Case Study: Natalee Williams
Directions
Review the case study and then answer the questions that follow.
Case Study
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 She has been sad and withdrawn, complaining about headaches and “tummy aches.”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
1. What are some differential diagnoses you would give – identify one medical differential diagnosis and two psychiatric differential diagnoses?
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 Microsoft 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 commonly expected side effects and potentially serious adverse effects and risks for a child of this age with taking this medication?
