{"id":9187,"date":"2021-10-21T08:19:06","date_gmt":"2021-10-21T08:19:06","guid":{"rendered":"https:\/\/nursingassignmentcrackers.com\/?p=9187"},"modified":"2024-03-12T12:23:45","modified_gmt":"2024-03-12T12:23:45","slug":"nurs-6630-assessing-and-treating-patients-with-anxiety-disorders","status":"publish","type":"post","link":"https:\/\/nursingassignmentcrackers.com\/nurs-6630-assessing-and-treating-patients-with-anxiety-disorders\/","title":{"rendered":"NURS 6630 Assessing and Treating Patients With Anxiety Disorders"},"content":{"rendered":"<h2><span style=\"color: #ff6600;\"><strong>Sample Answer for NURS 6630 Assessing and Treating Patients With Anxiety Disorders Included After Question<\/strong><\/span><\/h2>\n<p>Common symptoms of<a href=\"https:\/\/nursingassignmentcrackers.com\/psych-515-anxiety-disorders\/\"> 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>\n<h2><strong>To prepare for this Assignment:<\/strong><\/h2>\n<ul>\n<li>Review this week\u2019s Learning Resources, including the Medication Resources indicated for this week.<\/li>\n<li>Reflect on the <a href=\"https:\/\/nursingassignmentcrackers.com\/nurs-6630-psychopharmacologic-treatments-assignment\/\">psychopharmacologic treatments<\/a> you might recommend for the assessment and treatment of patients requiring anxiolytic therapy.<\/li>\n<\/ul>\n<h2><strong>The Assignment: 5 pages<\/strong><\/h2>\n<p>Examine<em>\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 processes.<\/p>\n<p>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<h2><strong>Introduction to the case (1 page)<\/strong><\/h2>\n<ul>\n<li>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<h3 style=\"text-align: center;\"><span style=\"color: #ff0000;\"><em><a style=\"color: #ff0000;\" href=\"https:\/\/nursingassignmentcrackers.com\/place-order\/\"><strong>Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Anxiety Disorders<\/strong><\/a><\/em><\/span><\/h3>\n<h2><strong>Decision #1 (1 page)<\/strong><\/h2>\n<figure id=\"attachment_108033\" aria-describedby=\"caption-attachment-108033\" style=\"width: 300px\" class=\"wp-caption alignright\"><img decoding=\"async\" class=\"size-medium wp-image-108033\" src=\"https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2021\/10\/NURS-6630-Assessing-and-Treating-Patients-With-Anxiety-Disorders-300x134.png\" alt=\"NURS 6630 Assessing and Treating Patients With Anxiety Disorders\" width=\"300\" height=\"134\" srcset=\"https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2021\/10\/NURS-6630-Assessing-and-Treating-Patients-With-Anxiety-Disorders-300x134.png 300w, https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2021\/10\/NURS-6630-Assessing-and-Treating-Patients-With-Anxiety-Disorders-768x343.png 768w, https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2021\/10\/NURS-6630-Assessing-and-Treating-Patients-With-Anxiety-Disorders.png 965w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-108033\" class=\"wp-caption-text\">NURS 6630 Assessing and Treating Patients With Anxiety Disorders<\/figcaption><\/figure>\n<ul>\n<li>Which decision did you select?<\/li>\n<li>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<li>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<li>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<li>Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n<h2><strong>Decision #2 (1 page)<\/strong><\/h2>\n<ul>\n<li>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<li>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<li>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<li>Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n<h2><strong>Decision #3 (1 page)<\/strong><\/h2>\n<ul>\n<li>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<li>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<li>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<li>Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.<\/li>\n<\/ul>\n<h2><strong>Conclusion (1 page)<\/strong><\/h2>\n<ul>\n<li>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<p><strong><em>Note:<\/em><\/strong><em>\u00a0Support 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<h2><strong>A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders<\/strong><\/h2>\n<h2><strong>Title: <\/strong><strong> NURS 6630 Assessing and Treating Patients With Anxiety Disorders<\/strong><\/h2>\n<p>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&#8217;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<h2><strong>Case Overview<\/strong><\/h2>\n<p>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<p>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<h2><strong>Decision #1<\/strong><\/h2>\n<p>Start Zoloft 50 mg orally daily.<\/p>\n<h2><strong>Why I Selected This Decision<\/strong><\/h2>\n<p>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<h2><strong>Why I Did Not Select the Other Options<\/strong><\/h2>\n<p>Imipramine was not an ideal choice because it is a 2<sup>nd<\/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<h2><strong>What I Was Hoping To Achieve<\/strong><\/h2>\n<p>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<h2><strong>How Ethical Considerations May Impact the Treatment Plan <\/strong><\/h2>\n<p>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<h2><strong>Decision #2<\/strong><\/h2>\n<p>Increase Zoloft to 75 mg daily.