This improvement should include participating in groups, peers interaction , improve sleep, appetite and academic improvement (American Psychiatric Association, 2018).
4 Differences between Expected outcome and Actual outcome There should be appositive noticeable change with therapeutic of Zoloft 50mg, a decrease in depression symptoms with and no adverse reaction that indicate otherwise that patient is tolerating the therapeutic medication adjustment well. 1 Since at this level, there is no difference between the expected result and the actual result therefore the patient will continue with the Zoloft 50mg. Patient should be monitoring continue, and the next schedule appointment.
Decision Point Three Maintain current dose of Zoloft 50mg orally daily Reason for Selection When the patient shows improvement, we have to keep schedule medication especially when there is no side effect of medication. My patient has shown great degree of improvement, and there is no side effect to this patient with the dose of Zoloft 50mg. 1 The monitoring of the side effect will include suicidal thought (National Alliance on Mental Illness, 2017).
Expected Results Treatment of depression, and monitoring is a continues process. 1Patient improvement should daily, and the signs of depression will be eliminated gradually with dosage of Zoloft 50mg. Patient peer interaction, sleep, appetite, should gradually improve.
Differences between Expected Results and Actual Results Choosing Zoloft 50mg on my African American child patient seems to be working, with no problem. Patient is responding well to therapy. I will continue patient with current dose. With this gradual improvement, I have no reasons to change medication or dosage. I will schedule an appointment and the dose might be increase if depression increases. 1 The expected result would be in treating any side effect to the medication so that maximum therapeutic effects can be achieved. The actual result is that there is an achievement in medication therapeutic effect that is needed by the patient (National Alliance on Mental Illness, 2017).
5 Ethical Considerations Suicidal ideation or behavior is only one reason for which close monitoring is important for children started on antidepressant therapy (Mitchell et al., 2014). Therefore, providers who are considering the use of antidepressants in children, adolescents, and young adults must first balance the risk of suicidality with the clinical need for an antidepressant (Mitchell et al., 2014). 1 The ethic consideration can be classified as an accumulation of reasoning and principle of treatment of depression.The suicidal tendency in the used of antidepressant medication has led the FDA to require that all antidepressant medicine should be labeled by pharmaceutical companies with the caution of suicidal on the label (Sondheimer, 2010). Any child that is below the age of 18years old cannot take decision on depression treatment without the parent approval according to FDA regulation (Sondheimer,2010). Therefore, it is paramount to educate the parent of the treatment given to the child as well the consent of the parent.In case of danger, the consent advice of the parent may be ignored (Sondheimer, 2010).The Zoloft is “off-label” so a greater precaution and parent approval needs to be obtain before dispensing.
6 This lack of knowledge leads many to believe that a mental health condition is a personal weakness or some sort of punishment from God. Many African Americans also have trouble recognizing the signs and symptoms of mental health conditions, leading to underestimating the effects and impact of mental health conditions. 3 Faith and spirituality can help in the recovery process but should not be the only option you pursue. If spirituality is an important part of your life, your spiritual practices can be a strong part of your treatment plan. Your spiritual leaders and faith community can provide support and reduce isolation.
7 Conclusion The FDA advises that doctors prescribe the smallest quantity of pills possible to help reduce the risk of deliberate or accidental overdose. A careful monitoring by parents, caregivers and health care professionals is important for any child or teenager taking an antidepressant for depression or any other condition. 1 Food and Drug Administration (FDA or USFDA) has a rule and regulation set for the treatment of behavioral disorder in children, the guideline which must be follow to the letter (National Alliance on Mental Illness, 2017). Supervising and safe monitoring of the child is very important during therapy (National Alliance on Mental Illness, 2017). 1 The legality guiding the treatment of a child with psychiatric problem has increase because of increase national awareness. As a psychiatric nurse, I strive to increase my knowledge of the legal and ethical implications of prescribing psychotropic medications for children.and adolescents with major depression and anxiety disorders. 3 African Americans are no different when its comes to prevalence of mental health conditions when compared to the rest of the population, depression one of the mental health issues in African American community.
1 References American Psychiatric Association (2018). Practice guideline for the treatment of patients with the major depressive disorder (3rd ed., pp. 152). Arlington (VA): 1 American Psychiatric Association (APA). 2 Retrieved from https://www.guideline.gov/summaries/summary/24158?