ASSESSING AND TREATING PATIENTS WITH ANXIETY DISORDERS NURS 6630

Sample Answer for ASSESSING AND TREATING PATIENTS WITH ANXIETY DISORDERS NURS 6630 Included After Question

ASSESSING AND TREATING PATIENTS WITH ANXIETY DISORDERS NURS 6630

Assessing and Treating Patients With Anxiety Disorders  

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. 

ASSESSING AND TREATING PATIENTS WITH ANXIETY DISORDERS NURS 6630
ASSESSING AND TREATING PATIENTS WITH ANXIETY DISORDERS NURS 6630

Resources 

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.  

WEEKLY RESOURCES 

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. 

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature. 

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting  

Links to an external site.. 

By Day 7 

Submit your Assignment.  

submission information 

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.  

  1. To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial  
  1. Then, click on Start Assignment near the top of the page. 
  1. Next, click on Upload File and select Submit Assignment for review. 

 

Rubric 

NURS_6630_Week6_Assignment_Rubric  

NURS_6630_Week6_Assignment_Rubric  
Criteria  Ratings  Pts  
This criterion is linked to a Learning Outcome 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.  
10 to >8.0 pts  

Excellent Point range: 90–100 

The response accurately, clearly, and fully summarizes in detail the case for the Assignment…. The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient. 

8 to >7.0 pts  

Good Point range: 80–89 

The response accurately summarizes the case for the Assignment…. The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient. 

7 to >6.0 pts  

Fair Point range: 70–79 

The response inaccurately or vaguely summarizes the case for the Assignment…. The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. 

6 to >0 pts  

Poor Point range: 0–69 

The response inaccurately and vaguely summarizes the case for the Assignment, or is missing…. The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. 

 

10 pts 
This criterion is linked to a Learning Outcome Decision #1 (1–2 pages)• 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.  
20 to >17.0 pts  

Excellent Point range: 90–100 

The response accurately and clearly explains in detail the decision selected…. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected…. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients…. Examples provided fully support the decisions and responses provided. 

17 to >15.0 pts  

Good Point range: 80–89 

The response accurately explains the decision selected…. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected…. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response…. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response…. The response accurately explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided support the decisions and responses provided. 

15 to >13.0 pts  

Fair Point range: 70–79 

The response inaccurately or vaguely explains the decision selected…. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected…. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided may support the decisions and responses provided. 

13 to >0 pts  

Poor Point range: 0–69 

The response inaccurately and vaguely explains the decision selected…. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing…. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing…. Examples provided do not support the decisions and responses provided, or is missing. 

 

20 pts 
This criterion is linked to a Learning Outcome Decision #2 (1–2 pages)• 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.  
20 to >17.0 pts  

Excellent Point range: 90–100 

The response accurately and clearly explains in detail the decision selected…. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected…. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients…. Examples provided fully support the decisions and responses provided. 

17 to >15.0 pts  

Good Point range: 80–89 

The response accurately explains the decision selected…. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected…. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response…. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response…. The response accurately explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided support the decisions and responses provided. 

15 to >13.0 pts  

Fair Point range: 70–79 

The response inaccurately or vaguely explains the decision selected…. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected…. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided may support the decisions and responses provided. 

13 to >0 pts  

Poor Point range: 0–69 

The response inaccurately and vaguely explains in detail the decision selected…. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing…. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing…. Examples provided do not support the decisions and responses provided, or is missing. 

 

20 pts 
This criterion is linked to a Learning Outcome Decision #3 (1–2 pages)• 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.  
20 to >17.0 pts  

Excellent Point range: 90–100 

The response accurately and clearly explains in detail the decision selected…. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected…. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response…. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients…. Examples provided fully support the decisions and responses provided. 

17 to >15.0 pts  

Good Point range: 80–89 

The response accurately explains the decision selected…. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected…. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response…. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response…. The response accurately explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided support the decisions and responses provided. 

15 to >13.0 pts  

Fair Point range: 70–79 

The response inaccurately or vaguely explains the decision selected…. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected…. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response…. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients…. Examples provided may support the decisions and responses provided. 

13 to >0 pts  

Poor Point range: 0–69 

The response inaccurately and vaguely explains in detail the decision selected…. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing…. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing…. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing…. Examples provided do not support the decisions and responses provided, or is missing. 

 

20 pts 
This criterion is linked to a Learning Outcome 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.  
15 to >13.0 pts  

Excellent Point range: 90–100 

The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient…. The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided. 

13 to >11.0 pts  

Good Point range: 80–89 

The response accurately summarizes the recommendations on the treatment options selected for this patient…. The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided. 

11 to >10.0 pts  

Fair Point range: 70–79 

The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient…. The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided. 

10 to >0 pts  

Poor Point range: 0–69 

The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing…. The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing. 

 

15 pts 
This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.  
5 to >4.0 pts  

Excellent Point range: 90–100 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 

4 to >3.5 pts  

Good Point range: 80–89 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time….Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. 

3.5 to >3.0 pts  

Fair Point range: 70–79 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic. 

3 to >0 pts  

Poor Point range: 0–69 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided. 