<\/p>\n<h2><strong>Why I Selected This Decision<\/strong><\/h2>\n<p>The Zoloft dose was increased because the patient&#8217;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<h2><strong>Why I Did Not Select the Other Options<\/strong><\/h2>\n<p>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&#8217;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<h2><strong>What I Was Hoping To Achieve<\/strong><\/h2>\n<p>I hoped that gradually increasing the dose would help to fully alleviate the depressive symptoms while at the same time monitoring the drug&#8217;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<h2><strong>How <a href=\"https:\/\/nursingassignmentcrackers.com\/nur-2790-module-9-discussion-brain-death-ethical-considerations\/\">Ethical Considerations<\/a> May Impact the Treatment Plan<\/strong><\/h2>\n<p>Nonmaleficence was upheld in this decision by gradually increasing the dose, which would allow the PMHNP to monitor the drug&#8217;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<h2><strong>Decision #3<\/strong><\/h2>\n<p>Maintain the current dose.<\/p>\n<h2><strong>Why I Selected This Decision<\/strong><\/h2>\n<p>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<h2><strong>Why I Did Not Select the Other Options<\/strong><\/h2>\n<p>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<h2><strong>What I Was Hoping To Achieve<\/strong><\/h2>\n<p>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<h2><strong>How Ethical Considerations May Impact the Treatment Plan<\/strong><\/h2>\n<p>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<h2><strong>NURS 6630 Assessing and Treating Patients With Anxiety Disorders Conclusion<\/strong><\/h2>\n<p>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<p>The patient&#8217;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<h2><strong>\u00a0<\/strong><strong>NURS 6630 Assessing and Treating Patients With Anxiety Disorders References<\/strong><\/h2>\n<p>Bipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care.\u00a0<em>Indian journal of psychological medicine<\/em>,\u00a0<em>41<\/em>(2), 108\u2013112. <a href=\"https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.4103\/IJPSYM.IJPSYM_59_19<\/a><\/p>\n<p>DeMartini, J., Patel, G., &amp; Fancher, T. L. (2019). Generalized Anxiety Disorder.\u00a0<em>Annals of internal medicine<\/em>,\u00a0<em>170<\/em>(7), ITC49\u2013ITC64. <a href=\"https:\/\/doi.org\/10.7326\/AITC201904020\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.7326\/AITC201904020<\/a><\/p>\n<p>Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., &amp; Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u00a0<em>Frontiers in psychiatry<\/em>, 1412. <a href=\"https:\/\/doi.org\/10.1176\/appi.focus.19203\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1176\/appi.focus.19203<\/a><\/p>\n<p>He, H., Xiang, Y., Gao, F., Bai, L., Gao, F., Fan, Y., &#8230; &amp; 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.\u00a0<em>Journal of psychiatric research<\/em>,\u00a0<em>118<\/em>, 21-30. <a href=\"https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1016\/j.jpsychires.2019.08.009<\/a><\/p>\n<p>Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., &amp; Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.\u00a0<em>Expert opinion on pharmacotherapy<\/em>,\u00a0<em>19<\/em>(10), 1057\u20131070. <a href=\"https:\/\/doi.org\/10.1080\/14656566.2018.1491966\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/p>\n<h2><strong>Lopes Write Policy<\/strong><\/h2>\n<p>For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a \u201cfinal submit\u201d to me.<\/p>\n<p>Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.<\/p>\n<p>Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else\u2019s thoughts more than your own?<\/p>\n<p>Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.<\/p>\n<h2><strong>Late Policy<\/strong><\/h2>\n<p>The university\u2019s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.<\/p>\n<p>Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.<\/p>\n<p>If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.<\/p>\n<p>I do not accept assignments that are two or more weeks late unless we have worked out an extension.<\/p>\n<p>As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.<\/p>\n<h2><strong>Communication<\/strong><\/h2>\n<p>Communication is so very important. There are multiple ways to communicate with me:<\/p>\n<p>Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.<\/p>\n<p>Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.<\/p>\n<h2><strong>Important information for writing discussion questions and participation<\/strong><\/h2>\n<h3><strong>Welcome to class<\/strong><\/h3>\n<p>Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the \u201cmessage\u201d icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to<\/p>\n<p>I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.<\/p>\n<p>Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.