I’m working on a nursing discussion question and need support to help me understand better.
The patient is too young to undergo such traumatic events that make her inefficient in the workplace due to feeling restless and on her past nine months.
·The suitable treatment goals for the patient can be psychotherapy for generalized anxiety disorder.
·Similarly, the patient can also opt for cognitive behavior therapy; it is also an effective GAD intervention (Michopoulos et al., 2017). The intervention will help the patient resume her daily activities and reduce GAD symptoms, making L.P competent at the workplace.
What drug therapy would you prescribe? Why?
Firstline therapy has different drugs for treating anxiety, such as SSRIs and tricyclic antidepressants(TCAs). Under second-line intervention, the patient can use Pregabalin (Lyrica) and quetiapine(Seroquel). It is because SSRI medications are effective for reducing the frequency and intensity of anxiety. They also relieve the fear that is linked to GAD. Moreover, the tricyclic antidepressants(TCAs) and their effectiveness exhibit in two weeks. They treat behavior-related issues of a patient, and they have fewer side effects. TCAs are known for their efficacy in not causing Emotional blunting (Michopoulos et al., 2017). It is significant to note that Pregabalin decreases GAD’s severity and issue with sleep disturbance as exhibited by Patient L.P. And Seroquel is the most recommendable for treating GAD. The research conducted in 2016 by WHO also proved the same.
What are the parameters for monitoring the success of the therapy?
Evaluation of the drug therapies to see if they are impacting the patient as directed by the physician. Also, conducting regular visits and constant interaction between the patient and the caregiver will create room for monitoring the patients’ progress and making precise adjustments if necessary. If the patient brings positive feedback with no adverse effects, it safe for the care provider to limit interaction but still ensure the patient has fully recovered.
Describe specific patient monitoring based on the prescribed therapy
SSRIs have been known for their effectiveness, especially in dealing with GAD conditions. Therefore, it is to note the significance of the medical personnel to notify the patient of both the benefits and side effects of using the SSRIs and TCAs. It is essential to monitor the drugs that interact with both SSRIs and TCAs to ensure the patient does not have severe allergies due to the drugs’ usage, especially the risk of serotonin syndrome.
List one or two adverse reactions for the selected agent that would cause you to change therapy
SSRIs’ adverse reactions include dizziness, nausea, headaches, and difficulties in sleeping, including gastrointestinal disorders (Dugas et al., 2018). Sleeping challenges and GID can lead to a change of therapy to avoid complicating the patient’s condition. TCAs the adverse effects that may lead to the evolution of treatment include constipation and blurred vision.
What would be the choice for second-line therapy?
Second-line intervention, the patient can use Pregabalin (Lyrica) and quetiapine(Seroquel) (Plummer et al., 2016). Pregabalin decreases the severity of GAD and problem with sleep disturbance, just as exhibited by Patient L.P. It makes the patient have enough sleep and engage in daily activities normally.
What dietary and lifestyle changes should be recommended for this patient?
There are several foods recommended for the GAD patients, such as;
·Utilizing complex carbohydrates like whole-grain bread, pasta, or brown rice (Dugas et al., 2018).
·Fruits like peaches, blueberries, or acai berries.
·More vegetables like spinach and legumes
·, healthy fats such as fish rich in Omega-3 fatty acids.
·Drinking plenty of water.
Dugas, M. J., Freeston, M. H., Ladouceur, R., Rhéaume, J., Provencher, M., & Boisvert, J. M. (2018). Worry themes in primary GAD, secondary GAD, and other anxiety disorders. Journal of anxiety disorders, 12(3), 253-261.
Michopoulos, V., Powers, A., Gillespie, C. F., Ressler, K. J., & Jovanovic, T. (2017). Inflammation in fear-and anxiety-based disorders: PTSD, GAD, and beyond. Neuropsychopharmacology, 42(1), 254-270.
Plummer, F., Manea, L., Trepel, D., & McMillan, D. (2016). Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic meta-analysis. General hospital psychiatry, 39, 24-31.