Anxiety increase with work/ losing weight/ social determinants of health
My focus as a family nurse practitioner will be on reducing the proportion of adults with Generalized Anxiety Disorder in the Plainfield community from symptoms of moderate anxiety to mild anxiety.
Include a summary of your synthesis paper including the disease process (pathophysiology), epidemiology, diagnostic measures (including pertinent lab test) diagnosis (including differential diagnoses) evaluation, management (including pharmacology), and the role of the nurse practitioner in the management of this patient utilizing the Shuler framework. Each student responds to one other student’s synthesis summary – 150-word response minimum. Include citations APA 7th edition, current evidenced-based peer-reviewed journals, or website.
Sample Solution
Let’s break down the key components you’ve outlined for your Generalized Anxiety Disorder (GAD) project.
Screening for GAD:
Several screening tools are available for GAD, each with its strengths and weaknesses:
GAD-7: A widely used, 7-item self-report questionnaire that assesses the severity of GAD symptoms. It’s brief, easy to administer, and has good psychometric properties.
Hamilton Anxiety Rating Scale (HAM-A): A clinician-administered scale that assesses both psychic and somatic symptoms of anxiety. It’s more comprehensive than the GAD-7 but requires training to administer accurately.
Beck Anxiety Inventory (BAI): A self-report questionnaire that focuses on the cognitive and somatic symptoms of anxiety.
Criteria for Screening Results:
Each screening tool has specific scoring criteria to categorize anxiety severity. For example, the GAD-7 typically classifies scores as minimal (0-4), mild (5-9), moderate (10-14), and severe (15-21) anxiety. It’s crucial to use the recommended cut-off scores for each tool to ensure accurate interpretation.
Action Plan for Patients with GAD:
Your action plan should be multi-faceted, addressing both immediate needs and long-term management:
Comprehensive Assessment: Thorough history, physical exam, and mental status assessment to rule out other medical or psychiatric conditions that might mimic or contribute to anxiety.
Education: Provide patient education about GAD, its causes, symptoms, and treatment options. Address misconceptions and stigma.
Psychotherapy: Referral for evidence-based psychotherapies, such as Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT), is crucial.
Pharmacotherapy (if indicated): Discuss medication options with the patient, including the benefits and risks. Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are commonly used first-line 1 medications.
1. www.helloklarity.com
Follow-up and Monitoring: Regular follow-up appointments to monitor treatment response, adjust medications if needed, and provide ongoing support.
Anxiety Increase with Work/Weight Loss/Social Determinants of Health:
It’s essential to explore these factors further:
Work-Related Stress: Identify specific stressors at work (e.g., workload, deadlines, interpersonal conflicts). Explore strategies for managing work stress, such as time management, assertiveness training, or relaxation techniques.
Weight Loss: Determine if the weight loss is intentional or unintentional. Unintentional weight loss could indicate an underlying medical condition contributing to anxiety. If intentional, ensure it’s being done in a healthy way.
Social Determinants of Health (SDOH): Assess for social factors that might be contributing to anxiety, such as financial difficulties, housing instability, food insecurity, or lack of social support. Connect patients with resources in the community to address these needs.
Synthesis Paper Summary (Example – You’ll need to fill in specifics from your research):
Generalized Anxiety Disorder (GAD) is characterized by excessive worry and anxiety about various events or activities. The pathophysiology involves dysregulation of neurotransmitter systems, particularly GABA, serotonin, and norepinephrine, as well as structural and functional changes in brain regions involved in fear and emotion processing (e.g., amygdala, prefrontal cortex). Epidemiologically, GAD affects approximately [prevalence rate] of the adult population, with women being more likely to be diagnosed than men. Diagnosis involves a thorough clinical assessment, including the use of standardized diagnostic criteria (DSM-5) and ruling out other medical or psychiatric conditions. Differential diagnoses include other anxiety disorders, depression, and medical conditions with anxiety symptoms. Pertinent lab tests may include a CBC, thyroid function tests, and vitamin D levels to rule out medical causes. Management involves a combination of psychotherapy (CBT, ACT), pharmacotherapy (SSRIs, SNRIs), and lifestyle modifications. The FNP plays a vital role in all aspects of patient care, from initial screening and assessment to ongoing monitoring and support, utilizing the Shuler framework [cite Shuler framework source].
Example Response to a Classmate (150 words minimum):
[Classmate’s Name],
Your summary of GAD was comprehensive and well-organized. I particularly appreciated your discussion of the differential diagnoses, as it’s crucial to rule out other potential causes of anxiety symptoms. I agree that the inclusion of specific lab tests, like thyroid function, is important, as thyroid disorders can sometimes mimic anxiety. I’m curious to know more about the specific interventions you plan to implement to address the impact of social determinants of health on GAD. For example, will you be collaborating with social workers or community organizations to connect patients with resources? Also, I’d be interested in learning more about your approach to patient education. What specific strategies will you use to ensure patients understand their condition and are actively involved in their treatment plan? Overall, your approach seems patient-centered and evidence-based, which is essential for effective GAD management. I look forward to discussing this further with you.
