Sample Answer for NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment Included After Question
NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment
Assignment: 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.
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.
By Day 7
Submit your Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK6Assgn+last name+first initial.(extension)” as the name.
- Click the Week 6 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 6 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK6Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 6 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 6 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 6
To participate in this Assignment:
Week 6 Assignment
Midterm Exam
This exam will cover the following topics, which relate to psychopharmacologic approaches to treatment for patients across the life span:
- Introduction to neuroscience, including concepts in neuroanatomy, neurotransmitters, and receptor theory
- Medication adherence
- Pediatric, adult, and geriatric Major Depressive Disorders (MDD)
- Bipolar disorder
- Anxiety and PTSD treatment
Photo Credit: [Vergeles_Andrey]/[iStock / Getty Images Plus]/Getty Images
Prior to starting the exam, you should review all of your materials. There is a 2.5-hour time limit to complete this 50-question exam. You may only attempt this exam once.
This exam is a test of your knowledge in preparation for your certification exam. No outside resources including books, notes, websites, or any other type of resource are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.
By Day 7
Submit your Midterm Exam by Day 7.
Submission Information
Submit Your Exam by Day 7
To submit your Midterm Exam:
Week 6 Midterm Exam
What’s Coming Up in Week 7?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Next week, you will continue to build on your assessment and treatment skills as you examine patients presenting with signs and symptoms consistent with schizophrenia.
Next Week
Week 6: Therapy for Patients With Anxiety Disorders and PTSD Treatment
I’m no longer at the mercy of my PTSD, and I would not be here today had I not had the proper diagnosis and treatment. It’s never too late to seek help.
—P.K. Philips, PTSD patient
For individuals presenting with posttraumatic stress disorder (PTSD) and other anxiety disorders, everyday life can be a constant challenge. Clients requiring anxiolytic therapy may present with anxiousness, depression, substance abuse issues, and even physical symptoms related to cardiovascular, respiratory, and gastrointestinal ailments. As a psychiatric nurse practitioner, you must be prepared to address the many needs of individuals seeking treatment for PTSD and other anxiety disorders.
This week, as you study anxiolytic therapies and PTSD treatments, you examine the assessment and treatment of patients with PTSD and other anxiety disorders. You also explore ethical and legal implications of these therapies.
Reference:
Philips, P. K. (n.d.). My story of survival: Battling PTSD. Anxiety and Depression Association of America. https://adaa.org/living-with-anxiety/personal-stories/my-story-survival-battling-ptsd
Learning Objectives
Students will:
- Assess patient factors and history to develop personalized plans of anxiolytic therapy for patients
- Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring anxiolytic therapy
- Synthesize knowledge of providing care to patients presenting with anxiolytic therapy
- Analyze ethical and legal implications related to prescribing anxiolytic therapy to patients across the lifespan
- Assess psychopharmacologic approaches to treatment for patients across the lifespan
Learning Resources
Required Readings (click to expand/reduce)
Bui, E., Pollack, M. H., Kinrys, G., Delong, H., Vasconcelos e Sá, D., & Simon, N. M. (2016). The pharmacotherapy of anxiety disorders. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 61–71). Elsevier.







Medication Resources (click to expand/reduce)
Note: To access the following medications, use the Drugs@FDA resource. Type the name of each medication in the keyword search bar. Select the hyperlink related to the medication name you searched. Review the supplements provided and select the package label resource file associated with the medication you searched. If a label is not available, you may need to conduct a general search outside of this resource provided. Be sure to review the label information for each medication as this information will be helpful for your review in preparation for your Assignments.
Review the following medications:
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Required Media (click to expand/reduce)
Case Study: A Middle-aged Caucasian Man with Anxiety
Note: This case study will serve as the foundation for this week’s Assignment.
