Sample Answer for NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Included After Question<\/strong><\/h2>\nCommon symptoms of anxiety disorders<\/a> 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\u2019s Learning Resources, consider how you might assess and treat patients presenting with anxiety disorders.<\/p>\nResources<\/strong><\/h2>\nBe sure to review the Learning Resources before completing this activity.
\nClick the weekly resources link to access the resources.<\/p>\n
WEEKLY RESOURCES<\/strong><\/a><\/h2>\nTo prepare for this Assignment:<\/strong><\/h3>\n\n- Review this week\u2019s Learning Resources, including the Medication Resources indicated for this week.<\/li>\n
- Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring anxiolytic therapy.<\/li>\n<\/ul>\n
The Assignment: 5 pages<\/strong><\/h2>\nExamine\u00a0Case Study: A Middle-Aged Caucasian Man With Anxiety.<\/em>\u00a0You 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\u2019s pharmacokinetic and pharmacodynamic<\/a> processes.<\/p>\nAt 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.<\/p>\n
Introduction to the case (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Decision #1 (1 page)<\/strong><\/h2>\n\n- Which decision did you select?<\/li>\n
- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #2 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #3 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Conclusion (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\nReminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\nLinks to an external site.<\/a>.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
<\/p>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nTitle: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nAnxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n
Case Overview<\/strong><\/h2>\nThe case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n
The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n
Decision #1<\/strong><\/h2>\nStart Zoloft 50 mg orally daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nSertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nImipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\nWhat I Was Hoping To Achieve<\/strong><\/h2>\nI hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\nEthical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n
Decision #2<\/strong><\/h2>\nIncrease Zoloft to 75 mg daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nThe Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\n![\"NURS](\"https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2023\/03\/NURS-6630-Assessing-and-Treating-Patients-With-Anxiety-Disorders-Assignment-300x137.png\")
NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/figcaption><\/figure>\nI hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nNonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n
Decision #3<\/strong><\/h2>\nMaintain the current dose.<\/p>\n
Why I Selected This Decision<\/strong><\/h3>\nThe current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nI was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nThe ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nThe specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nBipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\nDeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\nGarakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\nHe, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\nStrawn, 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis 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.<\/td>\n \n\n\n\n10 to >8.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
8 to >7.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
7 to >6.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
6 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
10 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
11 to >10.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
10 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct APA format with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) APA format errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) APA format errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
Resources<\/strong><\/h2>\nBe sure to review the Learning Resources before completing this activity.
\nClick the weekly resources link to access the resources.<\/p>\n
WEEKLY RESOURCES<\/strong><\/a><\/h2>\nTo prepare for this Assignment:<\/strong><\/h3>\n\n- Review this week\u2019s Learning Resources, including the Medication Resources indicated for this week.<\/li>\n
- Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring anxiolytic therapy.<\/li>\n<\/ul>\n
The Assignment: 5 pages<\/strong><\/h2>\nExamine\u00a0Case Study: A Middle-Aged Caucasian Man With Anxiety.<\/em>\u00a0You 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\u2019s pharmacokinetic and pharmacodynamic<\/a> processes.<\/p>\nAt 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.<\/p>\n
Introduction to the case (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Decision #1 (1 page)<\/strong><\/h2>\n\n- Which decision did you select?<\/li>\n
- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #2 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #3 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Conclusion (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\nReminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\nLinks to an external site.<\/a>.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
<\/p>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nTitle: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nAnxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n
Case Overview<\/strong><\/h2>\nThe case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n
The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n
Decision #1<\/strong><\/h2>\nStart Zoloft 50 mg orally daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nSertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nImipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\nWhat I Was Hoping To Achieve<\/strong><\/h2>\nI hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\nEthical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n
Decision #2<\/strong><\/h2>\nIncrease Zoloft to 75 mg daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nThe Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/figcaption><\/figure>\nI hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nNonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n
