Generalized anxiety disorder

Please see attached

Examine
Case Study:

The client is a 46-year-old white male who works as a welder at a local steel fabrication factory. He presents today after being referred by his PCP after a trip to the emergency room in which he felt he was having a heart attack. He stated that he felt chest tightness, shortness of breath, and feeling of impending doom. He does have some mild hypertension (which is treated with low sodium diet) and is about 15 lbs. overweight. He had his tonsils removed when he was 8 years old, but his medical history since that time has been unremarkable. Myocardial infarction was ruled out in the ER and his EKG was normal. The remainder of the physical exam was WNL.

He admits that he still has problems with tightness in the chest and episodes of shortness of breath- he now terms these “anxiety attacks.” He will also report occasional feelings of impending doom, and the need to “run” or “escape” from wherever he is at.

In your office, he confesses to occasional use of ETOH to combat worries about work. He admits to consuming about 3-4 beers/night. Although he is single, he is attempting to care for aging parents in his home. He reports that the management at his place of employment is harsh, and he fears for his job. You administer the HAM-A, which yields a score of 26.

The client has never been on any type of psychotropic medication. Diagnosis is Generalized anxiety disorder.

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. Please see the decisions I made below:

Decision Point One begin buspirone 10mg orally twice a day Buspirone 10 mg orally BID

RESULTS OF DECISION POINT ONE

·
Client returns to clinic in four weeks

·
Client reports slight decrease in symptoms

·
Client states that he still feels very anxious

·
HAM-A score decreased from 26 to 23

Decision Point Two

Discontinue buspirone and begin Lexapro 10 mg orally daily

RESULTS OF DECISION POINT TWO

·
Client returns to clinic in four weeks

·
Client reports that he feels “great”

·
Client states that his anxiety is getting “better”

·
HAM-A score has decreased from 23 to 13

·
Client does report that he sometimes feels sleepy for a few hours after taking the medication, but “perks up” by early to midafternoon

Decision Point Three

Continue same dose of Lexapro but change administration time to bedtime

Guidance and feedback to Student
At this point, the client reports that he is feeling “great” with a decrease in symptoms from an initial HAM-A score of 26 down to 13. This represents a 50% decrease in symptoms in just 4 weeks. Recall that an adequate trial can be as long as 12 weeks, we may not need to increase the drug any more at this point as we do not know how much more the current dose will improve the client’s symptoms. You could increase the dose, but this could increase the risk of side effects- especially the sleepiness that the client is complaining about in the morning after taking the medication. It is plausible that an increase in the dose would increase morning sedation.
The most prudent course of action would be to continue the same dose of medication but change the administration time to bedtime. This way, the client will not be troubled by the sedating effects of the medication, and sleep may be enhanced which could also improve overall anxiety.

Based on the information above, please answer questions below. 5 pages required.

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 make 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 (which are paxil 10mg orally daily and imipramine 25mg orally twice a day) 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 (which are increase busiprone to 10mg twice a day or 10mg three times a day) 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 (which are increase Lexapro to 15mg by mouth daily in the morning and restart Buspar to 10mg by mouth three times a day) 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.

Calculate the price of your order

Select your paper details and see how much our professional writing services will cost.

We`ll send you the first draft for approval by at
Price: $36
  • Freebies
  • Format
  • Formatting (MLA, APA, Chicago, custom, etc.)
  • Title page & bibliography
  • 24/7 customer support
  • Amendments to your paper when they are needed
  • Chat with your writer
  • 275 word/double-spaced page
  • 12 point Arial/Times New Roman
  • Double, single, and custom spacing
  • We care about originality

    Our custom human-written papers from top essay writers are always free from plagiarism.

  • We protect your privacy

    Your data and payment info stay secured every time you get our help from an essay writer.

  • You control your money

    Your money is safe with us. If your plans change, you can get it sent back to your card.

How it works

  1. 1
    You give us the details
    Complete a brief order form to tell us what kind of paper you need.
  2. 2
    We find you a top writer
    One of the best experts in your discipline starts working on your essay.
  3. 3
    You get the paper done
    Enjoy writing that meets your demands and high academic standards!

Samples from our advanced writers

Check out some essay pieces from our best essay writers before your place an order. They will help you better understand what our service can do for you.

  • Analysis (any type)
    Advantages and Disadvantages of Lowering the Voting Age to Thirteen
    Undergrad. (yrs 1-2)
    Political science
    APA
  • Coursework
    Leadership
    Undergrad. (yrs 1-2)
    Business Studies
    APA
  • Essay (any type)
    Is Pardoning Criminals Acceptable?
    Undergrad. (yrs 1-2)
    Criminal Justice
    MLA

Get your own paper from top experts

Order now

Perks of our essay writing service

We offer more than just hand-crafted papers customized for you. Here are more of our greatest perks.

  • Swift delivery
    Our writing service can deliver your short and urgent papers in just 4 hours!
  • Professional touch
    We find you a pro writer who knows all the ins and outs of your subject.
  • Easy order placing/tracking
    Create a new order and check on its progress at any time in your dashboard.
  • Help with any kind of paper
    Need a PhD thesis, research project, or a two-page essay? For you, we can do it all.
  • Experts in 80+ subjects
    Our pro writers can help you with anything, from nursing to business studies.
  • Calculations and code
    We also do math, write code, and solve problems in 30+ STEM disciplines.

Frequently asked questions

Get instant answers to the questions that students ask most often.

See full FAQ
  • Is there a possibility of plagiarism in my completed order?

    We complete each paper from scratch, and in order to make you feel safe regarding its authenticity, we check our content for plagiarism before its delivery. To do that, we use our in-house software, which can find not only copy-pasted fragments, but even paraphrased pieces of text. Unlike popular plagiarism-detection systems, which are used by most universities (e.g. Turnitin.com), we do not report to any public databases—therefore, such checking is safe.

    We provide a plagiarism-free guarantee that ensures your paper is always checked for its uniqueness. Please note that it is possible for a writing company to guarantee an absence of plagiarism against open Internet sources and a number of certain databases, but there is no technology (except for turnitin.com itself) that could guarantee no plagiarism against all sources that are indexed by turnitin. If you want to be 100% sure of your paper’s originality, we suggest you check it using the WriteCheck service from turnitin.com and send us the report.

  • I received some comments from my teacher. Can you help me with them?

    Yes. You can have a free revision during 7 days after you’ve approved the paper. To apply for a free revision, please press the revision request button on your personal order page. You can also apply for another writer to make a revision of your paper, but in such a case, we can ask you for an additional 12 hours, as we might need some time to find another writer to work on your order.

    After the 7-day period, free revisions become unavailable, and we will be able to propose only the paid option of a minor or major revision of your paper. These options are mentioned on your personal order page.

  • How will I receive a completed paper?

    You will get the first version of your paper in a non-editable PDF format within the deadline. You are welcome to check it and inform us if any changes are needed. If everything is okay, and no amendments are necessary, you can approve the order and download the .doc file. If there are any issues you want to change, you can apply for a free revision and the writer will amend the paper according to your instructions. If there happen to be any problems with downloading your paper, please contact our support team.
  • Where do I upload files?

    When you submit your first order, you get a personal account where you can track all your orders, their statuses, your payments, and discounts. Among other options, you will have a possibility to communicate with your writer via a special messenger. You will be able to upload all information and additional materials on your paper using the “Files” tab on your personal page. Please consider uploading everything you find necessary for our writer to perform at the highest standard.
See full FAQ

Take your studies to the next level with our experienced specialists

Live Chat+1 (857) 777-1210 EmailWhatsApp