NURS 6630 characteristic of generalized anxiety disorder
Walden University NURS 6630 characteristic of generalized anxiety disorder-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6630 characteristic of generalized anxiety disorder assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NURS 6630 characteristic of generalized anxiety disorder
Whether one passes or fails an academic assignment such as the Walden University NURS 6630 characteristic of generalized anxiety disorder depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NURS 6630 characteristic of generalized anxiety disorder
The introduction for the Walden University NURS 6630 characteristic of generalized anxiety disorder is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NURS 6630 characteristic of generalized anxiety disorder
After the introduction, move into the main part of the NURS 6630 characteristic of generalized anxiety disorder assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6630 characteristic of generalized anxiety disorder
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6630 characteristic of generalized anxiety disorder
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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NURS 6630 characteristic of generalized anxiety disorder
The case highlights a 46-year-old white male presenting with chest tightness, shortness of breath and feeling of impending doom. The patient has a history of mild hypertension and tonsillectomy, which has been accompanied by unremarkable medical history. The patient cites occasional shortness of breath, chest tightness, feelings of impending doom and the need to ‘escape’ or ‘run’ from one place. He confesses using ETOH to combat worries about work since the management at his place of work is harsh, and he fears for his job. The patient’s symptoms are characteristic of generalized anxiety disorder.
Anxiety can be a normal part of life, with concerns such as health, family challenges and money temporarily dominating individual experiences. Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder characterized by nightmares, flashbacks, and intrusive thinking related to catastrophic events in an individual’s life (Ostacher & Cifu, 2019). Exposure to traumatic and terrifying events triggers PTSD. It is a potentially debilitating condition that affects direct victims or witnesses of traumatic events such as accidents, natural disasters, loss of loved ones, violent assaults like rape, war and other life-threatening events. The events can trigger an obsessive, recurrent and repetitive behavior that increases the feeling of fear, worry, helplessness, and hopelessness (Ostacher & Cifu, 2019). Nightmares, intrusive memories and flashbacks are common in individuals with past traumatic experiences increasing the risk of panic disorders.
Generalized anxiety disorders are common in adults with PTSD manifestations evident several months after the exposure to the traumatic and terrifying event. The symptoms of the anxiety disorders can be detrimental, although they subside, reducing the struggle with coping and self-care.
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.
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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.
Note: 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.
Sample Answer for NURS 6630 characteristic of generalized anxiety disorder
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 substance 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.
Case Overview
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.
The patient factors that may influence medication prescribing include age, the severity of the patient’s GAD, treatment preferences, current medical condition and medications, and previous medication trials (DeMartini et al., 2019). The clinician needs to consider the patient’s current hypertension and overweight and prescribe a drug that will not aggravate the conditions.
Decision #1
Start Zoloft 50 mg orally daily.
Why I Selected This Decision
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.
Why I Did Not Select the Other Options
Imipramine was not an ideal choice because it is a 2nd 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).
What I Was Hoping To Achieve
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.
How Ethical Considerations May Impact the Treatment Plan
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.
Decision #2
Increase Zoloft to 75 mg daily.
Why I Selected This Decision
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’s side effects adequately.
Why I Did Not Select the Other Options
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).
What I Was Hoping To Achieve
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.
How Ethical Considerations May Impact the Treatment Plan
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.
Decision #3
Maintain the current dose.
Why I Selected This Decision
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).
Why I Did Not Select the Other Options
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.
What I Was Hoping To Achieve
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.
How Ethical Considerations May Impact the Treatment Plan
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).
Conclusion
The specific patient factors that may influence decisions on medication in the above patient include age, the severity of GAD, patient’s 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’s 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.
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’s decisions when developing the treatment plan.
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References
Bipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care. Indian journal of psychological medicine, 41(2), 108–112. https://doi.org/10.4103/IJPSYM.IJPSYM_59_19
DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder. Annals of internal medicine, 170(7), ITC49–ITC64. https://doi.org/10.7326/AITC201904020
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. Frontiers in psychiatry, 1412. https://doi.org/10.1176/appi.focus.19203
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. Journal of psychiatric research, 118, 21-30. https://doi.org/10.1016/j.jpsychires.2019.08.009
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. Expert opinion on pharmacotherapy, 19(10), 1057–1070. https://doi.org/10.1080/14656566.2018.1491966
Sample Answer 2 for NURS 6630 characteristic of generalized anxiety disorder
Anxiety disorder is defined as a mental health condition that causes repeated feelings of intense fear and anxiety. Anxiety disorders are caused by factors such as heredity, environmental factors, and chemical imbalances. The general symptoms include obsessive thoughts, nightmares, rapid heartbeat, sweating, and shortness of breath. The different types of anxiety disorders include post-traumatic stress disorder, obsessive-compulsive disorder, social phobia, panic disorder, and generalized anxiety disorder. Treatments include medications and psychotherapy. The paper aims to address genetics of anxiety disorders, cognitive-behavioral, and somatic therapies.
