Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt patients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, patients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with anxiety disorders.

To prepare for this Assignment:

• Review this week’s Learning Resources, including the Medication Resources indicated for this week.
• Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring anxiolytic therapy.

The Assignment: 5 pages

Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

• Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Solution:

Introduction

The cases of mental illnesses reported annually continue to increase, showing the prevalence of mental disorders. The most prevalent of the mental disorders is the GAD (Generalized Anxiety Disorder), which involves patients feeling excessively worried and depressed by the happenings of their life (Newman et al., 2017). The distress and anxiety resulting from GAD affect the ability of the patient to conduct their daily activities. Like other disorders, worry and fear remain crucial elements of a generalized anxiety disorder (National Institute of Mental Health, 2016). If mental agitation and worry prevail for more than six months without any external trigger, then a person suffers from GAD.

The causes, symptoms, and effects of GAD are almost similar to other disorders; hence can be difficult to detect (Bailey, 2021). One symptom is a person who is always anxious about everything in their life. Such a person will always have trouble concentrating on a given task without being distracted and daydreaming. Further, GAD patients are socially inactive and always prefer to stay away from crowds and people (Bailey, 2021). Lastly, affected patients experience insomnia due to intense anxiety, especially during the night.

The case study shows a 46-year old Caucasian man referred to the hospital. The patient is possibly suffering from GAD, given that he has experienced worries and anxiety about work for more than six months. Some of the symptoms presented by the patient include chest tightness, shortness of breath, and impending doom. The client’s score in the Hamilton Anxiety Rating Scale (HAM-A) was above 26, showing that he was suffering from generalized anxiety disorder (Thompson,2015). This essay looks into three decisions made by a PMHNP (psychiatric mental health nurse practitioner) regarding the medication prescribed to the Caucasian man as his treatment for GAD. The choices made in each decision will be explained using relevant evidence and literature. Further, the essay also looks into the relevant ethical considerations regarding the treatment process.

Decision One

The first decision made by the PMHNP involves determining the first medication that the patient should start taking. Three available medications can be administered to the patient, namely Imipramine 25mg, Zoloft 50mg, or Buspirone 10mg. My decision is that the patient receives the Zoloft 50mg orally daily for four weeks. Medics commonly use Zoloft as the first-time medication for anxieties especially. Zoloft is categorized as an SSRI (selective serotonin reuptake inhibitor) (Bandelow et al., 2017). The other options Imipramine and Buspirone, can still treat the anxiety, but Zoloft is more effective, hence giving it preference.

Research studies have shown that SSRIs such as Zoloft as the most effective treatments for generalized anxiety disorders (Bandelow et al., 2017). The medications are effective since they envelop various anxiety disorders in addition to GAD. SSRIs such as Zoloft are also tolerated by the body, meaning that they have few side effects compared to other medications (Bandelow et al., 2017). The 46-year old patient is an alcoholic who takes 3-4 bottles of beer every day.  Therefore, Imipramine cannot be prescribed to the patient since it can develop adverse side effects (Practo Laboratories, 2019). Consumption of alcohol during treatment with Imipramine will increase nausea, constipation, dizziness, and even death.

The expected result from this decision is that the patient will reduce the signs and…..Please click the icon below to purchase full answer at only $15

 

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