<\/p>\n<p>If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.<\/p>\n<p>Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.<\/p>\n<p>Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.<\/p>\n<p>I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God\u2019s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!<\/p>\n<p>Hi Class,<\/p>\n<p>Please read through the following information on writing a Discussion question response and participation posts.<\/p>\n<p>Contact me if you have any questions.<\/p>\n<h2><strong>Important information on Writing a Discussion Question<\/strong><\/h2>\n<ul>\n<li>Your response needs to be\u00a0a minimum\u00a0of 150 words (not including your list of references)<\/li>\n<li>There needs to be at least TWO references with ONE being a peer reviewed professional journal article.<\/li>\n<li>Include in-text citations in your response<\/li>\n<li>Do not include quotes\u2014instead summarize and paraphrase the information<\/li>\n<li>Follow APA-7th edition<\/li>\n<li>Points will be deducted if the above is not followed<\/li>\n<\/ul>\n<h3><strong>Participation \u2013replies to your classmates or instructor<\/strong><\/h3>\n<ul>\n<li>A minimum of 6 responses per week, on at least 3 days of the week.<\/li>\n<li>Each response needs at least ONE reference with citations\u2014best if it is a peer reviewed journal article<\/li>\n<li>Each response needs to be at least 75 words in length (does not include your list of references)<\/li>\n<li>Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of \u201cI agree\u201d or \u201cgreat post\u201d does not count for the word count.<\/li>\n<li>Follow APA 7th edition<\/li>\n<li>Points will be deducted if the above is not followed<\/li>\n<li>Remember to use and follow APA-7th\u00a0edition for all weekly assignments, discussion questions, and participation points.<\/li>\n<li>Here are some helpful links<\/li>\n<li><a href=\"https:\/\/apastyle.apa.org\/style-grammar-guidelines\/paper-format\/student-annotated.pdf\" target=\"_blank\" rel=\"noopener\">Student paper example<\/a><\/li>\n<li><a href=\"https:\/\/libguides.gcu.edu\/CitingSources\" target=\"_blank\" rel=\"noopener\">Citing Sources<\/a><\/li>\n<li>The\u00a0<a href=\"https:\/\/www.gcumedia.com\/lms-resources\/student-success-center\/v3.1\/\" target=\"_blank\" rel=\"noopener\">Writing Center\u00a0<\/a>is a great resource<\/li>\n<\/ul>\n<h2><strong>A Sample Answer 2 For the Assignment: NURS 6630 Assessing and Treating Patients With Anxiety Disorders<\/strong><\/h2>\n<h2><strong>Title: NURS 6630 Assessing and Treating Patients With Anxiety Disorders<\/strong><\/h2>\n<p><span data-contrast=\"auto\">Generalized anxiety disorder (GAD) is a common psychiatric condition that presents with excessive and uncontrollable anxiety or worries about various things or events. The anxiety or worry occurs for more days than not for more than six months. The cause of GAD is unknown, but it usually coexists in individuals with panic disorder, major depression, and alcohol use disorder (Strawn et al., 2018). The purpose of this paper is to describe the treatment for a patient with GAD.<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Introduction to the Case<\/span><\/b><span data-ccp-props=\"{&quot;335551550&quot;:2,&quot;335551620&quot;:2}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">The case depicts a 46-year-old man who comes to the psychiatric clinic following a referral by the PCP. The patient had gone to the ER after he experienced symptoms resembling a heart attack, including chest tightness, dyspnea, and a feeling of coming doom. He has a history of mild hypertension managed through a low sodium diet and weighs around 115 lbs. In addition, he has a history of tonsillectomy but no significant medical history. The patient&#8217;s EKG and physical exam were within the normal limits in the ER, and Myocardial infarction was excluded as a possible diagnosis. However, the patient mentions that he still experiences chest tightness and episodes of dyspnea. Besides, he experiences sporadic feelings of imminent doom and a need to flee from where he is.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">The patient reports occasionally taking alcohol to alleviate work-related worries. He is single but is trying to take care of his old parents. He states that his workplace management is harsh and worries for his job. The MSE findings are unremarkable except for the endorsement of nervousness and blunted affect that improves severally during the assessment. The patient was administered the HAM-A, which he scored 26, and was diagnosed with GAD. Specific patient factors that may influence treatment decisions include the patient&#8217;s age, medical history of hypertension, the severity of GAD, and the patient\u2019s overweight state (Garakani et al., 2020). Therefore, the treatment interventions used should have no potential effect on the patient\u2019s weight and blood pressure to avoid worsening his medical condition.