Genetics of Anxiety Disorders
Anxiety disorders are inheritable and can be transmitted from parents to children. Studies have indicated that this can partly (30-40%) be ascribed to genetic markers (Meier & Deckert, 2019). The risk in first-degree of patients who are related to suffer from the disorder is about four to five per cent higher in relation to patients with healthy control subjects (Gottschalk & Domschke, 2017). However, in these studies, the role of genetic influence against the effect of family environment is unclear and elusive. In contrast to monogenic traits, anxiety disorders are not caused by mutation of a single gene.
Cognitive Behavioural Therapy
Cognitive-behavioral therapy is viewed as the most effective method to treat anxiety disorders (Kodal et al., 2018). Most patients with these conditions tend to have negative thinking patterns and irrational beliefs, which lead to negative emotions of fear and anxiety. Thus, cognitive behavioral therapy aims to identify and replace these distorted and worrisome thoughts with more realistic views and thereby correcting the problematic behaviours (Suveg, et al., 2018). The principle behind the therapy is that if you change the way you think (not external situations), you can easily change how you look at yourself and the world.
Somatic Therapy
Somatic therapy focuses on regulating the nervous system in the treatment of anxiety disorder (Crawford et al., 2019). The therapies depends on the sensations in the body instead of thoughts and feelings. The sensations activate the defensive mechanism of the body to protect itself during stress. In this approach, the therapists help their patients engage their bodies’ innate ability to bounce back from fear and anxiety. The therapies are more impactful with the treatment of post-trauma disorders. Some known somatic approaches include sensorimotor psychotherapy, reprocessing, and somatic experiencing (Newby et al., 2018).
Conclusion
Anxiety disorders are moderately inheritable. Persons whose parents have previously suffered from the condition are more likely to inherit the disease. Cognitive-behavioral therapy and somatic therapies are some of the known approaches used to treat anxiety disorder. However, cognitive-behavioral therapy is the most widely used form of treatment.
References
Crawford, E. A., Burke, T. A., Siegel, D., Jager‐Hyman, S., Alloy, L. B., & Kendall, P. C. (2019). Somatic symptoms of anxiety and suicide ideation among treatment‐seeking youth with anxiety disorders. Suicide and Life‐Threatening Behavior, 49(3), 811-825. Doi: 10.1111/sltb.12479
Gottschalk, M. G., & Domschke, K. (2017). Genetics of generalized anxiety disorder and related traits. Dialogues in clinical neuroscience, 19(2), 159. Doi: 10.31887/DCNS.2017.19.2/kdomschke
Kaplan, J., & Sadock, M. D. (2003). Comprehensive textbook of psychiatry. on CD-ROM. Tijdschrift voor Psychiatrie, 45, 12-22. Doi: 10.22034/SSYJ.2020.678775
Kodal, A., Fjermestad, K., Bjelland, I., Gjestad, R., Öst, L. G., Bjaastad, J. F., & Wergeland, G. J. (2018). Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. Journal of anxiety disorders, 53, 58-67. 10.1016/j.janxdis.2017.11.003
Meier, S. M., & Deckert, J. (2019). Genetics of anxiety disorders. Current psychiatry reports, 21(3), 1-8. Doi: 10.1007/s11920-019-1002-7
Newby, J. M., Smith, J., Uppal, S., Mason, E., Mahoney, A. E., & Andrews, G. (2018). Internet-based cognitive behavioral therapy versus psychoeducation control for illness anxiety disorder and somatic symptom disorder: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 86(1), 89. Doi: 10.1037/ccp0000248
Suveg, C., Jones, A., Davis, M., Jacob, M. L., Morelen, D., Thomassin, K., & Whitehead, M. (2018). Emotion-focused cognitive-behavioral therapy for youth with anxiety disorders: A randomized trial. Journal of abnormal child psychology, 46(3), 569-580. Doi: 10.1007/s10802-017-0319-0