NURS 6630 Week 6 Assignment – Step-by-Step Guide
The first step before starting to write the NURS 6630 Week 6 Assignment: Assessing And Treating Patients With Anxiety Disorders, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.
How to Research and Prepare for NURS 6630 Week 6 Assignment
The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility.
Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.
How to Write the Introduction for NURS 6630 Week 6 Assignment
The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.
How to Write the Body for NURS 6630 Week 6 Assignment
The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.
How to Write the In-text Citations for NURS 6630 Week 6 Assignment
In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:
The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.
How to Write the Conclusion for NURS 6630 Week 6 Assignment
When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.
How to Format the Reference List for NURS 6630 Week 6 Assignment
The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication.
Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:
References
Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456
Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.
An Example NURS 6630 Week 6 Assignment Follows:
Case Study: A Middle-Aged Caucasian Man with Anxiety
Case Study Information
The 46-year-old Caucasian male client is employed as a welder at a nearby steel fabrication plant. He went to the ER because he thought he was having a heart attack, and his PCP referred him. He reported experiencing breathlessness, a sense of impending doom, and tightness in his chest. He is about fifteen pounds overweight and has mild hypertension, which is managed with a low-sodium diet. His medical history has been unremarkable since the removal of his tonsils when he was eight years old. His EKG was normal, and thus, myocardial infarction was ruled out in the emergency room. The rest of the physical examination yielded normal results. He acknowledges that he still experiences bouts of dyspnea and chest tightness, which he now refers to as “anxiety attacks.”. He will also occasionally express feelings of impending disaster and the urge to “run” or “escape” from his current location.
Furthermore, he admits that he sometimes uses alcohol to help him deal with work-related anxiety. He confesses to having three to four beers every night. He is a single man trying to take care of his elderly parents at home. He claims that he fears for his job because of the harsh management at his place of employment. His mental state exam is largely non-remarkable apart from mood findings. The client describes his mood as “dark” and admits feeling “nervous.” The effect weakens slightly but brightens several times during the clinical interview.
Broad influence. After administering the HAM-A, a score of 26 is obtained. The client is alert and pays attention to people, places, times, and events. He is dressed appropriately. Language is clear, consistent, and focused. The client denies visual or auditory hallucinations and shows no obvious delusions or paranoid thought processes. Judgment, as well as insight, are largely intact. He denies thoughts of suicide or murder. The client has never taken any psychotropic medication. This paper describes pharmacotherapy decisions made and the rationales behind these decisions.
Decision # 1
The initial decision was to begin Paxil 10 mg PO daily. Other options were to start imipramine 25 mg orally twice daily or begin with buspirone at 10 mg orally twice daily. However, the patient was started on a once-daily dosing of 10 mg of Paxil (paroxetine). This would accumulate to a total of 10 mg of paroxetine daily, which is pharmacodynamically safe.
The rationale for the Decision
Paroxetine is a selective serotonin reuptake inhibitor that has been approved for use in various mood disorders (American Psychiatric Association., 2010). The Food and Drug Administration (FDA) approved paroxetine for use in generalized anxiety disorder as well as other mood disorders such as major depressive disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Therefore, this choice is evidence-based and safe. According to an observational study by Ielmini et al. (2018), paroxetine was effective in reducing HAM scores among intervention-group patients. It also improved the quality of life for these patients in different dose titrations. The other options for this case study could be effective as well. However, imipramine – a tricyclic antidepressant – is yet to be FDA-approved for GAD (Stahl, 2021). Buspirone is approved for anxiety disorders, especially for short-term relief. Taking Paxil would be more convenient than the twice daily dosing of buspirone for this patient who has numerous social responsibilities. This is also because it would reduce the pill burden as well.