\u00a0<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Decision Point One<\/span><\/b><span data-ccp-props=\"{&quot;335551550&quot;:2,&quot;335551620&quot;:2}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Start Zoloft 50 mg orally daily.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Why I Selected This Decision<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Zoloft was the ideal drug because it is recommended in the first-line treatment of GAD in adults, among other SSRIs (Strawn et al., 2018). Guaiana et al. (2018) found that SSRIs are superior in alleviating GAD symptoms, and Zoloft was established to be effective and well-tolerated due to its modest side effects.<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Why I Did Not Select the Other Options\u00a0<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Imipramine was not selected because of its documented antihistaminic effects as a TCA, which increase appetite resulting in weight gain. This would worsen the client\u2019s overweight condition. Garakani et al. (2020) explain that although TCAs have similar efficacy to SSRIs, they are rarely prescribed because of side effects like weight gain, sedation, dry mouth, urinary hesitancy, arrhythmias, and mortality risk with overdose. Buspirone was not the best option because it has been established to have a delayed onset of action and is weak effective (Strawn et al., 2018). Thus, it cannot be prescribed as monotherapy in GAD, limiting its use in this patient.<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">What I Was Hoping To Achieve<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">The clinician anticipated that Zoloft would reduce the GAD symptoms and lower the HAM-A score by half. The patient reported a significant decrease in worry, dyspnea, and feeling of imminent doom. Lewis et al. (2019) found that Zoloft improves anxiety, self-rated mental health, and quality of life in GAD patients, which is clinically important. Besides, Strawn et al. (2018) established that SSRIs like Zoloft <\/span><span data-contrast=\"none\">have a significant treatment response rate of 30-50% in patients with GAD and would thus significantly reduce the patient\u2019s GAD symptoms.\u00a0<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Ethical Considerations Impact on the Treatment Plan and Communication<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">The ethical principle of beneficence may affect the treatment since the clinician has to select the intervention established to have the best outcomes in GAD. For example, the PMHNP selected Zoloft because studies support its efficacy in suppressing GAD symptoms and is tolerable. In addition, autonomy may affect communication since the PMHNP had to obtain consent from the patient to begin treatment.<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Decision Point Two<\/span><\/b><span data-ccp-props=\"{&quot;335551550&quot;:2,&quot;335551620&quot;:2}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Increase dose to 75 mg OD.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Why I Selected This Decision<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Zoloft was increased because of the evident improvement in the patient\u2019s GAD symptoms and partial decrease in HAM-A score with Zoloft therapy. According to Edinoff et al. (2021), SSRIs like Zoloft should be gradually increased to enable the clinician to monitor the adverse effects. Strawn et al. (2018) found that patients increasingly demonstrated improvement in anxiety symptoms when the Zoloft dose was increased by 25 mg.\u00a0<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Why I Did Not Select the Other Options\u00a0<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Increasing Zoloft to 100 mg was not the best option because the PMHNP may be unable to monitor side effects with a high dose increase. Edinoff et al. (2021) explain that patients can be sensitive to SSRIs, and thus, gradually increasing SSRIs is vital in achieving the desired treatment outcomes. The dose was not also maintained at 50 mg since the client demonstrated only a partial response to treatment. Lewis et al. (2019) established that Zoloft leads to decreased anxiety symptoms and improved mental health within six weeks, but a complete reduction of symptoms takes longer and is more modest. Thus, maintaining the dose would have delayed achieving complete remission of GAD.\u00a0<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">What I Was Hoping To Achieve<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">The clinician expected that the patient\u2019s GAD symptoms would decrease further with an increased dose, and the patient would achieve a better clinical response after four weeks. Mangolini et al. (2019) found that increasing the SSRI dose results in a better clinical response in GAD. Furthermore, Edinoff et al. (2021) found sertraline to be more effective in the acute phase (6-12 weeks) of treatment than other SSRIs.