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Content
Name: NURS_6630_Week6_Assignment_Rubric
| Excellent
Point range: 90–100 |
Good
Point range: 80–89 |
Fair
Point range: 70–79 |
Poor
Point range: 0–69 |
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| 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. |
Points Range: 9 (9%) – 10 (10%)
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. |
Points Range: 8 (8%) – 8 (8%)
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. |
Points Range: 7 (7%) – 7 (7%)
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. |
Points Range: 0 (0%) – 6 (6%)
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. |
|
| Decision #1 (1–2 pages)
• Which decision did you select? |
Points Range: 18 (18%) – 20 (20%)
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. |
Points Range: 16 (16%) – 17 (17%)
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. |
Points Range: 14 (14%) – 15 (15%)
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. |
Points Range: 0 (0%) – 13 (13%)
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. |
|
| Decision #2 (1–2 pages)
• Which decision did you select? |
Points Range: 18 (18%) – 20 (20%)
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. |
Points Range: 16 (16%) – 17 (17%)
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. |
Points Range: 14 (14%) – 15 (15%)
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. |
Points Range: 0 (0%) – 13 (13%)
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. |
|
| Decision #3 (1–2 pages)
• Which decision did you select? |
Points Range: 18 (18%) – 20 (20%)
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. |
Points Range: 16 (16%) – 17 (17%)
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. |
Points Range: 14 (14%) – 15 (15%)
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. |
Points Range: 0 (0%) – 13 (13%)
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. |
|
| 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. |
Points Range: 14 (14%) – 15 (15%)
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. |
Points Range: 12 (12%) – 13 (13%)
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. |
Points Range: 11 (11%) – 11 (11%)
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. |
Points Range: 0 (0%) – 10 (10%)
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. |
|
| 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. |
Points Range: 5 (5%) – 5 (5%)
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. |
Points Range: 4 (4%) – 4 (4%)
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. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
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. |
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. |
|
| Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors. |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) grammar, spelling, and punctuation errors. |
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. |
|
| 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. | Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors. |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) APA format errors. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) APA format errors. |
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors. |
|
| Total Points: 100 | |||||
Name: NURS_6630_Week6_Assignment_Rubric
A Sample Answer For the Assignment: NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment
Title: NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment
Assessing and Treating Patients with Anxiety Disorders
Anxiety is an emotional response, such as tension, fear, or uneasiness, to the prospect of danger, the source of which is frequently unknown or unidentified. When anxiety impairs one’s ability to perform, achieve desired goals or fulfillment, or maintain adequate emotional comfort, it may be termed pathologic (Locke, Kirst & Shultz, 2015). Obsessive-compulsive disorder (OCD), panic disorder, generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and phobias are all examples of anxiety disorders. This project will investigate a case study of a client who suffers from an anxiety illness, outline his treatment plan, and discuss ethical issues that may affect the treatment plan.
Overview of the Case Study
The case scenario depicts a 46-year-old Caucasian male who was referred by his primary care physician following an ER visit for what he considered to be a heart attack. He was admitted to the emergency room with chest pain, shortness of breath, and a sense of impending doom (Laureate Education, 2016). The client has a history of moderate hypertension that is being controlled with a low salt diet and is around 15 pounds overweight. His EKG was normal, ruling out myocardial infarction, and his physical examination revealed no abnormalities. The client describes chest tightness and episodes of shortness of breath as anxiety attacks. He also occasionally has emotions of impending doom and the desire to flee or escape (Laureate Education, 2016). He admits to using alcohol on occasion, 3-4 beers per night, to alleviate his concerns about his job, which he believes will be lost. The client has a Hamilton Anxiety Rating Scale score of 26. He admits to feeling nervous throughout the mental status examination. Although affect is rather muted, it brightens numerous times during the clinical interview.
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Decision Point One
Begin Zoloft 50 mg orally daily.
Why I Selected This Decision
I selected the option of Zoloft because it is an FDA approved drug in the treatment of GAD. Zoloft is an antidepressant under the class
of Selective serotonin reuptake inhibitors (SSRIs) and indicated as a first-line drug in GAD treatment (Bandelow, Michaelis & Wedekind, 2017). Zoloft was my drug of choice since SSRIs have a response rate of 30-50% in GAD treatment (Strawn et al., 2018). It acts by inhibiting presynaptic serotonin reuptake causing accumulation of serotonin. In the CNS, Serotonin regulates mood, personality, and wakefulness. Besides, I selected Zoloft because it has few adverse effects, which promotes compliance.
Why I Did Not Select the Other Two Options
Imipramine was not selected because it has high levels of toxicity and is potentially lethal in an overdose. It is only indicated when SSRIs are not effective in treating GAD (Bandelow et al., 2017). Imipramine exerts peripheral anticholinergic and sedative effects, causing side effects such as sedation, dry mouth, and constipation, lowering the patient’s compliance (Strawn et al., 2018). Buspirone was not selected because it has a limitation of lacking antipanic activity (Locke et al., 2015). Consequently, the drug would have been ineffective in alleviating the client’s acute anxiety symptoms. Buspirone has a prolonged onset of action, limiting its use as a sole drug in the treatment of acute anxiety episodes as in the client’s anxiety attacks. NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment
What I Was Hoping To Achieve By Making This Decision
I hoped that Zoloft therapy would alleviate the client’s anxiety symptoms by at least 50% within four weeks. I was hoping that the client’s HAM-A score would decrease to at least 14 after four weeks of treatment.
How Ethical Considerations May Impact the Treatment Plan
Ethical principles of beneficence and nonmaleficence may impact the treatment plan since the practitioner must ensure that the medication will have the best possible outcome and not harm the client (Haddad & Geiger, 2019). For instance, the principles guided my decision since I had to select a drug with the least potential side effects and one that is associated with better outcomes. NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment
Decision Point Two
Increase Zoloft to 75 mg daily.
Why I Selected This Decision
I selected the option of increasing Zoloft since the client demonstrated a positive response with the drug but had not attained a full remission of anxiety symptoms (Locke et al., 2015). The client had a partial decrease in the HAM-A score to 18 from 26. Gradually increasing the dose enables the clinician to monitor the associated adverse effects effectively.
