic effect at the 5-HT2A and D2 receptors (Citrome, 2020). Studies have revealed great effectiveness of the drug and long-term adherence among patients on extended-release (XR) quetiapine which is administered once daily. The drug also exhibits a desirable safety profile with mild side effects which can be managed non-pharmacologically such as changes in weight. The drug is metabolized in the liver by cytochrome P450 (CYP) 3A4, which is low among patients with CYP2D6*10 allele such as Asians. This promotes slow metabolism, hence prolonged duration of action.
The use of lithium is not appropriate given that the patient stopped taking the drug immediately, which is discouraged as a result of increased risks of relapse and non-compliance. Lithium is also associated with undesirable side effects such as weight gain and GI disturbances especially when administered in higher doses like 300mg (Lin et al., 2020).
Risperdal is also not a good alternative for the patient as monotherapy. The drug displays great effectiveness when administered in combination with lithium (Marzani, & Neff, 2021). Consequently, the recommended starting dose with Risperdal is 2 to 3mg once daily, which makes the 1mg dose undesirable.
Expected Outcome
Within the next 4 weeks, the patient is expected to exhibit at least 50% remission of manic symptoms (Citrome, 2020). Her compliance level is also expected to improve, with good sleeping patterns. Her agitation is also expected to reduce. Upon administration of the Young Mania Rating Scale (YMRS), the patient should record a score of less than 12.
Ethical Considerations Impact on Treatment Plan
According to the legal and ethical guidelines, the PMHNP must take into account the patient’s race and ethnicity in formulating the most effective treatment plan (Lin et al., 2020). Consequently, given that the patient is an adult, the nurse needs to involve the patient in making decisions concerning the medication choice to promote satisfaction.
Decision 2:
Discontinue using Seroquel and Start 40mg Geodon 40 mg orally BID.
Reason Behind Decision 2:
The initial intervention revealed minimal effectiveness in controlling the patient’s manic episodes. Consequently, undesired side effects were exhibited by the patient such as constipation, weight gain, and dry mouth which made the patient uncomfortable with the drug. As such it is necessary to discontinue the drug and initiate Geodon which is FDA approved for the management of manic episodes among patients diagnosed with bipolar 1 disorder (Marzani, & Neff, 2021). The drug exhibits a desirable safety profile, unlike Seroquel. Consequently, studies show that Geodon has great bioavailability, and hence must be administered with a 500 calorie intake. The patient also disliked the weight gain side effect associated with the initial drug which will not be the case with Geodon.
Increasing the dose of Seroquel is not appropriate as this will only worsen the side effects already exhibited by the patient (Rhee et al., 2020). The patient also suggested the drug changes, and ignoring her request would only promote non-compliance and affects their therapeutic relationship with the nurse.
Continuing the same dose of the medication is also against the patient’s will as this will lead to a further increase in the patient’s body weight (Lin et al., 2020). Consequently, the drug displayed minimal effectiveness which is below the desired therapeutic threshold in the management of bipolar.
Expected Outcome
The patient is expected to display at least 50% remission of symptoms within the next four weeks. Her sleeping pattern and agitation levels are expected to improve significantly (Rhee et al., 2020). Consequently, the initial side effects such as dry mouth, constipation, and weight gain are expected to resolve once Seroquel has been discontinued.
Ethical Considerations Impact on Treatment Plan
The legal and ethical requirements give the patient the right of making decisions concerning her health (Marzani, & Neff, 2021). As such, the PMHNP must respect the patient’s decision and make appropriate interventions as desired by the patient to promote satisfaction which intern builds on a positive therapeutic relationship with the patient.
Decision 3:
Continue the same dose and reassess in 4 weeks.
Reason Behind Decision 1:
The patient displayed great tolerance and adherence to the previous intervention with 50% remission of symptoms. Consequently, the undesired side effects were resolved within this time, promoting patient compliance. Studies show that despite the goal of attaining 100% remission of symptoms with psychotropic agents, a 50% management of symptoms is still desirable. Consequently, Geodon takes up to 8 to 12 weeks to completely managed maniac symptoms among patients with bipolar disorder (Mazza et al., 2020). As such, it is necessary to continue the same dose to promote further management of the patient’s symptoms, with no side effects. The treatment outcome must however be evaluated after four weeks, given that the treatment regimen was changed just after the first intervention failed.
Increasing the dose of Geodon is not necessary given the great tolerance and effectiveness displayed by the patient (Mazza et al., 2020). Consequently, studies show that increased plasma concentrations of the drug are associated with severe side effects such as weight gain which resulted in to change of regimen in the first place.