Decision #3<\/strong><\/h2>\nMaintain the current dose.<\/p>\n
Why I Selected This Decision<\/strong><\/h3>\nThe current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nI was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nThe ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nThe specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nBipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\nDeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\nGarakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\nHe, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\nStrawn, 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis 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.<\/td>\n \n\n\n\n10 to >8.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
8 to >7.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
7 to >6.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
6 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
10 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
11 to >10.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
10 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct APA format with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) APA format errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) APA format errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\nClick the weekly resources link to access the resources.<\/p>\n
To prepare for this Assignment:<\/strong><\/h3>\n\n- Review this week\u2019s Learning Resources, including the Medication Resources indicated for this week.<\/li>\n
- Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring anxiolytic therapy.<\/li>\n<\/ul>\n
The Assignment: 5 pages<\/strong><\/h2>\nExamine\u00a0Case Study: A Middle-Aged Caucasian Man With Anxiety.<\/em>\u00a0You 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\u2019s pharmacokinetic and pharmacodynamic<\/a> processes.<\/p>\nAt 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.<\/p>\n
Introduction to the case (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Decision #1 (1 page)<\/strong><\/h2>\n\n- Which decision did you select?<\/li>\n
- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #2 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #3 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Conclusion (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\nReminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\nLinks to an external site.<\/a>.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
<\/p>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nTitle: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nAnxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n
Case Overview<\/strong><\/h2>\nThe case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n
The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n
Decision #1<\/strong><\/h2>\nStart Zoloft 50 mg orally daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nSertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nImipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\nWhat I Was Hoping To Achieve<\/strong><\/h2>\nI hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\nEthical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n
Decision #2<\/strong><\/h2>\nIncrease Zoloft to 75 mg daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nThe Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/figcaption><\/figure>\nI hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nNonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n
Decision #3<\/strong><\/h2>\nMaintain the current dose.<\/p>\n
Why I Selected This Decision<\/strong><\/h3>\nThe current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nI was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nThe ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nThe specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nBipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\nDeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\nGarakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\nHe, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\nStrawn, 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis 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.<\/td>\n \n\n\n\n10 to >8.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
8 to >7.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
7 to >6.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
6 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
10 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
11 to >10.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
10 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct APA format with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) APA format errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) APA format errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
The Assignment: 5 pages<\/strong><\/h2>\nExamine\u00a0Case Study: A Middle-Aged Caucasian Man With Anxiety.<\/em>\u00a0You 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\u2019s pharmacokinetic and pharmacodynamic<\/a> processes.<\/p>\nAt 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.<\/p>\n
Introduction to the case (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Decision #1 (1 page)<\/strong><\/h2>\n\n- Which decision did you select?<\/li>\n
- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #2 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #3 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Conclusion (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\nReminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\nLinks to an external site.<\/a>.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
<\/p>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nTitle: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nAnxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n
Case Overview<\/strong><\/h2>\nThe case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n
The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n
Decision #1<\/strong><\/h2>\nStart Zoloft 50 mg orally daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nSertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nImipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\nWhat I Was Hoping To Achieve<\/strong><\/h2>\nI hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\nEthical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n