Why I Did Not Select the Other Two Options
I did not select the dose to 100 mg orally daily, because a high dose increase would not allow effective monitoring of the drug’s side effects. Patients with GAD are sensitive to treatment with antidepressants and require slow titration for successful therapy (Locke et al., 2015). I did not also select the option of not changing the dose because the client was only on the starting dose, which had demonstrated a partial response. Failing to increase the drug may result in the lack of a further decrease in anxiety symptoms. NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment
What I Was Hoping To Achieve By Making This Decision
I was hoping that increasing the Zoloft dose would promote remission of anxiety symptoms by at least 75% within four weeks and reduce the HAM-A score to 8.
How Ethical Considerations May Impact the Treatment Plan
Nonmaleficence may impact the treatment plan. The clinician has to evaluate or medication side effects and modify the treatment plan if they interfere with the quality of life (Haddad & Geiger, 2019). The clinician must also assess the client’s response to treatment and modify the treatment plan to promote better patient outcomes. For instance, I increased the dose of Zoloft to promote better patient outcomes since the client had achieved only a partial response with the initial dose.
Decision Point Three
Maintain current dose.
Why I Selected This Decision
I chose to maintain the Zoloft dose at 75 mg/day because the client had a positive response to the current dose. This is demonstrated by a decrease in anxiety symptoms by more than 60% with the dose. I also marinated the dose because the client did not report any associated side effects after titrating the dose to 75 mg.
Why I Did Not Select the Other Two Options
I did not select the option to increase the Zoloft dose to 100 mg daily because the client demonstrated an adequate response with the current dose. Although increasing Zoloft dose at this point may result in a further decrease in anxiety symptoms, it increases the risk of adverse effects, which can reduce compliance (Locke et al., 2015). I did not add an augmentation agent in the treatment plan since the client demonstrated a good response to monotherapy witty Zoloft. I also wanted to avoid polypharmacy as a sole drug had adequately managed the symptoms. NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment
What I Was Hoping To Achieve By Making This Decision
I was hoping that by maintain the Zoloft dose at 75 mg, the anxiety symptoms would progressively reduce to full remission. I also hoped that the client’s HAM-A score would reduce to below 5 within four weeks of therapy.
How Ethical Considerations May Impact the Treatment Plan
Ethical considerations may impact the treatment plan as the practitioner has to uphold principles of autonomy by allowing the client to make decisions concerning his treatment. Beneficence and nonmaleficence have to be maintained to ensure the treatment options selected will promote the best possible outcome and have no potential harm to the client (Haddad & Geiger, 2019). In this case, I did not increase the dose since there is potential harm from the side effects associated with a high Zoloft dose.
NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment Conclusion
In the case scenario, the client presented with symptoms of generalized anxiety disorder such as excessive concerns about his job, nervousness, chest tightness, shortness of breath, and feeling of impending doom. His initial HAM-A score was 26, which indicates severe anxiety. The first decision was to initiate therapy with Zoloft 50 mg daily. Zoloft was selected to alleviate the anxiety symptoms, and since it is useful in managing anxiety disorders. The drug effectively alleviated the symptoms of chest tightness and shortness of breath and reduced the client’s worries about his work. It also partially decreased the HAM-A score to 18. In decision point two, I increased the Zoloft dose to 75 mg to promote a further remission of anxiety. An increased dose led to a remission of anxiety symptoms by 61% and decreased HAM-A score to 10.
In decision point three, I chose to maintain the Zoloft dose at 75 mg because the client had demonstrated a good response to the current dose. Increasing the dose would not have been appropriate because it put the client at risk of side effects. Besides, adding an augmenting agent would have led to polypharmacy. Ethical principles that might impact the treatment plan include autonomy, beneficence, and nonmaleficence. The clinician should uphold the principles by involving the client in decision making and choosing a therapy that will promote the best possible outcome and have minimal side effects.
NURS 6630 Case Study A Middle-Aged Caucasian Man With Anxiety Assignment References
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93–107. https://doi.org/10.31887/DCNS.2017.19.2/bbandelow
Haddad, L. M., & Geiger, R. A. (2019). Nursing Ethical Considerations. In StatPearls [Internet]. StatPearls Publishing.
Laureate Education. (2016b). Case study: A middle-aged Caucasian man with anxiety [Interactive media file]. Baltimore, MD: Author.
Locke, A., Kirst, N., & Shultz, C. G. (2015). Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician, 91(9), 617-624.
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
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The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
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Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
- Your response needs to be a minimum of 150 words (not including your list of references)
- There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
- Include in-text citations in your response
- Do not include quotes—instead summarize and paraphrase the information
- Follow APA-7th edition
- Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
- A minimum of 6 responses per week, on at least 3 days of the week.
- Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
- Each response needs to be at least 75 words in length (does not include your list of references)
- Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
- Follow APA 7th edition
- Points will be deducted if the above is not followed
- Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
- Here are some helpful links
- Student paper example
- Citing Sources
- The Writing Center is a great resource