Decision Making When Treating Psychological Disorders

Discussion: Decision Making When Treating Psychological Disorders Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders. For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. Decision Making When Treating Psychological Disorders . You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology. To Prepare Review this week’s interactive media pieces and select one to focus on for this Discussion. Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology. *** (1-2 Pages) Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples. References http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_05/index.html https://www.youtube.com/watch?v=4ZHudeMho8g&t=24s

Introduction

Psychological disorders are classified differently including mood disorders such as anxiety, eating disorders, personal disorders, psychotic disorders and sexual disorders. People suffering from Generalised Anxiety Disorder (GAD) experience persistent and excessive worry about certain things such as health, money or family that are major concerns in the person’s life and fear of a disaster emanating affecting them. According to statistics, the condition affects women twice as much and affects 6.8 million adults in the U.S(ADAA, 2021). annually. The exact cause of GAD is unknown but things such as family backgrounds and stressful situations are evident causes.Decision Making When Treating Psychological Disorders

Case Study

The patient is a 46 year white male who works as a welder and is single. Presented to the ER where he felt like he was having a heart attack. Complains included chest tightness, shortness of breath and feeling of impending doom. Prior diagnosed with mild hypertension that is kept in control with a low-sodium diet, overweight, tonsils that were treated. Myocardial infarction ruled out by normal ER and EKG results. On being brought still has chest tightness, anxiety attacks, occasional feeling of impending doom and fear and flight feelings. The patient also consumes 3-4 beers per night to get rid of his worries due to his harsh employment. The HAM-A score is 26 and diagnosed with Generalised Anxiety Disorder. Client has never been under psychotropic medication prior (Psychopharmacologic Approaches to Treatment of Psychopathology, n.d.).

Decision Point 1:Begin Buspirone 10 mg orally BID

Buspirone is a good drug of choice in this case due to its minimal effects of sedation that are experienced due to the patient’s daily duties and his ETOH behaviour. The drug does not also have withdrawal effects experienced with barbiturates and Benzodiazepines. The drug acts by having a strong affinity to serotonin 5HT1a receptors acting as a partial agonist bringing out its clinical effects(Wilson & Tripp, 2020). After 4 weeks the patient was to return to the clinic where his HAM-A score decreased from 26 to 23. He acknowledged that his symptoms decreased but still felt very anxious. This is because Buspirone takes its effects slowly and go detected after 2-4 weeks and may have adverse effects of the anxiety increasing.Decision Making When Treating Psychological Disorders

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Decision Point 2: Increase Buspirone intake to 10mg orally TID

This decision is seen as the client has been able to have relieve from some of his symptoms and since the drug acts within a long period, explanation to the patient that the anxiety is just an effect of the action of drug is advised. However after visiting for clinic after four weeks, Burispone did not show any significant effect in decreasing patient’s anxiety. The HAM-A score was only reduced from 23-22. This showed that even though it had a small therapeutic effect and an increase in dosage with Burispone, the anxiety was not eliminated.

Decision Point 3: Discontinue Burispone and start Zoloft 50mg taken orally daily

Due to Burispone having less than 25% change in the HAM-A score of the patient, the drug is discontinued to take Zoloft, which is a first line SSRI. SSRI’s work by serotonin which is an important neurotransmitter playing a role in feelings of well-beings, happiness, thinking well, having good digestion and circulation, and having good sleep(Gomez et al., 2020). Zoloft is also not addictive and due to the patient needing long-term care is a good choice of drug to avoid withdrawal after care.

Conclusion

Generalised Anxiety Disorder although affects a person’s ability to live a normal life, drugs can be used such as Benzodiazepines, Barbiturates, SSRI’s, and Burispone. The decision on treating the condition with the right drug depends on the age of the patient, its adverse effects, and the personal life of the patient. In this case, due to the patient’s harsh working condition, a drug with minimal effect would be good such as Burispone and SSRI which have no withdrawal symptoms.Decision Making When Treating Psychological Disorders

References

ADAA. (2021). Generalized Anxiety Disorder (GAD) | Anxiety and Depression Association of America, ADAA. https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad

Gomez, A., MA, & Hofmann, S. (2020). SSRIs and Benzodiazepines for General Anxiety Disorders (GAD). https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/ssris-and-benzodiazepines-general-anxiety

Psychopharmacologic Approaches to Treatment of Psychopathology. (n.d.). Retrieved 17 January 2021, from http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_05/3.html

Wilson, T. K., & Tripp, J. (2020). Buspirone. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK531477/. Decision Making When Treating Psychological Disorders