Decision #2<\/strong><\/h2>\nIncrease Zoloft to 75 mg daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nThe Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/figcaption><\/figure>\nI hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nNonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n
Decision #3<\/strong><\/h2>\nMaintain the current dose.<\/p>\n
Why I Selected This Decision<\/strong><\/h3>\nThe current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nI was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nThe ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nThe specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nBipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\nDeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\nGarakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\nHe, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\nStrawn, 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis 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.<\/td>\n \n\n\n\n10 to >8.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
8 to >7.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
7 to >6.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
6 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
10 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
11 to >10.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
10 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct APA format with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) APA format errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) APA format errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
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.<\/p>\n
Introduction to the case (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Decision #1 (1 page)<\/strong><\/h2>\n\n- Which decision did you select?<\/li>\n
- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #2 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #3 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Conclusion (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\nReminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\nLinks to an external site.<\/a>.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
<\/p>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nTitle: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nAnxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n
Case Overview<\/strong><\/h2>\nThe case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n
The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n
Decision #1<\/strong><\/h2>\nStart Zoloft 50 mg orally daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nSertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nImipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\nWhat I Was Hoping To Achieve<\/strong><\/h2>\nI hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\nEthical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n
Decision #2<\/strong><\/h2>\nIncrease Zoloft to 75 mg daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nThe Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/figcaption><\/figure>\nI hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nNonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n
Decision #3<\/strong><\/h2>\nMaintain the current dose.<\/p>\n
Why I Selected This Decision<\/strong><\/h3>\nThe current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nI was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nThe ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nThe specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nBipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\nDeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\nGarakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\nHe, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\nStrawn, 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis 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.<\/td>\n \n\n\n\n10 to >8.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
8 to >7.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
7 to >6.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
6 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
10 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
11 to >10.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
10 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct APA format with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) APA format errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) APA format errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
Decision #1 (1 page)<\/strong><\/h2>\n\n- Which decision did you select?<\/li>\n
- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #2 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #3 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Conclusion (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\nReminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\nLinks to an external site.<\/a>.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
<\/p>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nTitle: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nAnxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n
Case Overview<\/strong><\/h2>\nThe case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n
The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n
Decision #1<\/strong><\/h2>\nStart Zoloft 50 mg orally daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nSertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nImipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\nWhat I Was Hoping To Achieve<\/strong><\/h2>\nI hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\nEthical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n
Decision #2<\/strong><\/h2>\nIncrease Zoloft to 75 mg daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nThe Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/figcaption><\/figure>\nI hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nNonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n
Decision #3<\/strong><\/h2>\nMaintain the current dose.<\/p>\n
Why I Selected This Decision<\/strong><\/h3>\nThe current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nI was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nThe ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nThe specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nBipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\nDeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\nGarakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\nHe, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\nStrawn, 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis 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.<\/td>\n \n\n\n\n10 to >8.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
