Photo Credit: Getty Images/iStockphotoGeneralized Anxiety Disorder is a psychological condition that affects 6.1 million Americans, or 3.1% of the US Population. Despite several treatment options, only 43.2% of those suffering from GAD receive treatment. This week you will review several different classes of medication used in the treatment of Generalized Anxiety Disorder. You will examine potential impacts of pharmacotherapeutics used in the treatment of GAD. Please focus your assignment on FDA approved indications when referring to different medication classes used in the treatment of GAD.
To PrepareReview the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history with GAD.
By Day 3 of Week 8Post a discussion of pharmacokinetics and pharmacodynamics related to anxiolytic medications used to treat GAD. In your discussion, utilizing the discussion highlights, compare and contrast different treatment options that can be used.
By Day 6 of Week 8Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients diagnosed with GAD. In addition, suggest different treatment options you would suggest to treat a patient with the topic of discussion.
female with and painThis week, complete the Aquifer case titled Family Medicine 20: 28-year-old female with abdominal pain.
After completing your Aquifer Case Study, answer the following questions using the latest evidenced based guidelines:
Discuss the questions that would be important to include when interviewing a patient with this issue.• Describe the clinical findings that may be present in a patient with this issue.• Are there any diagnostic studies that should be ordered on this patient? Why?• List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.• Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.
You introduce yourself to Ms. Bell and her 4-year-old son, Cooper, who is accompanying her. Cooper is seated on Ms. Bell’s lap and is trying to hide his face in his mom’s jacket. Both the patient and son are neatly dressed, well nourished, and in no apparent physical distress.You begin to take a history of the present illness:”The nurse has written in your chart that you have been having some pain in your lower abdomen. Can you tell me more about this?”Ms. Bell states, “Yes, the pain started to get pretty bad about two weeks ago. I have probably been having pain for the past month or so, off and on. The pains feel sore, achy, and crampy. Anyway, I missed some days at work because of these pains, whatever they are, and now I need a work slip in order to go back.””Does the pain seem to stay in the lower part of your abdomen, or does it move anywhere else?””No, it seems to stay in the lower part.””How bad would you say your pain is, on a scale of 1–10, with 10 being the worst pain you can imagine?”She answers, “It’s usually about 3 out of 10. But it can be worse, maybe up to a 5, but when it gets that bad it only lasts for a few seconds.””What makes the pain better or worse?””Being still helps.But the pain can just come and go on its own. Moving around, like walking or exercise, seems to make the pain worse. I can’t seem to make sense of it all. Sometimes when my husband and I have relations, you know, sex, or even when I just do mild exercise, the lower part hurts. Maybe it’s just sore muscles from my starting back with trying to exercise.””Does the pain come at any particular time of day?””No, not really.””Do you get the pain during the night? Does it wake you up from sleep or prevent you from going to sleep?””No. I sleep okay most of the time. My son occasionally wakes up at night with bad dreams, so I get up with him for a while, but I don’t think the pain wakes me up.””Did anything happen a month ago when these pains started?””No, not really, although I have been under some extra stress, I guess, but that has been for longer than a month.”Pain scaleWhen you ask her about associated symptoms, she notes occasional nausea, vomiting, loose stools, and constipation. She adds that the changes in her bowel movements come and go; between times, her bowel movements are normal. Upon further questioning, she tells you that her stools are a normal brown color, not bloody or black. She also informs you that she had a mild temperature elevation about a week and a half ago. She did not know what caused that.She has medicated the abdominal pain with two 200 mg tablets of over-the-counter ibuprofen a few times over the past couple of weeks but, “They really didn’t do anything much for the pain.” She reports not taking any regular medications, vitamins, or supplements. She’s never had an allergic reaction to any medicines.
Dr. Nayar has suggested that you do the talking and discuss your assessment and plans with the patient.You say: “First of all, we would like to treat your trichomonas infection with an antibiotic, metronidazole. It is important that you and your husband both take these pills, but he cannot drink any alcohol while the medicine is in his system. Beyond this, Dr. Nayar and I have talked about the things we have heard you say today. We have discussed ways that we think might be helpful to you, but now we want to discuss these options with you. We believe that you are at high risk of your husband hurting you again when you return home because of the violence that has already occurred, the fact that he drinks, and the presence of a gun in your home.We know that you are in the best position to assess your levels of danger, so if you decide to return home, we respect your decision. We are not here to make decisions for you, but to facilitate your ability to think through alternatives and seek an acceptable course of action for yourself and your child.”Dr. Nayar adds, “No one, including you, deserves to be injured by their partner.”She responds, “I think things will be better, I don’t think he’ll hurt me or Cooper.””All right,” you acknowledge. “If you decide to go home, we support your decision, but we want you to know that you are not alone. We are concerned that it might not be safe for you to make phone calls to support agencies from your home. I have the phone number to a shelter that I want to give you today so that you can call and talk to the counselor there. We have a quiet room where you can be by yourself so that you can speak with this counselor today if you would like. We can have the staff member continue playing with Cooper while you are talking on the phone. We don’t want your husband coming home, checking the phone, and finding that you have been calling around to various shelters.””Well, it is true that my husband would find out if I was calling these numbers from home. He checks the computer at home to see what websites I’ve looked at. He checks the cell phone log to see my outgoing calls. And, after he has been drinking, he even checks *69 on the home phone to see who has called me. But I don’t want to go to a shelter,” she says.
Case Study: A 25-year-old presented to the labor and delivery unit with complaints of uterine cramping and lower backNursing Assignment Help Case Study: A 25-year-old presented to the labor and delivery unit with complaints of uterine cramping and lower back pain. The client denied any vaginal bleeding and had a history of preterm birth at 32 weeks (about 7 and a half months) gestation with her last pregnancy. The baby from that pregnancy is three years old has no developmental issues. The client’s gestational age is 30 weeks (about 7 months). She is O , and all other lab values are normal. No evidence of sexually transmitted infections (STI’s).
(Group Beta Strep is missing from the labs and most often is obtained at 35 – 37 weeks (about 8 and a half months) gestation. Without this information, it is often determined to treat the patient anyway, to protect a premature baby from the risk.)
1. What additional information should the nurse obtain from the client?
2. What nursing intervention is most appropriate in this situation?
3. What screening tests should be obtained to determine the risk for preterm labor?
4. If the client is in preterm labor, what medications would the nurse expect to be ordered, and what are the priorities for the nurse to assess post-administration? (Include dose, side effects and expected outcomes of the medication).
Read National Council of State Boards of Nursing.Read National Council of State Boards of Nursing. Nursing Pathways for Patient Safety 1st ed. St. Louis: MO: Elsevier Saunders. 9780323065177. · Chapter 1 Pages 1-29
Research the Institute of Medicine Competencies http://qsen.org/competencydomains/teamwork-and-col…
Select and discuss one of the 5 QSEN(Quality and Safety Education for Nurses competencies;)
Minimum: 300 words minimum and 500 words maximum excluding bibliography
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