A Concise Program of Treatment that Best Fits the Patient (Research Paper Sample)

A Concise Program of Treatment that Best Fits the Patient
Patient factors and history
Mental health treatment is an intricate process that requires the psychiatric nurse practitioner to develop a concise program of treatment that best fits the patient. The program is only derived from studying the patient’s history, the current environment, and other patient factors in developing personalized treatment for the patient (Olsson et al., 2020). Due diligence at the initial stage allows the psychiatric nurse practitioner to protract issues affecting the treatment of the patient. The date allows the specialist to overcome the unique conditions that face the patient to engineer a customized treatment program unique to the patient yielding the maximum benefits.
Maximum benefits when treating patients with mental health problems are evident in; Minimizing the burden of cost and allowing the patient to complete the treatment successfully. Minimizing the side effect of bodily harm that arises from the treatment, like drug side effects. Integrating the treatment into the patient’s life allows them to finish the treatment program successfully. Correct diagnosis allows the treatment of the root cause of the problem through careful examination of symptoms (Yohannes, 2018). During the initial stages, the psychiatric nurse practitioner has to engage the patient to make them an integral part of the diagnosis process.
Background information of the patient
The patient is a 46-year-old white male. The client was ordered to seek treatment by the PCP after the patient was brought into the emergency room, claiming to have had a heart attack at work. In their own words, the patient described that an overwhelming feeling of impending doom overcame them. Accompanied by the sense of doom was a tight feeling in their chest and shortness of breath. The patients are 15lbs overweight and have hypertension which is treated through lifestyle adjustment where he has a low sodium diet. The patient had their tonsils removed when he was five. In the ER, myocardia infraction was ruled out while the patient's EGK was recorded as normal. The patient’s physical exam was WNL. The patients insist that they still have a problem with their chest even after the exams. He terms the periods where he experiences shortness f breath and tightening of the chest as “anxiety attacks," which are often accompanied by the need to run from where he is when it happens.
The patient drinks an average of four beers a night, coupled with the daily use of ETOH to combat his work anxiety. The patient has little social life and a poor support system; the only people in his life are his parent, of whom he is the caregiver. The work environment is harsh, as the patient describes the management as harsh. The hostile work environment constantly makes him worry about his employment status. The patient has never been on any psychotropic drug treatment. The administered HAM-A test yields a score of 26.
Mental status
The patients are cognizant of the time and place. He has a clear understanding of events and their chronological occurrence. The patient is alert and also rightfully oriented to persons. The patient describes his mood as "blah" while admitting to feeling Nervous. The effect of the patents is generally blunt, but a few moments of sparked interest is noticeable during the examination. The client reports no auditory or visually induced hallucinations. The patient also has no apparent overt or paranoid thought processes that are immediately observable. The patient’s judgment is intact, as is his insight into his environment.
Diagnosis
The patient has General anxiety disorder (GAD).
Treatment
A treatment regimen is derived from a culmination of factors that guide the psychiatric nurse practitioner on the correct treatment to administer to the patient. In-depth analysis and synthesis allow the psychiatric nurse practitioner to decipher the correct medication to administer to patients. The psychiatric nurse practitioner has to consider the pharmacokinetics and pharmacodynamics therapeutic efficacy of the medication they seek to administer.
The pharmacokinetics aspect of drug quality is the factors that arise from how the drug goes into the body, the process of the drug while in the body, and how the drug goes out of the body. Therefore, pharmacokinetics is the absorption of the drug physically into the body through the different physical means of administering the drug. Pharmacokinetics also determines the way the drug travels the bloodstream to be distributed to the requisite part of the body requiring treatment. Through pharmacokinetics, the expert determines the processes through which a drug is broken down into elements that are useful for the desired treatment or therapeutic effect. Finally, pharmacokinetics seeks to understand how the byproduct produced by the drug is passed out of the system. Pharmacokinetics tests like the Genomind PGx are important in identifying genes that affect drug exposure preventing adverse effects of drug administration to people predisposed to particular genomic traits (Yohannes, 2018). A more precise study on drug effect is focused on the biochemical and physiological effect of the drug on the patient is called pharmacodynamics. The in-depth analysis also shows how the drugs potentiate each other. The study is vital in unknowing how different drugs interact and how they are likely to affect each other. The study of pharmacodynamics allows the psychiatric nurse practitioner to dispense treatment prudently.
Anxiety is attributed to the imbalance in brain chemicals involved in neural transmissions, such as serotonin and norepinephrine. The chemicals are highly influential in a person's ability to relax, which causes different anxiety disorders. The use of antidepressants and anti-anxiety drugs helps the brain maintain the chemical balance at the functionality levels, controlling the psychological symptoms.
Anxiolytic drugs are administered using the class or between class switching, allowing optimal dosage realization. Before the psychiatric nurse practitioner rules anxiolytic dug as ineffective, they must ensure strict adherence to the dosage. Different forms of anxiolytic drugs are classified according to their effect and mode of action. Benzodiazepines increase the amino acid GABA giving the patient a sense of calm for example Lorazepam and diazepam. Barbiturates operate the same way as Benzodiazepines, increasing the amino acid GABA in the brain, but they are much stronger (van den Anker et al., 2018). Selective serotonin reuptake inhibitors are anxiolytic drugs that dispense a counter effect to anxiety by increasing the activity of serotonin-like Paroxetine. The anxiolytic treatment is intermittent, and therefore mild approaches are taken and advanced with the leave of effect they have on the patient. If the patient does not respond, the psychiatric nurse practitioner has to augment the treatment. Augmentation is the use of antidepressants that have research asked efficacy to realize combination therapy.
Patient anxiolytic treatment
Initial prescription for the patient
The decision is to put the patient under 10 mg of Paroxetine (PO) qDay to adjust the dose according to the patient's response to the drug.
Results after four weeks
* The patient has no shortness of breath.
* The client does not experience tightening in the chest
* The client has had fewer worries over work over the four days
* HAM-A scores have dropped to 18
Decision; increase the dose to 20 mg PO qDay
The client returns after four weeks (total time of the treatment eight weeks)
* Further reduction in symptoms
* HAM-A symptoms have dropped to 10
* The expected rate of reduction in symptoms at the current dose is 61%