8 to >7.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
7 to >6.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
6 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
10 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
11 to >10.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
10 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct APA format with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) APA format errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) APA format errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
Decision #2 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Decision #3 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Conclusion (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\nReminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\nLinks to an external site.<\/a>.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
<\/p>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nTitle: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nAnxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n
Case Overview<\/strong><\/h2>\nThe case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n
The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n
Decision #1<\/strong><\/h2>\nStart Zoloft 50 mg orally daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nSertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nImipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\nWhat I Was Hoping To Achieve<\/strong><\/h2>\nI hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\nEthical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n
Decision #2<\/strong><\/h2>\nIncrease Zoloft to 75 mg daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nThe Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/figcaption><\/figure>\nI hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nNonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n
Decision #3<\/strong><\/h2>\nMaintain the current dose.<\/p>\n
Why I Selected This Decision<\/strong><\/h3>\nThe current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nI was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nThe ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nThe specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nBipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\nDeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\nGarakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\nHe, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\nStrawn, 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis 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.<\/td>\n \n\n\n\n10 to >8.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
8 to >7.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
7 to >6.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
6 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
10 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
11 to >10.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
10 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct APA format with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) APA format errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) APA format errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
Decision #3 (1 page)<\/strong><\/h2>\n\n- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.<\/li>\n
- 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.<\/li>\n
- 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).<\/li>\n
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n
Conclusion (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\nReminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\nLinks to an external site.<\/a>.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
<\/p>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nTitle: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nAnxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n
Case Overview<\/strong><\/h2>\nThe case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n
The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n
Decision #1<\/strong><\/h2>\nStart Zoloft 50 mg orally daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nSertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nImipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\nWhat I Was Hoping To Achieve<\/strong><\/h2>\nI hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\nEthical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n
Decision #2<\/strong><\/h2>\nIncrease Zoloft to 75 mg daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nThe Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/figcaption><\/figure>\nI hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nNonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n
Decision #3<\/strong><\/h2>\nMaintain the current dose.<\/p>\n
Why I Selected This Decision<\/strong><\/h3>\nThe current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nI was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nThe ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nThe specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nBipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\nDeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\nGarakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\nHe, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\nStrawn, 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis 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.<\/td>\n \n\n\n\n10 to >8.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
8 to >7.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
7 to >6.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
6 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
10 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
11 to >10.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
10 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct APA format with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) APA format errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) APA format errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