 

5 pts 
This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation  
5 to >4.0 pts  

Excellent Point range: 90–100 

Uses correct grammar, spelling, and punctuation with no errors. 

4 to >3.5 pts  

Good Point range: 80–89 

Contains a few (1 or 2) grammar, spelling, and punctuation errors. 

3.5 to >3.0 pts  

Fair Point range: 70–79 

Contains several (3 or 4) grammar, spelling, and punctuation errors. 

3 to >0 pts  

Poor Point range: 0–69 

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. 

 

5 pts 
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.  
5 to >4.0 pts  

Excellent Point range: 90–100 

Uses correct APA format with no errors. 

4 to >3.5 pts  

Good Point range: 80–89 

Contains a few (1 or 2) APA format errors. 

3.5 to >3.0 pts  

Fair Point range: 70–79 

Contains several (3 or 4) APA format errors. 

3 to >0 pts  

Poor Point range: 0–69 

Contains many (≥ 5) APA format errors. 

 

5 pts 
Total Points: 100  

 

 

A Sample Answer For the Assignment: ASSESSING AND TREATING PATIENTS WITH ANXIETY DISORDERS NURS 6630

Title: ASSESSING AND TREATING PATIENTS WITH ANXIETY DISORDERS NURS 6630

Assessing and Treating Patients with Anxiety Disorders  

This case study is about a 46-ar-old white male who came to the clinic as a referral by his primary care provider for what he felt as a heart attack. The patient reported symptoms that included chest tightness, shortness of breath, and feeling of impending doom. His medical history is significant for mid hypertension, overweight, and tonsillectomy. EKG results were normal. According to the patient, the shortness of breath and chest tightness are anxiety attacks. He reports occasional use of ETOH, consumes 3-4 beers per night, single, and fears losing his job. The HAM-A score is 26. The client denied any use of psychotropic medications.  

A mental status examination was administered to the patient. It showed that the patient was oriented to place, time, person, and events. His speech was clear, goal-oriented, and coherent. The client reported feeling nervous, bleh mood, blunted affect, with no visual or auditory hallucinations. There were no paranoid or delusional thought processes, homicidal or suicidal ideation. The client was diagnosed with generalized anxiety disorder based on these findings. Therefore, this paper focuses on three treatment decisions that will be adopted for this patient. The factors that will affect the selected treatments will include his HAM-A score, medical history, treatment response, and substance use.  

Decision 1 

Selected Decision 

Begin Paxil 10 mg po daily  

Reason for the Selection  

Paxil is a selective serotonin inhibitor that has been recommended in America for use in anxiety disorders. Paxil inhibits the reuptake of serotonin, which increases its synaptic concentration, extra-synaptic diffusion, and mood. Paxil has broad spectrum efficacy in treating anxiety disorders both in short and long-term. Its tolerance level is also high (Strawn et al., 2018). Besides improving anxiety symptoms, Paxil also enhances daily functioning and improvement in HAM-A score.  

Why the other Two were not Selected 

The decision to begin with Imipramine 25 mg po BID was not selected since Imipramine is considered in patients that have proven unresponsive to first-line treatments such as selective serotonin reuptake inhibitors. It also has the side effect of weight gain, which may worsen the currently overweight patient’s status. It can also cause QT prolongation and cardiac arrythmias. Buspirone 10 mg po BID was not selected since it is a second line of treatment for generalized anxiety disorder (Strawn et al., 2018).  

What I was hoping to Achieve  

I was hoping to achieve a reduction in the client’s symptoms of generalized anxiety disorder. I was also hoping to lower the client’s HAM-A score by at least 25% within the first four weeks. I was also hoping to improve the client’s functioning since studies have demonstrated symptom improvements with the use of Paxil (Strawn et al., 2018).  

Ethical Considerations  

Psychiatric mental health nurse practitioners must prioritize safety and quality in treating mental health problems. They make their decisions based on evidence-based data, patient factors, and their expertise. Evidence-based data supports Paxil use as first-line treatment in generalized anxiety disorder (Strawn et al., 2018). Therefore, by adopting Paxil, I anticipated enhanced outcomes such as safety, quality, and efficiency, hence, the influence of ethics in the treatment process. 

Decision 2 

Selected Decision 

Increase dose to 20 mg po daily  

Reason for the Selection  

The initial decision to start the patient on Paxil 10 mg po daily led to moderate improvement in symptoms. The client came after four weeks reporting that he no longer has chest tightness or shortness of breath. He also reports decreased worries about work over the last 4 or 5 days and reduction in HAM-A score to 18. An effective decision would be to increase the dosage of Paxil to 20 mg po daily to improve symptoms of generalized anxiety disorder. A systematic titration of the dose is recommended until optimum symptom improvement is achieved. For example, the study by Serdarević et al., (2018) investigated the effectiveness of Paxil 20 mg dose in generalized anxiety disorder over 12-months period. The results showed statistically significant reduction in the severity of anxiety disorder among the participants. Therefore, increasing the dose to 20 mg is safe, tolerable, and efficient in improving the patient’s symptoms.  

