Unit 7 Discussion 1 - Anxiety

Unit 7 Discussion 1 - Anxiety Discussion: Unit 7, Due Wednesday by 11:59 pm CT Anxiety Instructions: It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format. Classroom Participation Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren't just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature. All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation. Discussion Prompt Scenario:  A 32-year-old white female is in the ofÏce today with a chief complaint "I have to force myself to go to work and other than that I don't want to leave my house."         She reports that last week she tried to go to a Pampered Chef party one of her coworkers was having and she only got about three blocks from her house and had to turn around and go back home. She admits that being anxious is not new for her but feels as though lately those feelings are negatively impacting her life. Her medical history is inclusive for a diagnosis of psoriasis. She is married and has a 4-year-old son. She is presently on no routine medications. She takes an over-thecounter B-50 vitamin to help her manage stress associated with marital strife and childcare challenges secondary to her work schedule. Her last menstrual period was two weeks ago. BP 100/58, P 66, R 18 Large raised silvery-white scaly patch noted posterior occipital region of scalp; no thyroid enlargement or tenderness with palpation; heart -regular rate and rhythm; lungs are clear to auscultation Subjective (S): The patient is a 32-year-old white female who is here for an office visit with a chief complaint. "I have to force myself to go to work, and other than that, I do not want to leave my house." The patient reports that she is unable to attend parties due to anxiety about being away from her home and feels compelled to turn around and go home. The patient says she has had issues with anxiety, but lately, these feelings are negatively impacting her life. The patients only pre-existing condition is psoriasis. She is married and has a 4-year old son. She is on no routine medications except for and over-the-counter B12 vitamin for stress management from marital strife and childcare challenges secondary to her work schedule. Her last menstrual period was two weeks ago. Objective (O): BP 100/58, P 66, R 18. During physical assessment, regular heart rate and rhythm. Lungs are clear bilaterally on auscultation. No thyroid enlargement or tenderness with palpation, noted a large raised silvery-white scaly patch noted on the occipital region of the scalp. Plan (P): Most importantly, I need to address the patients' generalized anxiety. I would also recommend starting her on something for her psoriasis since she has never taken any medication to manage that disorder. Therapeutics: For the patients generalized anxiety, I would recommend a selective serotonin reuptake inhibitor (SSRIs) such as Paxil. In older patients who suffer from depression, it is essential to address their depression because the use of an antidepressant tends to enhance nourishment and purpose and to helps to reduce symptoms of discomfort and sleep disturbances. (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Selective serotonin reuptake inhibitors have the benefit of taking it daily and less adverse effects than tricyclic antidepressants. (Arcangelo et al., 2017). She can start Zoloft at 50mg/daily. (Arcangelo et al., 2017). Since she does not take any other medications, she can continue the use of her B-12 without the risk of any side effects. (Rxlist, 2020). I would write a prescription of Calcipotriene (Davonex), which is a topical Vitamin D ointment for the relief of mild psoriasis treatment. (Arcangelo et al., 2017). A small amount is applied two times a day to the affected area for about 6 to 8 weeks. (Arcangelo et al., 2017). Education: The patient and her family should be educated on the potential problems with depression and medication therapy. (Arcangelo et al., 2017). The patient and family need to know that it will take 4 to 6 weeks for the medication to be active, and the patient needs to continue taking the medication as prescribed. (Arcangelo et al., 2017). I will recommend a support group for her. Group therapy can be beneficial in helping to deal with anxiety disorders. (Arcangelo et al., 2017). The treatment of her anxiety can also help to lessen the flare-ups of her psoriasis since stress can cause an exacerbation. (Arcangelo et al., 2017). Consultation: I would refer this patient to a psychologist to continue her mediation therapy for her anxiety disorder. I feel it is also a good idea for her to have an appointment with a dermatologist to help manage her psoriasis.