Augmenting Geodon with lithium is desirable, but at low doses to avoid side effects (Mazza et al., 2020). Consequently, this intervention could only be considered among patients who are not lithium defaulters as this will only compromise the patient’s compliance levels.
Expected Outcome
The patient is expected to display complete remission of symptoms within the next four weeks. She should be able to sleep well, with significantly reduced agitation levels (Rhee et al., 2020). Her scores upon administration of the Young Mania Rating Scale should also display a reading of less than 8.
Ethical Considerations Impact on Treatment Plan
According to the nursing code of ethics, it is the obligation of the PMHNP to promote the patient’s health and prevent harm. Consequently, holistic care requires the nurse to promote patient-centered care to attain positive treatment outcomes (Rhee et al., 2020). As such, listening to the patient and involving them in making decisions concerning which intervention is appropriate for their health is necessary.
Conclusion
Bipolar disorder is one of the most common mental illnesses across the world with increased morbidity and mortality rates. However, with early detection, studies show that patients can greatly benefit from the available treatment options with improved quality of life. Clinicians must also consider pharmacodynamic and pharmacokinetic factors when deciding on which medication to use for a given patient (Citrome, 2020). In the provided case study, the first intervention was to initiate the patient on Seroquel which is FDA approved for the management of bipolar among adults. However, the drug displayed undesired side effects such as weight gain, which made the patient uncomfortable with taking the medication (Lin et al., 2020). Consequently, the drug displayed minimal effectiveness, which led to changing the treatment regimen is the second decision. Geodon, is also FDA approved for the management of manic episodes among bipolar patients, hence considered as the best replacement for Seroquel (Mazza et al., 2020). The patient displayed great adherence and tolerance to this medication with 50% remission of symptoms. Consequently, the initial side effects were resolved.
As a result, it was necessary to maintain the dose of this medication for the third intervention to avoid additional side effects and promote further remission of the patient’s symptoms. several legal and ethical considerations were encountered with the PMHNP in the management of this patient (Marzani, & Neff, 2021). For instance, the patient being an adult gives her the right of making decisions concerning her health. As such, the nurse needed to change the patient’s regimen when she was not comfortable with the weight to gain side effects as a result of Seroquel (Rhee et al., 2020). General, the nurse has the obligation of promoting the patient health and preventing harm.
References
Citrome, L. (2020). Food and Drug Administration–Approved Treatments for Acute Bipolar Depression: What We Have and What We Need. Journal of Clinical Psychopharmacology, 40(4), 334-338. DOI: 10.1097/JCP.0000000000001227
Lin, Y., Mojtabai, R., Goes, F. S., & Zandi, P. P. (2020). Trends in prescriptions of lithium and other medications for patients with bipolar disorder in office-based practices in the United States: 1996–2015. Journal of Affective Disorders, 276, 883-889. https://doi.org/10.1016/j.jad.2020.07.063
Marzani, G., & Neff, A. P. (2021). Bipolar Disorders: Evaluation and Treatment. American Family Physician, 103(4), 227-239. PMID: 33587568.
Mazza, M., Marano, G., Giuseppin, G., & Janiri, L. (2020). Ziprasidone in treating bipolar child and adolescent patients: More research is warranted. Bipolar disorders, 22(3), 311-312. https://doi.org/10.1111/bdi.12911
Rhee, T. G., Olfson, M., Nierenberg, A. A., & Wilkinson, S. T. (2020). 20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings. American Journal of Psychiatry, 177(8), 706-715. https://doi.org/10.1176/appi.ajp.2020.19091000
A Sample Answer 2 For the Assignment: NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders
Title: NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders
According to the National Institution of Mental Health, approximately 9% of children and adolescents from age 12 years to age 17 years, are diagnosed with depression each year (Lamy & Erickson, 2018). Despite the negative impact of depression on the patient’s life, only a few individuals seek medical attention, which worsens the condition in the majority of the population. However, thanks to evidence-based practice for the current pharmacological and psychotherapeutic interventions available in the management of depressive disorders among children and adolescents (Bitsko et al., 2022). The purpose of this discussion is to illustrate the clinical decision-making on the most appropriate drug of choice for the treatment of an African American male patient with depression based on pharmacodynamic and pharmacokinetic factors.
The provided case study demonstrates an 8-year-old African American male patient with symptoms of depression. The patient is positive for loss of appetite, feeling sad, being irritable and withdrawn, even from his peers at school. Upon conducting a mental status examination, the patient acknowledges that he often thinks about death and how it would feel like to be dead. He however denies a history of suicidal attempts. The patient recorded a score of 30 on the Children’s Depression Rating Scale (CDRS), which led to the diagnosis of major depressive disorder. Other than the patient’s symptoms, CDRS scores, and diagnosis of MDD, additional factors which might affect the pharmacodynamic and pharmacokinetic process of drugs administered include his African American race and his age. These factors will affect the choice of drug for this patient.
