Depression

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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 She has been sad and withdrawn, complaining about headaches and “tummy aches.”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.

What are some differential diagnoses you would give – identify one medical differential diagnosis and two psychiatric differential diagnoses?
What diagnosis would you give Natalee? On what evidence/symptoms do you base your diagnosis?
What medication(s) would you prescribe for Natalee and why? Please note the medication, initial dose, and dosing schedule.
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 Microsoft Word document.
How will you educate and inform Trina (Natalee’s mother) about how this medication will work?
How will you discuss with Trina the commonly expected side effects and potentially serious adverse effects and risks for a child of this age with taking this medication?

Sample Solution

hroughout the years, the United States has experienced a disparity in the prices paid for pharmaceuticals when compared to the rest of the world. In a study conducted in 2011, the United States comprised 45% of pharmaceutical profits while the remaining countries made up the a total of 55% (True cost). The increasing cost of medication in the United States is a burden not only for the patients, but also to insurance providers. Our goal is to have an in-depth analysis of the reasons behind this price increase in order to formulate alternatives that can lead to positive clinical implications and lessened financial burden for all parties involved.

In order to understand the reasoning behind the heightened costs of medication in the United States, an investigation of the laws and procedures around manufacturing medication is imperative. Unlike many other developed nations, the United States is prohibited from having delegated sectors to negotiate drug prices.  Pharmaceutical companies are able to set their own prices with minimal interference from government and private insurance programs. Laws have been established preventing programs such as Medicare and Medicaid from bargaining prescription drug prices despite catering to millions of individuals (JAMA). The inability to negotiate costs of medications has led to the steady increase of the money spent on prescription drugs in the United States. In fact, figure 1 below shows tha

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