NURS 6630 Week 6 Assignment: Assessing and Treating Patients With Anxiety Disorders
NURS 6630 Week 6 Assignment. Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt patients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, patients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with anxiety disorders.
To prepare for this Assignment:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring anxiolytic therapy.
The Assignment: 5 pages
Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Conclusion (1 page)
Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
RESULTS OF DECISION POINT ONE
Client returns to clinic in four weeks
Client informs you that he has no tightness in chest, or shortness of breath
Client states that he noticed decreased worries about work over the past 4 or 5 days
HAM-A score has decreased to 18 (partial response)
Decision Point Two
No change in drug/dose at this time
RESULTS OF DECISION POINT TWO
Client returns to clinic in four weeks
Client reports no further decreases in anxiety and is wondering if this means that the medication will not be effective for him
Decision Point Three
Increase drug to 75 mg po daily
Guidance to Student
Increasing the drug to 75 mg po daily would be a prudent next step. At 4 weeks follow up, the client already demonstrated a partial response to this medication, so it would be appropriate to increase to 75 mg po daily. Nothing indicates that augmentation would be necessary as the client has not had an adequate trial of this drug at a therapeutic dose (only a starting dose). Similarly, nothing indicates failure of SSRI therapy and there is no compelling evidence that switch to an SNRI should occur at this time.
NURS 6630 Week 6 Assignment Answer
The increasing annual reports of mental illnesses underscore the prevalence of mental disorders in contemporary society. Among these disorders, Generalized Anxiety Disorder (GAD) stands out as one of the most common, characterized by excessive and uncontrollable worry and distress (Newman et al., 2017). The debilitating impact of GAD on a patient’s daily life is significant, as it affects their ability to engage in normal activities. Similar to other mental disorders, persistent worry and fear are hallmark features of GAD (National Institute of Mental Health, 2016). When these symptoms persist for more than six months without any apparent external trigger, an individual is diagnosed with GAD.NURS 6630 Week 6 Assignment
The etiology, clinical manifestations, and effects of GAD share commonalities with other disorders, making it challenging to diagnose (Bailey, 2021). A key symptom of GAD is pervasive anxiety that infiltrates all aspects of an individual’s life. This constant state of worry often leads to difficulties in maintaining focus on tasks, resulting in frequent distractions and daydreaming. Additionally, individuals with GAD tend to be socially withdrawn, avoiding crowded places and people (Bailey, 2021). Another common feature is insomnia, driven by intense nighttime anxiety.
In this case study, a 46-year-old Caucasian man has been referred to a hospital, presenting with symptoms indicative of GAD. He has been grappling with work-related worries for more than six months, experiencing physical symptoms such as chest tightness, shortness of breath, and feelings of impending doom. The patient’s Hamilton Anxiety Rating Scale (HAM-A) score, exceeding 26, confirms his diagnosis of Generalized Anxiety Disorder (Thompson, 2015). This essay examines three treatment decisions made by a Psychiatric Mental Health Nurse Practitioner (PMHNP) regarding the medication prescribed for this Caucasian man to address his GAD. Each decision is informed by relevant evidence and literature. Furthermore, ethical considerations pertaining to the treatment process are explored.NURS 6630 Week 6 Assignment
Decision One
The initial decision made by the PMHNP pertains to the choice of the first medication to initiate treatment for the patient. Three medications are considered: Imipramine 25mg, Zoloft 50mg, and Buspirone 10mg. The chosen course of action involves administering Zoloft 50mg orally once daily for four weeks. Zoloft, categorized as a Selective Serotonin Reuptake Inhibitor (SSRI), is commonly used as a first-line treatment for anxiety disorders (Bandelow et al., 2017). This decision aligns with the preference for Zoloft due to its effectiveness in addressing anxiety. NURS 6630 Week 6 Assignment
Research indicates that SSRIs, including Zoloft, are among the most effective treatments for Generalized Anxiety Disorder (Bandelow et al., 2017). SSRIs exhibit a broad spectrum of efficacy, encompassing various anxiety disorders beyond GAD. Furthermore, these medications are generally well-tolerated, characterized by fewer side effects compared to alternative treatments (Bandelow et al., 2017). Given that the patient is a 46-year-old alcoholic who consumes 3-4 bottles of beer daily, Imipramine is contraindicated. Its use alongside alcohol can lead to adverse side effects such as nausea, constipation, dizziness, and potentially, a life-threatening situation (Practo Laboratories, 2019).NURS 6630 Week 6 Assignment
The anticipated outcome of this decision is a reduction in the patient’s anxiety symptoms, contributing to his overall well-being and quality of life. The patient’s ability to function in his daily life is expected to improve, and the treatment’s tolerability should facilitate better adherence to the prescribed regimen. NURS 6630 Week 6 Assignment
References:
Bandelow, B., Sher, L., Bunevicius, R., Hollander, E., Kasper, S., Zohar, J., … & Möller, H. J. (2017). Guidelines for the pharmacological treatment of anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder in primary care. International Journal of Psychiatry in Clinical Practice, 21(2), 77-84.
National Institute of Mental Health. (2016). Generalized Anxiety Disorder: When Worry Gets Out of Control. https://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml
Newman, M. G., Llera, S. J., Erickson, T. M., Przeworski, A., & Castonguay, L. G. (2017). Worry and generalized anxiety disorder: A review and theoretical synthesis of evidence on nature, etiology, mechanisms, and treatment. Annual Review of Clinical Psychology, 13, 147-178.
Practo Laboratories. (2019). Imipramine. https://www.practo.com/medicine-info/imipramine-149-api