Decision #1
Selected Decision and Rationale
Initiate Zoloft 25mg once daily. Previous evidence demonstrates great effectiveness in the use of selective serotonin reuptake inhibitors like Zoloft in the management of depression among children below the age of 18 years (Mullen, 2018). The mode of action of this medication is through neuronal inhibition of serotonin (5HT) uptake in the central nervous system. The drug has a desirable safety profile, which led to its approval by the FDA for the management of depressive disorders among pediatric patients except for those with obsessive-compulsive disorder (Kupfer, 2022). However, due to the risks of suicidal ideation and suicidality among children, close monitoring of the patient and the use of low doses (25mg) are recommended. Studies show great adherence and tolerance of the medication by most pediatric patients as the drug undergoes first-pass metabolism in the liver with reduced side effects.
Paxil could not be considered at this point, as studies show that the drug is associated with increased side effects and high risks of suicidality among children as compared to Zoloft (Hetrick et al., 2021). As such, the drug is only recommended when there is no other alternative for children above the age of 10 years.
Wellbutrin is also not recommended for children below the age of 18 years due to its increased risk of seizure (Lamy & Erickson, 2018). As such, the drug is only recommended for use as send option, when the first drug is ineffective, or if the patient has depression with comorbid ADD.
Expected Outcome
The patient is expected to report at least 50% remission of symptoms within the next 4 weeks. His CDRS scores are expected to reduce to less than 20 (Mullen, 2018). He is also expected to be more joyful and engage with his peers appropriately within this time.
Ethical Consideration
Since the patient is below the age of 18 years, her parents or caregivers have legal responsibilities for making decisions concerning his health (Hetrick et al., 2021). As such, the PMHNP must educate the patient’s parents on the diagnosis, and available treatment options before deciding on which drug to go with.
Decision #2
Selected Decision and Rationale
The second intervention is to increase the dose of Zoloft from 25mg to 50mg once daily. The patient displayed great adherence and compliance to the initial intervention, as no side effects were reported. However, no changes in the patient’s symptoms were realized which calls for dose increment to attain optimal therapeutic levels (Bitsko et al., 2022). Clinical guidelines recommend a dose increment of Zoloft by 25mg every week from an initial dose of 25mg once daily to attain the optimal threshold (Kupfer, 2022). This helps reduce the risks of side effects and toxicity.
Increasing the Zoloft dose to 37.5mg is inadequate as no changes will be experienced (Hetrick et al., 2021). The patient may also end up losing trust in the PMHNP and refuse to take the medication, even when the optimum dosage has not been attained, compromising the entire treatment process.
Changing the drug to Prozac was also not appropriate as the patient had already displayed great tolerance and adherence to Zoloft (Mullen, 2018). Prozac is also associated with increased risks of suicidal ideation which is inappropriate for the patient given the history of suicidal ideation.
Expected Outcome
Within the next 4 weeks, the patient is expected to report back to the clinic with at least 50% remission of symptoms, with the increased dose (Bitsko et al., 2022). His CDRS scores as mentioned earlier are expected to reduce to less than 20. He is also expected to sleep and eat well and engage with her peers in school.
Ethical Consideration
Legal and ethical guidelines require clinicians to prevent harm and promote the health of the patient (Lamy & Erickson, 2018). As such, this intervention to maintain the same drug and increase the dose was necessary since the patient displayed great tolerance and adherence to the medication. Changing the regime could otherwise harm the patient.
Decision #3
Selected Decision and Rationale
The last decision was to maintain the dose of Zoloft at 50mg orally once daily and continue monitoring the patient for progress. This decision was based on the outcome reported by the patient’s mother from the initial intervention. The patient displayed great compliance and adherence to the medication which lead to more than 50% remission of depressive symptoms with no side effects reported. Studies show that when the optimal dose of Zoloft has been attained, the drug will take between 6 to 8 weeks for the complete remission of depressive symptoms (Mullen, 2018). As such, it was necessary to maintain the dose to avoid side effects and monitor the patient’s progress for a better outcome.
Increasing the Zoloft dose to 75mg was not necessary as this would otherwise have led to the occurrence of side effects like increased agitation. Consequently, studies show that at high doses, Zoloft can increase the risks of suicidality among children below the age of 18 years (Kupfer, 2022).