Conclusion (1 page)<\/strong><\/h2>\n\n- 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.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\nReminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\nLinks to an external site.<\/a>.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK6Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
<\/p>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nTitle: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nAnxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n
Case Overview<\/strong><\/h2>\nThe case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n
The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n
Decision #1<\/strong><\/h2>\nStart Zoloft 50 mg orally daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nSertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nImipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\nWhat I Was Hoping To Achieve<\/strong><\/h2>\nI hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\nEthical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n
Decision #2<\/strong><\/h2>\nIncrease Zoloft to 75 mg daily.<\/p>\n
Why I Selected This Decision<\/strong><\/h2>\nThe Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/figcaption><\/figure>\nI hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nNonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n
Decision #3<\/strong><\/h2>\nMaintain the current dose.<\/p>\n
Why I Selected This Decision<\/strong><\/h3>\nThe current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\nIncreasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n
What I Was Hoping To Achieve<\/strong><\/h2>\nI was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\nThe ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nThe specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n
The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\nBipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\nDeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\nGarakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\nHe, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\nStrawn, 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis 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.<\/td>\n \n\n\n\n10 to >8.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
8 to >7.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
7 to >6.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
6 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
10 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
11 to >10.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
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.<\/td>\n
10 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
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.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
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.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct APA format with no errors.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (1 or 2) APA format errors.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (3 or 4) APA format errors.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
Note:<\/em><\/strong> 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.<\/em><\/p>\n Reminder\u00a0<\/strong>: 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<\/a>). All papers submitted must use this formatting <\/a><\/p>\n Links to an external site.<\/a>.<\/p>\n Submit<\/strong> your Assignment.<\/p>\n Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n <\/p>\n Anxiety disorders are characterized by pathologically elevated levels of anxiety. One of the common anxiety disorders is generalized anxiety disorder (GAD). It is characterized by anxiety, tension, worry, and fears about various day-to-day events and problems. Patients with GAD experience difficulties controlling excessive worries (DeMartini et al., 2019). GAD’s excessive anxiety and worry cannot be accounted for by a medical condition or\u00a0substance use. The purpose of this paper is to discuss the case scenario of a patient with an anxiety disorder and describe the treatment and ethical considerations that may impact treatment.<\/p>\n The case scenario portrays a 46-year-old white male referred by his PCP after visiting the ER due to the fear of having a heart attack. The client mentions that he experienced chest tightness, dyspnea, and a feeling of impending doom. He has a history of mild hypertension and is overweight by roughly 15 lbs, but the rest of his medical history is unremarkable. His EKG and physical exam findings were normal, and myocardial infarction was ruled out. The client reports that he still experiences chest tightness and episodes of dyspnea, which he calls anxiety attacks. He also has infrequent feelings of impending doom and a need to escape. He scores 26 on the Hamilton Anxiety Rating Scale and is diagnosed with GAD.<\/p>\n The patient factors that may influence medication prescribing include age, the severity of the patient\u2019s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient\u2019s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.<\/p>\n Start Zoloft 50 mg orally daily.<\/p>\n Sertraline, a selective serotonin reuptake inhibitor (SSRI), was chosen because it is the most cost-effective SSRI. It is also indicated in the first-line treatment of GAD in adults. Strawn et al. (2018) found that the potential side effects of Zoloft are relatively well-tolerated, which leads to a higher compliance rate and better patient outcomes.<\/p>\n Imipramine was not an ideal choice because it is a 2nd<\/sup> line therapy used when SSRIs are unsuccessful in alleviating GAD symptoms. Besides, Imipramine is associated with anticholinergic unpleasant side effects such as dry mouth, sedation, and constipation (Strawn et al., 2018). The side effects may contribute to a low compliance rate, which delays achieving the desired treatment effects. In addition, Buspirone was not ideal since it has no antipanic activity. Thus, it would not adequately alleviate the anxiety attacks in the client. Furthermore, Buspirone has a prolonged onset of action and is not recommended as monotherapy in treating GAD (Strawn et al., 2018).<\/p>\n I hoped that Zoloft would improve the GAD symptoms by at least 50% by the fourth week, and the HAM-A score would improve to 12. According to Garakani et al. (2020), SSRIs such as Zoloft have been established to be efficacious in treating anxiety disorders.