Treating Patients with Anxiety Disorders Discussion Paper

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Treating Patients with Anxiety Disorders Discussion Paper

Decision #1

The best decision will be, to begin with, Zoloft 50mg PO BID. This decision is normally used for start-up medication, especially for patients with anxiety disorder. However, it is important to note that there has been medical advancement in terms of drugs that are used to treat this medical condition.

The Reason for selecting the Decision

It is recommended that a patient is not introduced to a higher amount of oral dosage or subjected to progressive medication (Feldman & Chung, 2021). Thus the need to start the patient off with Zoloft 50mg PO BID which ought to be taken orally every day to relieve anxiety. According to studies, the most effective dose of Zoloft is 50mg per day as it is tolerable for most patients. Doctors will only increase the dosage if the patient is not responding to the 50mg per day. It is important to note that the drug does not work immediately and it may take two to six weeks for the anxiety symptoms to start to reduce the patient should not stop taking the drug if the symptoms do not reduce immediately. In case the patient reacts to Zoloft 50mg, it is at this point that the physician can select another decision in case the dosage does not work for the patient. Treating Patients with Anxiety Disorders Discussion Paper

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Results for the Decision Selected

After the patient takes Zoloft 50mg, I expect that the patient will report of reduction of anxiety symptoms contrary to what he had previously recorded. Although all symptoms do not reduce at once, at least the patient ought to communicate a slight improvement after the administration of the drug. Based on the symptoms that the patient presented, the Zoloft 50mg PO BID was a good recommendation and it would alleviate some of the symptoms although not all.

The Difference between the expected results and the Actual Results of the Decision

Although I expected that there would be some slight changes after administering Zoloft 50mg that was not the case for the patient. The patient reported back to the facility after four weeks of medication and the PNHNP recognized some notable changes as the patient reported a reduction in shortness of breath and chest tightness. Also, the patient worried less compared to before he started on the medication. The HAM-A score was initially at 26 and on the first attempt with Zoloft medication, the score decreased to 8. Thus informing the next decision which hugely relies on the results of decision one. Treating Patients with Anxiety Disorders Discussion Paper

Decision #2

The middle-aged Caucasian man will greatly benefit from Decision #2 as it is the most effective for his anxiety. However, it is important to note that the outcomes and results of the first decision did not demand another intervention to be employed because Zoloft 50mg worked positively for the patient. The second decision would mean increasing the dosage to 75mg to be administered to be taken orally if some symptoms persisted and would have cleared some symptoms for good.

The Reason for Selecting the Decision

The reason for increasing the dosage from 50mg PO BID to 75mg, was to relieve the client of any other symptoms and to also reduce the HAM-A score and the weight issue. However, it is important to note that Zoloft 50mg had a positive impact on the client.

The Anticipated Results of the Second Decision

Zoloft 50mg significantly improved the patient’s symptoms such as the reduction of chest tightness and shortness of breath. If the dosage would have been increased to 75mg, it would have addressed any other complications and adjusted them to normal levels where the client would have functioned normally and reduced the risk of struggling with hypertensive conditions and heart attacks.

Differences in the Anticipated Results and the Real Initial Results of the Second Decision

The initial expectation was surpassed as after four weeks of taking Zoloft 75mg, the client reported worrying less about his work, and the issue of chest tightness and shortness of breath had been dealt with. Evidently, most of the symptoms had been eradicated with that dosage and the most shocking result was the HAM-A scale rating reducing from 18 to 10. Treating Patients with Anxiety Disorders Discussion Paper

Third Decision

The third decision is normally applied to very special cases and advanced levels of the condition. One of the ways that physicians use is to educate the client on the advantage of losing weight and on the need to be on the right diet while administering the same dosage.

The Reason for Selecting the Decision

In most cases, when the prescribed dosage does not positively influence the patient, there is always a need to change the medication and alter the dosages (Newman et al, 2022). However, there was no need to have a quantitative change in Zoloft 75mg administration as the condition is different since the other illnesses are not been treated by the current medication. This decision has been adopted to help the client understand the need to balance a healthy lifestyle and medication. Sometimes, the side effect of the drug is adding weight, hence the need to educate on diet and encourage the client to continue taking the medication despite the weight gain.