Changing the treatment regimen to an SNRI was also not appropriate, as this would only compromise the patient’s compliance and adherence, leading to side effects. Previous evidence also demonstrates increased incidences of suicidal ideation with the use of SNRIs as compared to SSRIs like Zoloft (Bitsko et al., 2022).
Expected Outcome
Based on the previous outcome, the patient is expected to report even further remission of depression symptoms over the next four weeks. He should display a CDRS score of less than 10 (Mullen, 2018). He should improve in school performance and play with peers more frequently.
Ethical Consideration
The PMHNP is required to observe the legal and ethical obligation of promoting the patient’s well-being and preventing harm (Lamy & Erickson, 2018). As such, the nurse needs to make decisions that are well supported by the patient’s parents, based on positive outcomes as displayed by previous interventions.
Conclusion
Depression is a common mental illness reported among pediatric patients. Despite limited evidence supporting the use of antidepressants, several studies have proven their effectiveness and reduced risks of side effects in the management of depression among children such as SSRIs like Zoloft (Lamy & Erickson, 2018). As such, for the pediatric patient in the provided case study, the first intervention for the management of depression was to administer Zoloft 25mg once daily and monitor the patient for dose adjustment aiming at attaining the optimal dose (Mullen, 2018). The other two medications were not appropriate for the patient as Paxil is known to increase the risks of suicidal ideation, while Wellbutrin is not recommended for patients under the age of 18 years (Hetrick et al., 2021). The second intervention was to increase the dose of Zoloft to 50mg once daily, based on the reported outcome from the initial intervention (Hetrick et al., 2021). The patient displayed great adherence and tolerance to the medication which called for no change of regimen. Increasing the dose to 37.5 mg was not appropriate as a similar effect would have been realized.
The last intervention was to maintain the dose at 50 mg once daily as the patient displayed great tolerance and compliance to the medication with no side effects. Increasing the dose to 75 mg once daily would lead to side effects while changing the regimen to an SNRI would compromise patients’ compliance and increase the risks of suicidal ideation (Bitsko et al., 2022). Given that the patient is a minor, several ethical considerations were to be considered by the PMHNP. For instance, the patient’s parents have a legal obligation of deciding the health of her child hence the need to be adequately informed about the diagnosis and the treatment options (Kupfer, 2022). The PMHNP also has the legal obligation of promoting the health of the child and prevent harm.
References
Bitsko, R. H., Claussen, A. H., Lichstein, J., Black, L. I., Jones, S. E., Danielson, M. L., … & Meyer, L. N. (2022). Mental health surveillance among children—the United States, 2013–2019. MMWR supplements, 71(2), 1. DOI: 10.15585/mmwr.su7102a1
Hetrick, S. E., McKenzie, J. E., Bailey, A. P., Sharma, V., Moller, C. I., Badcock, P. B., … & Meader, N. (2021). New generation antidepressants for depression in children and adolescents: a network meta‐analysis. Cochrane Database of Systematic Reviews, (5). https://doi.org/10.1002/14651858.CD013674.pub2
Kupfer, D. J. (2022). The pharmacological management of depression. Dialogues in clinical neuroscience.
https://doi.org/10.31887/DCNS.2005.7.3/dkupfer
Lamy, M., & Erickson, C. A. (2018). Pharmacological management of behavioral disturbances in children and adolescents with autism spectrum disorders. Current problems in pediatric and adolescent health care, 48(10), 250-264. https://doi.org/10.1016/j.cppeds.2018.08.015
Mullen, S. (2018). Major depressive disorder in children and adolescents. Mental Health Clinician, 8(6), 275-283. https://doi.org/10.9740/mhc.2018.11.275
Name: NURS_6630_Week4_Assignment_Rubric
| 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. |
Points Range: 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. |
Points Range: 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. |
Points Range: 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. |
Points Range: 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? |
Points Range: 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 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. |
Points Range: 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 impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. |
Points Range: 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 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. |
Points Range: 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. 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? |
Points Range: 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 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. |
Points Range: 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 impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. |
Points Range: 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 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. |
Points Range: 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 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? |
Points Range: 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 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. |
Points Range: 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 impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. |
Points Range: 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 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. |
Points Range: 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 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. |
Points Range: 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. |
Points Range: 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. |
Points Range: 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. |
Points Range: 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. |
Points Range: 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. |
Points Range: 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. |
Points Range: 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. |
Points Range: 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 |
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors. |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) grammar, spelling, and punctuation errors. |
Points Range: 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. | Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors. |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) APA format errors. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) APA format errors. |
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors. |
|
| Total Points: 100 | |||||