Why the other Two were not Selected 

I did not select the decision to increase the dose of Paxil to 40 mg po daily because of safety concerns. A sharp quadrupling of the dosage increases the risk of the patient developing adverse effects of Paxil such as erectile dysfunction, xerostomia, and insomnia. I did not select the decision not to change the drug/dose at this time because it would not yield further improvement in symptoms (Baldwin, 2020). The required plasma concentration of Paxil has not been achieved. As a result, maintaining the current dose is not recommended.  

What I was hoping to Achieve  

I was hoping to further reduce symptoms of generalized anxiety disorder. I was also hoping for at least 50% reduction in HAM-A score. I also anticipated improved patient’s functioning (Strawn et al., 2018).  

Ethical Considerations  

The ethical principle of ensuring non-maleficence informed the decision made in this step. Psychiatric mental health nurses must ensure that the adopted treatments minimize patient harm while optimizing on its benefits. As a result, I selected the decision to titrate the dosage upwards with the aim of improving symptoms and minimizing harm (Butts & Rich, 2022). Quadrupling the dosage could have increased the risk of adverse events.  

Decision 3 

Selected Decision 

Maintain the current dose  

Reason for the Selection  

The client returned to the clinic after four weeks with reports of further symptom improvement. The HAM-A score decreased to 10, translating into 61% reduction in symptoms. The assessment findings demonstrate that the treatment outcomes have been achieved. Therefore, it is appropriate to maintain the current dosage for optimum symptom management. The client has also demonstrated tolerance to the treatment (He et al., 2019). A further increase in dosage may led to the development of adverse reactions and potential poor treatment adherence by the patient.  

Why the other Two were not Selected 

I did not select the decision to increase the dosage to 30 mg po daily due to safety concerns. As noted above, the desired treatment outcomes have been achieved. Increasing the dosage further may lead to unwanted side and adverse effects, which will affect safety and quality of treatment, as well as adherence. I did no select the decision to add augmentation agent such as buspirone since Paxil has been effective in improving symptoms of generalized anxiety disorder. Adding another drug at this stage is not recommended (Baldwin, 2020).  

What I was hoping to Achieve  

I was hoping to witness a further reduction in symptoms. I was also hoping to see a decrease in HAM-A score to almost zero. I was also hoping that the patient will report return to his previous level of functioning.  

Ethical Considerations  

Patients have a right to informed care when receiving psychiatry services. As a result, the patient in this case study should be informed about any treatment decisions made and changes in the current regime. The patient should also be involved in his care for empowerment, sustainable change, and satisfaction with the care given to him (Butts & Rich, 2022).  

Conclusion 

In summary, the decision to begin the patient on Paxil was effective. Its effectiveness could be seen from the evidence that Paxil is the recommended first-line drug of choice for generalized anxiety disorder. The drug has enhanced efficacy in symptom improvement and enhancing patient’s functioning (Strawn et al., 2018). The other options such as starting the patient on Imipramine and buspirone were not selected in the first step because of their associated safety issues. The decision to increase the dosage of Paxil in the second step was effective. It led to optimum symptom improvement, as evidenced by the reduction in HAM-A score by more than 50% and symptoms of generalized anxiety disorder. The decisions to maintain the current dose and quadruple the dosage of Paxil were not selected due to safety concerns and the potential of minimal symptom improvements. The optimum improvement in symptoms informed the decision to maintain the dose of Paxil in the third step (Baldwin, 2020). It also informed the decision not to increase the dosage further or augment the treatment.  

Ethical considerations informed the decisions made in this case study. Accordingly, evidence-based data was used to select the best treatment for the patient. Sources of evidence-based data such as journals provided insights into the safety and efficacy of the different drugs used for treating generalized anxiety. Evidence-based decisions optimize on outcomes such as safety, quality, and efficiency in disease management. The other ethical considerations that informed the treatment decisions included non-maleficence and justice (Butts & Rich, 2022). Justice was maintained by informing and involving the patient in the treatment process.  

 

References 

Baldwin, D. S. (2020). Pharmacological Treatment of Generalized Anxiety Disorder (GAD). In Generalized Anxiety Disorder and Worrying (pp. 297–318). John Wiley & Sons, Ltd. https://doi.org/10.1002/9781119189909.ch14 

Butts, J. B., & Rich, K. L. (2022). Nursing Ethics: Across the Curriculum and Into Practice. Jones & Bartlett Learning. 

He, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., Lyu, J., & Ma, X. (2019). Comparative efficacy and acceptability of first-line drugs for the acute treatment of generalized anxiety disorder in adults: A network meta-analysis. Journal of Psychiatric Research, 118, 21–30. https://doi.org/10.1016/j.jpsychires.2019.08.009 

Serdarević, A. M., Halilović, Z., Bahto, A., Kapo, B., & Delić, D. (2018). Observational multicenter study of efficacy of paroxetine film-coated tablet in the treatment of anxiety disorder. Medicinski Glasnik, 15(2). 

Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: An evidence-based treatment review. Expert Opinion on Pharmacotherapy, 19(10), 1057–1070. https://doi.org/10.1080/14656566.2018.1491966