Make three decisions concerning the medication to prescribe to this client.

Make three decisions concerning the medication to prescribe to this client.

Decision Point one I choose is to begin Zoloft 25 mg orally daily.

Result of decision point one.

Client returns to clinic in four weeks, Reports a 25% decrease in symptoms. Client is concerned over the new onset of erectile dysfunction.

Decision Point Two: I choose to Continue same dose and counsel client.

Results of decision point two

Client returns to clinic in four weeks, Client informed the PMHNP that he stopped taking the drug because his inability to perform sexually was worsening his self esteem.

Decision point Three

I choose to change medication to Wellbutrim XL.

Guidance to student.

Encouraging client to restart at previous dose would not be appropriate. Obviously, the side effect did not abate so there is no reason to assume that it wound abate at the previous dose. Restarting the drug at 50% of starting dose maybe appropriate to determine whether or not side effect is dose dependent, If the side effect of erectile dysfunction returns once the drug is returned to full dose, the PMHNP would need to change the drug. Changing to wellbetrim XL may be appropriate at this point, but may worsen his insomnia.Additionally, guidelines tell us that another SSRI should be attempted for an adequate trial before switching drug classes

Please use the below rubric to answer the case study

This is the Assignment Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?