<\/p>\n Ethical principles that may affect the treatment plan include beneficence (duty to do good) and nonmaleficence (duty to cause no harm) (Bipeta, 2019). The PMHNP upheld beneficence and nonmaleficence by prescribing Zoloft, which is associated with the best treatment outcomes and least side effects. The other drugs were not prescribed due to their associated treatment outcomes and side effects.<\/p>\n Increase Zoloft to 75 mg daily.<\/p>\n The Zoloft dose was increased because the patient’s anxiety symptoms had not fully abated. Although he reported that the chest tightness and dyspnea had abated, he still experienced some degree of worry, and the HAM-A sore showed a partial response. Increasing the dose was thus an ideal choice to promote full remission of GAD symptoms (Strawn et al., 2018). Besides, the dose increase was gradual since it allows the PMHNP to monitor the drug\u2019s side effects adequately.<\/p>\n Increasing Zoloft to 100 mg was inappropriate since it is a high dose increase. Thus, it does not allow the clinician to effectively monitor the drug’s effect on the patient and its side effects. It is recommended that the dose is gradually increased to promote successful therapy. In addition, changing the dose was not ideal because the patient exhibited a partial treatment response to the initial dose. Treatment guidelines recommend that the drug be changed only when there is no positive response to therapy after eight weeks or adverse effects (Garakani et al., 2020).<\/p>\n I hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug’s associated side effects. The initial dose of Zoloft is 25 to 75 mg daily, while the usual dose range is 50-200 mg daily (Garakani et al., 2020). Thus, 75 mg is an acceptable dose for this patient.<\/p>\n Nonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug’s effect, thus preventing harm to the patient (Bipeta, 2019). Besides, beneficence was upheld by increasing the dose to promote complete remission of symptoms and better patient outcomes.<\/p>\n Maintain the current dose.<\/p>\n The current dose was maintained at 75 mg because the patient demonstrated an adequate positive response to the dose. The patient reported a further decrease in the depressive symptoms with a 61% reduction in symptoms, and the HAM-A score improved to 10. Besides, there were no reported side effects, and thus, maintaining the dose was ideal to avoid adverse effects if the dose was increased (He et al., 2019).<\/p>\n Increasing Zoloft to 100 mg was not an appropriate choice because the patient had an adequate positive response to the current 75 mg dose. Increasing to 100 mg may alleviate the symptoms further but poses the risk of side effects which may affect the drug compliance rate (He et al., 2019). Besides, an augmenting agent was not added to the plan because the patient had an adequate response with Zoloft monotherapy. Besides, monotherapy is highly recommended to prevent polypharmacy.<\/p>\n I was hoping that maintaining the dose would promote a progressive remission of the GAD symptoms and further improve the HAM-A score while at the same time causing no harm to the patient through side effects. Strawn et al. (2018) found that Zoloft continues to improve GAD symptoms over time regardless of a fixed dose.<\/p>\n The ethical principle of autonomy may impact the treatment plan if the patient does not consent to the medications or requests a change in treatment due to side effects. The PMHNP must obtain informed consent and explain the benefit of the prescribed medication and potential side effects (Bipeta, 2019).<\/p>\n The specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient\u2019s treatment preferences, current medical condition and medications, and previous medication trials. The patient was initiated with Zoloft 50 mg daily. The drug was selected because it is indicated as a first-line treatment in GAD and is associated with effective treatment outcomes (Strawn et al., 2018). Besides, it is associated with minimal side effects compared to Imipramine. Buspirone was not selected due to the lack of antipanic activity, which is crucial in managing the patient\u2019s anxiety attacks. The initial dose led to a partial decrease in GAD symptoms, which led to increasing Zoloft to 75 mg daily (Strawn et al., 2018). The aim of this decision was to alleviate the GAD symptoms further. The dose was not increased to 100 mg daily to allow monitoring of side effects. Besides, the drug was not changed because the patient demonstrated a positive response to the initial drug, and no side effects were reported.<\/p>\n The patient’s symptoms decreased with Zoloft 75 mg with a 61% remission in symptoms. The dose was then maintained at 75 mg to allow for a progressive decrease in symptoms and monitoring of side effects. Augmentation was not recommended to avoid polypharmacy (Garakani et al., 2020). Ethical principles of beneficence and nonmaleficence influenced the treatment plan. The clinician selected medication known to have the best treatment outcomes and the least adverse effects to promote better health outcomes (Bipeta, 2019). Autonomy should also be respected by considering the client\u2019s decisions when developing the treatment plan.<\/p>\n Bipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0Indian journal of psychological medicine<\/em>,\u00a041<\/em>(2), 108\u2013112. https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\n DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0Annals of internal medicine<\/em>,\u00a0170<\/em>(7), ITC49\u2013ITC64. https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\n Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0Frontiers in psychiatry<\/em>, 1412. https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\n He, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., … & 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.\u00a0Journal of psychiatric research<\/em>,\u00a0118<\/em>, 21-30. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\n 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.\u00a0Expert opinion on pharmacotherapy<\/em>,\u00a019<\/em>(10), 1057\u20131070. https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\n Excellent Point range: 90\u2013100<\/p>\n 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.<\/td>\n Good Point range: 80\u201389<\/p>\n 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.<\/td>\n Fair Point range: 70\u201379<\/p>\n 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.