Expected Outcomes and Obtained Results
Starting Paxil was expected to reduce anxiety symptoms and, as such, improve the HAM-A scores after the first month of treatment. The patient was expected to report minimal adverse effects in the next clinic visit. Side effects constitute some of the commonest reasons for poor medication compliance and, thus, poor treatment. The client revisits the clinic after four weeks. The client reports the absence of any tightness in the chest or shortness of breath. Furthermore, the client mentions a noticeable reduction in work-related concerns over the past four or five days. It is worth noting that the HAM-A score also decreased to 18, indicating a partial response.
Ethical Consideration
Ethical principles of beneficence and non-maleficence would ensure that my therapeutic decision aims at doing good by achieving positive patient clinical outcomes while doing no harm to the patient’s wellbeing (Varkey, 2021). For example, I prioritized evidence-based guidelines and adverse effects and events in the decision selection. Therefore, selecting a drug with low dosing frequency, proven clinical efficacy, and minimal side effects at minimal efficacious dosage would determine the clinical outcomes.
Decision # 2
The client demonstrated clinical improvement after starting Paxil. The decision at this point was not to change the drug or the dosage of Paxil. Therefore, the client would continue with 10mg Paxil PO OD for the next month. Other decision options at this point in this case study were to either increase the dose of Paxil to 20 mg PO daily or increase the dose to 40 mg PO daily.
The Rationale for this Decision
Psychotropics may take longer than most medications, such as non-psychotropics in clinical practice, to achieve complete remission of symptoms. Considering that the patient is already exhibiting progress with the existing dosage, it would be wise to observe their ongoing development and reassess the treatment strategy during subsequent follow-up consultations. Paxil’s approval by the U.S. Food and Drug Administration (2014) for the management of generalized anxiety disorder was based on multiple clinical trials that reported clinical improvement optimally after at least eight weeks.
The patient has done four weeks of treatment and has shown improvement, signifying that this strategy is efficacious. The goals of decision #1 have been met; thus, there would be no need to change the intervention with positive outcomes. Implementing substantial modifications, such as elevating the dosage to 20 mg or 40 mg orally daily, could potentially entail risks and adverse effects. Therefore, I chose to maintain the current Paxil dose. Some of the anticipated side effects that might cause poor medication compliance would include dizziness, nausea, vomiting, trouble sleeping, and weakness.
Expected Outcomes and Actual Outcomes
The anticipated outcomes of this decision included minimizing the risk of side effects and continued improvement in the HAM-A score. It was also expected that the patient would report further absence of anxiety symptoms. After four weeks, the client presented to the clinic, reporting no further decrease in anxiety symptoms. The client expressed doubts about the efficacy of Paxil. This showed that the outcomes did not meet the expectations of decision #2.
Ethical Consideration
At this point, a conflict of interest in the risks and benefits of the decision came up, which could impact the care outcomes. For example, increasing the dosages of Paxil would increase the clinical improvement in terms of reduction of anxiety symptoms. However, the risks of treatment adverse effects and events would risk poor adherence and, thus, outcomes. Therefore, I let safety concerns override the risks of harm because the evidence in the positive partial response has guaranteed the clinical benefits.
Decision #3
After eight weeks of pharmacotherapy, the client demonstrated a partial response to Paxil 10mg orally daily. Therefore, I chose to increase the dose to 75mg orally daily. Other options at this point were to switch from Paxil to another selective serotonin reuptake inhibitor, such as venlafaxine, or augment Paxil with another anxiolytic, such as buspirone.
The Rationale for this Decision
It would be wise to consider increasing the dosage of the drug to 75 mg orally per day as the next course of action. After 12 weeks of therapy now at the same Paxil dose, the client showed partial improvement but a static response with this medication, indicating that increasing the dosage to 75 mg orally per day would be suitable. There is no indication that additional medication should be added as the client has not yet undergone a sufficient trial of this drug at a therapeutic dosage, only at a starting dosage.
