Create a response to the post by Erin

Reference no: EM132405721 , Length: word count:300

Assignment -

Create a response to the post below by Erin. Using APA style and a minimum of 1 page

Discussion Post by Erin: I would begin my focused assessment by listening to the patient's heart, to rule out any abnormalities with rate or rhythm and check the patient's blood pressure. Then I would use the PRIME-MD screening tool for anxiety, which consists of a provider portion and a self-evaluation questionnaire for the patient with twenty-five "yes" or "no" questions to complete. I would want to know how long these symptoms had been occurring. In order to make a generalized anxiety disorder diagnosis, the symptoms must be present for at least six months. I would ask the patient to provide more details of each symptom she is experiencing, any medications (OTC, prescription, herbal tinctures/ supplements) she may be on, if she has a drug abuse disorder, a history of depression, what her regular diet is, and what her sleep hygiene regimen is currently (Dunphy, 2019).

Differential diagnoses could be heart disease, hyperthyroidism, caffeine intoxication, substance abuse, hypnotic withdrawal, and anxiolytic. Suicide risk/ do they have a plan, is an important assessment that must be addressed. (Dunphy, 2019).

Medical testing required for this patient would be CBC, CMP, EKG, and thyroid panel to rule out underlying physiological health issues that could be causing symptoms of anxiety (Dunphy, 2019).

Management of a patient with anxiety begins with education of combination therapy: medication and counseling. The treatment focus should be on self-awareness and relaxation techniques, which are effective coping tools for halting an anxiety attack before it gets out of control. Ideally, the goal of treatment should be allowing the patient to return to activities of daily living without being consumed or constantly distracted by anxious thoughts. Lexapro or Effexor may be suitable for this patient depending on the details of the patient's HPI. Response to medications should be evaluated eight weeks after treatment. Cognitive-behavioral therapy would be useful for this patient and have been proven as effective as SSRIs but without the side effects (Dunphy, 2019).

If the patient has begun medication (Lexapro), then a follow-up appointment should be scheduled for two weeks after the initial appointment and prescription. Appointments thereafter should be scheduled every two to four weeks until a therapeutic dose is reached. Patient education includes not stopping an SSRI abruptly and the importance of relaxation techniques that allow them to manage oncoming attacks. (Dunphy, 2019). The patient should also be educated on anxiety symptoms and how they can feel extremely scary at times. Also taking the time to help them differentiate between anxiety symptoms and other serious medical issues, such as an MI. Encouraging counseling in tandem with medication will be most effective for patients.

Dunphy, L. M. (2019). Primary Care: Art and Science of Advanced Practice Nursing - an Interprofessional Approach, DavisEdge. [VitalSource Bookshelf]. Need 300 words.

Reference no: EM132405721

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