<\/td>\n Poor Point range: 0\u201369<\/p>\n 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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n Excellent Point range: 90\u2013100<\/p>\n 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.<\/td>\n Good Point range: 80\u201389<\/p>\n 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.<\/td>\n Fair Point range: 70\u201379<\/p>\n 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.<\/td>\n Poor Point range: 0\u201369<\/p>\n 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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n Excellent Point range: 90\u2013100<\/p>\n 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.<\/td>\n Good Point range: 80\u201389<\/p>\n 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.<\/td>\n Fair Point range: 70\u201379<\/p>\n 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.<\/td>\n Poor Point range: 0\u201369<\/p>\n 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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n Excellent Point range: 90\u2013100<\/p>\n 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.<\/td>\n Good Point range: 80\u201389<\/p>\n 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.<\/td>\n Fair Point range: 70\u201379<\/p>\n 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.<\/td>\n Poor Point range: 0\u201369<\/p>\n 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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n Excellent Point range: 90\u2013100<\/p>\n 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.<\/td>\n Good Point range: 80\u201389<\/p>\n 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.<\/td>\n Fair Point range: 70\u201379<\/p>\n 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.<\/td>\n Poor Point range: 0\u201369<\/p>\n 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.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n Excellent Point range: 90\u2013100<\/p>\n 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.<\/td>\n Good Point range: 80\u201389<\/p>\n 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.<\/td>\n Fair Point range: 70\u201379<\/p>\n Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n Poor Point range: 0\u201369<\/p>\n Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n Excellent Point range: 90\u2013100<\/p>\n Uses correct grammar, spelling, and punctuation with no errors.<\/td>\n Good Point range: 80\u201389<\/p>\n Contains a few (1 or 2) grammar, spelling, and punctuation errors.<\/td>\n Fair Point range: 70\u201379<\/p>\n Contains several (3 or 4) grammar, spelling, and punctuation errors.<\/td>\n Poor Point range: 0\u201369<\/p>\n Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n Excellent Point range: 90\u2013100<\/p>\n Uses correct APA format with no errors.<\/td>\n Good Point range: 80\u201389<\/p>\n Contains a few (1 or 2) APA format errors.<\/td>\n Fair Point range: 70\u201379<\/p>\n Contains several (3 or 4) APA format errors.<\/td>\n Poor Point range: 0\u201369<\/p>\n Contains many (\u2265 5) APA format errors.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/a><\/span><\/h3>\n
By Day 7<\/strong><\/h2>\n
submission information<\/strong><\/h3>\n
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A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\n
Title: NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\n
Case Overview<\/strong><\/h2>\n
Decision #1<\/strong><\/h2>\n
Why I Selected This Decision<\/strong><\/h2>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\n
What I Was Hoping To Achieve<\/strong><\/h2>\n
How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\n
Decision #2<\/strong><\/h2>\n
Why I Selected This Decision<\/strong><\/h2>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\n
What I Was Hoping To Achieve<\/strong><\/h2>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\n
Decision #3<\/strong><\/h2>\n
Why I Selected This Decision<\/strong><\/h3>\n
Why I Did Not Select the Other Options<\/strong><\/h2>\n
What I Was Hoping To Achieve<\/strong><\/h2>\n
How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\n
Conclusion NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\n
References NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment<\/strong><\/h2>\n
NURS 6630 Assessing and Treating Patients With Anxiety Disorders Assignment Rubric<\/h2>\n
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\n NURS_6630_Week6_Assignment_Rubric<\/td>\n<\/tr>\n \n Criteria<\/strong><\/td>\n Ratings<\/strong><\/td>\n Pts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n \n 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.<\/td>\n \n \n\n
\n 10 to >8.0 pts<\/p>\n 8 to >7.0 pts<\/p>\n 7 to >6.0 pts<\/p>\n 6 to >0 pts<\/p>\n 10 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome Decision #1 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n \n\n
\n 20 to >17.0 pts<\/p>\n 17 to >15.0 pts<\/p>\n 15 to >13.0 pts<\/p>\n 13 to >0 pts<\/p>\n 20 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome Decision #2 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n \n\n
\n 20 to >17.0 pts<\/p>\n 17 to >15.0 pts<\/p>\n 15 to >13.0 pts<\/p>\n 13 to >0 pts<\/p>\n 20 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome Decision #3 (1\u20132 pages)\u2022 Which decision did you select?\u2022 Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.\u2022 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.\u2022 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).\u2022 Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/td>\n \n \n\n
\n 20 to >17.0 pts<\/p>\n 17 to >15.0 pts<\/p>\n 15 to >13.0 pts<\/p>\n 13 to >0 pts<\/p>\n 20 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome Conclusion (1 page)\u2022 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.<\/td>\n \n \n\n
\n 15 to >13.0 pts<\/p>\n 13 to >11.0 pts<\/p>\n 11 to >10.0 pts<\/p>\n 10 to >0 pts<\/p>\n 15 pts<\/td>\n<\/tr>\n \n 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\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n \n\n
\n 5 to >4.0 pts<\/p>\n 4 to >3.5 pts<\/p>\n 3.5 to >3.0 pts<\/p>\n 3 to >0 pts<\/p>\n 5 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation<\/td>\n \n \n\n
\n 5 to >4.0 pts<\/p>\n 4 to >3.5 pts<\/p>\n 3.5 to >3.0 pts<\/p>\n 3 to >0 pts<\/p>\n 5 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, parenthetical\/in-text citations, and reference list.<\/td>\n \n \n\n
\n 5 to >4.0 pts<\/p>\n 4 to >3.5 pts<\/p>\n 3.5 to >3.0 pts<\/p>\n 3 to >0 pts<\/p>\n 5 pts<\/td>\n<\/tr>\n \n Total Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n