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Ethical Considerations Impact on the Treatment Plan and Communication<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">The ethical principle of nonmaleficence (do no harm) impacted the treatment since the PMHNP had to make the decision associated with the least adverse effects. For example, the dose was increased to 75 mg rather than 100 mg for the clinician to monitor side effects. The right to autonomy affected communication since the PMHNP had to involve the patient in decision-making. The client was asked about his treatment response and was involved in deciding whether to increase the dose.<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Decision Point Three<\/span><\/b><span data-ccp-props=\"{&quot;335551550&quot;:2,&quot;335551620&quot;:2}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Maintain the Zoloft 75 mg dose.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Why I Selected This Decision<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">The PMHNP maintained Zoloft at 75 mg because the patient exhibited a satisfactory positive response to the dose, with a 61% reduction in anxiety symptoms. Furukawa et al. (2019) found that 80% occupancy of serotonin transporters occurs at minimum therapeutic doses in Zoloft. Besides, increasing transporter occupancy &gt; 80% does not lead to better treatment efficacy. Strawn et al. (2018) also assert that SSRIs in the lower therapeutic range (50 mg-100 mg) are adequate in achieving the desired effect.\u00a0<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Why I Did Not Select the Other Options\u00a0<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Increasing Zoloft to 100 mg was not ideal because the patient had achieved a satisfactory therapeutic response. According to Edinoff et al. (2021), increasing Zoloft can lead to further reduction of symptoms, but it increases the risk of side effects, compromising treatment compliance. Augmenting treatment with Buspirone was not ideal since the client had an adequate therapeutic response with Zoloft. Mangolini et al. (2019) assert that augmentation causes polypharmacy and should thus be avoided if there is an adequate response with monotherapy.\u00a0<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">What I Was Hoping To Achieve<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">The practitioner hoped that continuing with the 75mg dose would increasingly alleviate GAD symptoms and help achieve complete remission of symptoms within 4-6 weeks (Furukawa et al., 2019). Strawn et al. (2018) established that flexibly dosing Zoloft significantly reduces GAD symptoms.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Ethical Considerations Impact on the Treatment Plan and Communication<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Beneficence (duty to do good) and confidentiality may impact treatment and communication in this case. For example, beneficence impacted treatment as the PMHNP had to select the decision that would have the best outcomes without compromising patient safety. Besides, the PMHNP has to be confidential with the patient\u2019s information and seek consent before sharing it with other providers.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Conclusion<\/span><\/b><span data-ccp-props=\"{&quot;335551550&quot;:2,&quot;335551620&quot;:2}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">The patient was diagnosed with GAD based on his history of having excessive worries about his job and the presence of symptoms like dyspnea, chest tightness, and feeling of imminent doom. Specific factors that may influence treatment decisions include the patient\u2019s age, weight, history of hypertension, and severity of GAD (Garakani et al., 2020). The patient was initiated on Zoloft 50 mg since it is recommended as a first-line agent in treating GAD in adults. Besides, it has been established to be effective and tolerable due to its modest side effects (Guaiana et al., 2018). Imipramine was not ideal because it causes weight gain and would have affected the patient\u2019s weight. Buspirone was not selected because it is not effective as a monotherapy.\u00a0<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Zoloft partially reduced the patient&#8217;s symptoms, leading to increasing the dose to 75 mg. The dose was gradually increased because it allowed the clinician to monitor the adverse effects (Strawn et al., 2018). Maintaining Zoloft at 50 mg was not ideal because the patient demonstrated a partial response. Increasing to 100 mg was not the best choice since the patient could have developed adverse effects from a high dose increase (Edinoff et al., 2021). The patient&#8217;s symptoms were further reduced to 61%, and the dose was then maintained at 75 mg. Increasing the dose to 100 mg would have had the disadvantage of side effects and, thus, not an ideal choice. Furthermore, augmenting with Buspirone was not ideal because it would have led to polypharmacy.\u00a0<\/span><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;335559731&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><span data-contrast=\"auto\">References<\/span><span data-ccp-props=\"{&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559685&quot;:720,&quot;335559991&quot;:720}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">Edinoff, A. N., Akuly, H. A., Hanna, T. A., Ochoa, C. O., Patti, S. J., Ghaffar, Y. A., Kaye, A. D., Viswanath, O., Urits, I., Boyer, A. G., Cornett, E. M., &amp; Kaye, A. M. (2021). Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review.\u202f<\/span><i><span data-contrast=\"auto\">Neurology International<\/span><\/i><span data-contrast=\"auto\">,\u202f<\/span><i><span data-contrast=\"auto\">13<\/span><\/i><span data-contrast=\"auto\">(3), 387\u2013401. <a href=\"https:\/\/doi.org\/10.3390\/neurolint13030038\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.3390\/neurolint13030038<\/a><\/span><span data-ccp-props=\"{&quot;335559685&quot;:720,&quot;335559991&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Furukawa, T. A., Cipriani, A., Cowen, P. J., Leucht, S., Egger, M., &amp; Salanti, G. (2019). Optimal dose of selective serotonin reuptake inhibitors, venlafaxine, and mirtazapine in major depression: a systematic review and dose-response meta-analysis.\u202f<\/span><i><span data-contrast=\"auto\">The Lancet Psychiatry<\/span><\/i><span data-contrast=\"auto\">,\u202f<\/span><i><span data-contrast=\"auto\">6<\/span><\/i><span data-contrast=\"auto\">(7), 601-609.<\/span><span data-ccp-props=\"{&quot;335559685&quot;:720,&quot;335559991&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., &amp; Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: current and emerging treatment options.\u202f<\/span><i><span data-contrast=\"auto\">Frontiers in psychiatry<\/span><\/i><span data-contrast=\"auto\">, 1412. <a href=\"https:\/\/doi.org\/10.3389\/fpsyt.2020.595584\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.3389\/fpsyt.2020.595584<\/a><\/span><span data-ccp-props=\"{&quot;335559685&quot;:720,&quot;335559991&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Guaiana, G., Barbui, C., &amp; Abouhassan, R. (2018). Antidepressants versus placebo for generalized anxiety disorder (GAD). <\/span><i><span data-contrast=\"auto\">The Cochrane Database of Systematic Reviews<\/span><\/i><span data-contrast=\"auto\">,\u202f<\/span><i><span data-contrast=\"auto\">2018<\/span><\/i><span data-contrast=\"auto\">(2), CD012942. <a href=\"https:\/\/doi.org\/10.1002\/14651858.CD012942\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1002\/14651858.CD012942<\/a><\/span><span data-ccp-props=\"{&quot;335559685&quot;:720,&quot;335559991&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Lewis, G., Duffy, L., Ades, A., Amos, R., Araya, R., Brabyn, S., &#8230; &amp; Lewis, G. (2019). The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomized trial. <\/span><i><span data-contrast=\"auto\">The Lancet Psychiatry<\/span><\/i><span data-contrast=\"auto\">,\u202f<\/span><i><span data-contrast=\"auto\">6<\/span><\/i><span data-contrast=\"auto\">(11), 903-914.<\/span><span data-ccp-props=\"{&quot;335559685&quot;:720,&quot;335559991&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Mangolini, V. I., Andrade, L. H., Lotufo-Neto, F., &amp; Wang, Y. P. (2019). Treatment of anxiety disorders in clinical practice: a critical overview of recent systematic evidence.\u202f<\/span><i><span data-contrast=\"auto\">Clinics (Sao Paulo, Brazil)<\/span><\/i><span data-contrast=\"auto\">,\u202f<\/span><i><span data-contrast=\"auto\">74<\/span><\/i><span data-contrast=\"auto\">, e1316. <a href=\"https:\/\/doi.org\/10.6061\/clinics\/2019\/e1316\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.6061\/clinics\/2019\/e1316<\/a><\/span><span data-ccp-props=\"{&quot;335559685&quot;:720,&quot;335559991&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., &amp; Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.\u202f<\/span><i><span data-contrast=\"auto\">Expert opinion on pharmacotherapy<\/span><\/i><span data-contrast=\"auto\">,\u202f<\/span><i><span data-contrast=\"auto\">19<\/span><\/i><span data-contrast=\"auto\">(10), 1057\u20131070. <a href=\"https:\/\/doi.org\/10.1080\/14656566.2018.1491966\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1080\/14656566.2018.1491966<\/a><\/span><span data-ccp-props=\"{&quot;335559685&quot;:720,&quot;335559991&quot;:720}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Sample Answer for NURS 6630 Assessing and Treating Patients With Anxiety Disorders Included After Question Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt patients to seek care from their primary care providers [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_lock_modified_date":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9187","post","type-post","status-publish","format-standard","hentry","category-nursing-papers"],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":6}},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NURS 6630 Assessing and Treating Patients With Anxiety Disorders - Nursing Assignment Crackers<\/title>\n<meta name=\"description\" content=\"NURS 6630 Assessing and Treating Patients With Anxiety Disorders-Common symptoms of anxiety disorders include chest pains, shortness of breath, 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