Question

Natalee Williams, a 10-year-old African American girl, comes to your psychiatric nurse practitioner office for evaluation. She has been sad and withdrawn, complaining about headaches and “tummy aches.”

Her mother, Trina, accompanies her to the appointment. Trina notes that Natalee has seemed depressed and presents as irritable. The mother notes her daughter’s mood change occurred about two months ago. Natalee’s school performance has fallen and she is now doing C work. Last term, she earned all As. She wants to sleep more and her appetite has decreased. She rarely wants to play with friends and spends a lot of time in her room alone. Her height and weight are normal for her age, but she has lost 2 pounds over the last two months.

There is a history of depression in the family, as Natalee’s maternal grandmother and maternal aunt both have had major depression. Her maternal grandmother was hospitalized for psychiatric care 20 years ago for depression and a suicide attempt by an overdose of Tylenol.

Questions

From your perspective as Natalee’s psychiatric nurse practitioner, answer the following questions in a paper no longer than two double-spaced pages (not including the reference page and prescription) and in APA format. Include at least three peer-reviewed, evidence-based references.

1. What differential diagnoses you would give?
2. What diagnosis would you give Natalee? On what evidence/symptoms do you base your diagnosis?
3. What medication(s) would you prescribe for Natalee and why? Please note the medication, initial dose, and dosing schedule.
4. Fill out a prescription (PDF) (Links to an external site.) for this medication. (Print the template, fill it out, and scan it or take a photo. Insert the image at the end of your Word document.)
5. How will you educate and inform Trina (Natalee’s mother) about how this medication will work?
6. How will you discuss with Trina the side effects and risks for a child of this age with taking this medication?

Answer 1

Ms Natale williams , 10 year old school age child expressing symptoms of sad all time, withdrawal behavior, loss of appetite, want to spend more time on sleeping, lost 2 pounds within 2 months, decreased school performances, spent more time alone, rarely wants to play with friends. All the above signs and symptoms gives a clear cut picture of Depressive disorder.

The evidence behind this diagnosis is purely based on observation of child behavior and there is a family history Natale grandmother hospitalized in psychiatric unit before 20 years and she also attempt suicide using tylenol.

Depression is a mood disorder. If the emotional problems persisted for more than two weeks a confirmation diagnosis can be made for depression. Depression is a serious disturbances hindering day to day activities like eating ,sleeping and patient never likes to get out of the bed.

The first line treatment for depression on childhood is psychotherapy : talking with the child to identify the root cause of depression.

Medication commonly administered for depression are : FDA approves antidepressants to treat children with depression includes: Prozac (fluoxetine) and Lexapro (escitalopram.