The Anticipated Results of the Third Decision

The anticipated result of this decision is to help the client achieve the desired weight and adopt healthy eating habits. This decision is important as it helps the client to avoid other conditions that may be a result of being overweight. Treating Patients with Anxiety Disorders Discussion Paper

The Differences in Expected Results and the Actual Initial Results of the Decision

PMHNP suggested that having a constant dosage of Zoloft may not be effective in helping the patient reduce weight. The patient must remain on the same dosage because alterations to it will mean the risk of gaining more weight which will place him at high risk of more side effects. The recommendation would be, that if the weight issue persists, another drug such as Polypharmacy will be advisable since the drug being used cannot address all the symptoms associated with anxiety disorder. The patient and the physician need to work together and make decisions together to come up with the appropriate remedy.

The Ethical Considerations in the Treatment Plana and Communication with Patients

The correct prescriptions for each level of disorder

When treating anxiety, this ethical consideration assists the physicians to administer the correct prescriptions to treat mild, moderate as well as severe conditions of anxiety disorder.

The proper administration

It is the role of pharmacists and physicians to ensure that they explain the dosage and instructions on how to take the medication to ensure that they do not abuse the drug (Newman et al, 2022). Instructions such as taking the drug with food are crucial for the patient to know and also advise on the risk of discontinuation without the doctor’s knowledge.

Alteration of the dosage

Altering the correct dosage for any disorder is deemed an ethical issue. Therefore, nurses ought to be careful when reducing dosages ensuring that it is reduced appropriately depending on the patient’s condition (Zemestani et al, 2021). Any alteration of medication should be communicated to the patient and the new instructions communicated to avoid abuse of the drug. Also, any alteration should be done in consultation with the patient’s doctor. Treating Patients with Anxiety Disorders Discussion Paper

Provision of Patient Education

Ensuring that the patient is aware of what they expect during and after the medication is crucial. Essentially, it helps the patient to know the side effects to watch out for so that they can communicate the same to the nurses. Also, the patients can understand the need to continue with a drug even if it is not desirable to them (Zemestani et al, 2021). Physicians and nurses need to know that patient education is a continuous process where they influence the behavior of a patient, and their attitudes and develop crucial skills in them that are crucial for improving health. Part of the education includes care management so that a patient can achieve wellness and health (Zemestani et al, 2021). Patients may also need to know who to contact in case of an emergency. Typically, when a patient does not have health literacy or the ability to comprehend and engage health information, they tend to experience negative health outcomes. Thus, the need for healthcare providers to ensure that they provide patient education as necessary.

References

Feldman, E., & Chung, K. (2021). Issues Relevant to Treating Patients with Anxiety Disorders in the Emergency Department. Emergency Medicine Reports, 42(13). https://www.proquest.com/openview/c68e281ef4a6dec04b25baac647cb066/1?pq-origsite=gscholar&cbl=2046460

Newman, M. G., Basterfield, C., Erickson, T. M., Caulley, E., Przeworski, A., & Llera, S. J. (2022). Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts. Expert Review of Neurotherapeutics, (just-accepted). https://doi.org/10.1080/14737175.2022.2125800 Treating Patients with Anxiety Disorders Discussion Paper

Zemestani, M., Beheshti, N., Rezaei, F., van der Heiden, C., & Kendall, P. C. (2021). Cognitive behavior therapy targeting intolerance of uncertainty versus selective serotonin reuptake inhibitor for generalized anxiety disorder: A randomized clinical trial. Behaviour Change, 38(4), 250-262

Case study:
https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6630/DT/week_05/index.html

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 patientâ€™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. Treating Patients with Anxiety Disorders Discussion Paper
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)

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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)

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. Treating Patients with Anxiety Disorders Discussion Paper