course material

1. Week 6 assign 6630 nurs | NURS 6630 – Psychopharmacologic Approaches
to Treatment of Psychopathology | Walden University
Assignment: Assessing and Treating Patients With Anxiety DisordersCommon 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 pagesExamine 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.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

2. 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.Reminder : The
College of Nursing requires that all papers submitted include a title page, introduction,
summary, and references. The Sample Paper provided at the Walden Writing Center
provides an example of those required elements (available at
https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-
20293632). All papers submitted must use this formatting.CASE STUDYBACKGROUND
INFORMATIONThe 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.
Remainder of 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.Client has never been on any type of psychotropic medication.MENTAL
STATUS EXAMThe client is alert, oriented to person, place, time, and event. He is
appropriately dressed. Speech is clear, coherent, and goal-directed. Client’s self-reported
mood is “bleh” and he does endorse feeling “nervous”. Affect is somewhat blunted, but does
brighten several times throughout the clinical interview. Affect broad. Client denies visual

3. or auditory hallucinations, no overt delusional or paranoid thought processes readily
apparent. Judgment is grossly intact, as is insight. He denies suicidal or homicidal
ideation.You administer the Hamilton Anxiety Rating Scale (HAM-A) which yields a score of
26.Diagnosis: Generalized anxiety disorderRESOURCES§ Hamilton, M. (1959). Hamilton
Anxiety Rating Scale. Psyctests, doi:10.1037/t02824-0XLearning ResourcesRequired
Readings (click to expand/reduce)Bui, E., Pollack, M. H., Kinrys, G., Delong, H., Vasconcelos e
Sá, D., & Simon, N. M. (2016). The pharmacotherapy of anxiety disorders. In T. A. Stern, M.
Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital
psychopharmacology and neurotherapeutics (pp. 61–71). Elsevier.American Psychiatric
Association. (2010a). Practice guideline for the treatment of patients with acute stress
disorder and posttraumatic stress disorder.
https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acut
estressdisorderptsd.pdfAmerican Psychiatric Association. (2010c). Practice guideline for
the treatment of patients with panic disorder (2nd ed.).
https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/pani
cdisorder.pdfBendek, D. M., Friedman, M. J., Zatzick, D., & Ursano, R. J. (n.d.). Guideline watch
(March 2009): Practice guideline for the treatment of patients with acute stress disorder
and posttraumatic stress disorder.
https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acut
estressdisorderptsd-watch.pdfCohen, J. A. (2010). Practice parameter for the assessment
and treatment of children and adolescents with posttraumatic stress disorder. Journal of the
American Academy of Child and Adolescent Psychiatry, 49(4), 414–430.
https://jaacap.org/action/showPdf?pii=S0890-8567%2810%2900082-1Davidson, J.
(2016). Pharmacotherapy of post-traumatic stress disorder: Going beyond the guidelines.
British Journal of Psychiatry, 2(6), e16–e18. 10.1192/bjpo.bp.116.003707.
http://bjpo.rcpsych.org/content/2/6/e16Hamilton, M. (1959). Hamilton Anxiety Rating
Scale (HAM-A). PsycTESTS. https://doi.org/10.1037/t02824-0Ostacher, M. J., & Cifu, A. S.
(2019). Management of posttraumatic stress disorder. JAMA, 321(2), 200–201.
https://doi.org/10.1001/jama.2018.19290Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn,
M. A., & Strakowski. S. (2012). Establishing the neurobiologic basis of treatment in children
and adolescents with generalized anxiety disorder. Depression and Anxiety, 29(4), 328–
339. https://doi.org/10.1002/da.21913Medication Resources (click to expand/reduce)IBM
Corporation. (2020). IBM
Micromedex.https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkacc
ess?source=deepLink&institution=SZMC%5ESZMC%5ET43537Note: To access the
following medications, use the IBM Micromedex resource. Type the name of each
medication in the keyword search bar. Be sure to read all sections on the left navigation bar
related to each medication’s result page as this information will be helpful for your review
in preparation for your Assignments.Review the following
medications:benzodiazepinescitalopramdesvenlafaxineduloxetineescitalopramfluoxetinepa
roxetinesertralinevenlafaxinevilazodonevortioxetinepropranololprazosinRequired Media
(click to expand/reduce)Case Study: A Middle-aged Caucasian Man with Anxiety Note: This

4. case study will serve as the foundation for this week’s Assignment.6 RESOURCES FROM
SCHOOL RESOURCES