A study by Ielmini et al. (2018) demonstrated the efficacy of the safety of dose titration for paroxetine in clinical practice. Per the information in the case study, there is no evidence suggesting that SSRI therapy has failed, and there is no compelling reason to switch from an SSRI at this time. It is important to note that increasing the drug dosage to 75 mg orally per day is a prudent decision based on the client’s partial response and the lack of evidence supporting the need for augmentation or a switch to an SNRI. However, the risk of dose-dependent side effects should alert the prescriber of the need to titrate the dose or change the medication to achieve optimal clinical outcomes.
Expected Outcomes
The decision is expected to improve clinical response to this medication. This means that the anxiety symptoms, such as shortness of breath, chest tightness, and episodic worries about his social circumstances, would reduce or cease to exist after another four weeks of treatment and observation. These outcomes would be reflected in the HAM-A score in the next visit. There have been no reported adverse effects that would warrant titration down of dose or discontinuation of the medication. However, this massive dose increment could lead to adverse events in the next four weeks, and thus, the prescriber should anticipate the aforementioned outcomes.
Ethical Consideration
At this point, shared decision-making was an important ethical consideration that would impact the treatment plan. For example, the client had expressed concern over the effectiveness of my medication therapy. Therefore, explaining to them the benefits and rationale of this decision would influence their uptake and compliance with this therapeutic step. According to Aoki et al. (2023), this approach emphasizes prioritizing a value-based discussion between the patient and their clinician. The focus is on fostering two-way communication between the patient and their clinician, where they discuss the positive and negative aspects of each treatment option and facilitate a collaborative decision-making process between the patient and their clinician.
Conclusion
The patient, in this case study, had generalized anxiety disorder because he met the set criteria for diagnosis and objectively had a high HAM-A score. Besides, this client had socioeconomic and medical determinants that would later influence clinical decisions and outcomes of these decisions. The patient has social and financial obligations to meet for the family and also reports a stressful work environment. These identifiable stressors could be easily overlooked in the care of this patient. The patient is a known hypertensive as well, and thus, the risks of pill burden were considered (Santomauro et al., 2023). The decisions made to pharmacotherapeutic care for him were guided by ethical considerations as well as evidence-based scientific and clinical information. The case study presented multiple options and outcomes at every stage of care.
The initial recommended step was to start the patient on 10mg of Paxil orally and observe the outcomes after four weeks. This medication was expected to reduce anxiety symptoms at the minimum effective dose. The medication showed partial response with no notably reported adverse effects from the case study. This meant that the intervention achieved the intended goal but just partially.
The next recommended step was to maintain this safe dose and observe for further improvement, but this did not happen because no further reduction in symptoms was reported. Instead, the client reported concerns over the effectiveness of medication. Therefore, the next best step was to titrate the dose of Paxil. However, this was only to be effected in a collaborative discussion with the patient to ensure that they comply with the new treatment strategy. This principle of shared decision-making came into focus because it was also intended to implement patient-focused care. In sum, the decisions made at each step aimed at ensuring monotherapy leading medication compliance while observing patient-centered care.
You are now conversant with assessing and treating patients presenting with bipolar disorder, depressive disorder and anxiety disorder. For this reason, the next task will examine you on the concepts learned so far in this class. So, prepare for the NURS 6630 Midterm Exam, due in week 6 of this class. reach out for professional guidance and revision materials for the exam.
NURS 6630 Week 6 Assignment References
American Psychiatric Association. (2010). Practice guidelines for the treatment of patients with acute stress disorder and posttraumatic stress disorder. The American Journal of Psychiatry, 161(11 Suppl), 3–31. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd.pdf
Aoki, Y., Takaesu, Y., Inada, K., Yamada, H., Murao, T., Kikuchi, T., Takeshima, M., Tani, M., Mishima, K., & Otsubo, T. (2023). Development and acceptability of a decision aid for anxiety disorder considering discontinuation of benzodiazepine anxiolytic. Frontiers in Psychiatry, 14, 1083568. https://doi.org/10.3389/fpsyt.2023.1083568
Ielmini, M., Poloni, N., Caselli, I., Bianchi, L., Diurni, M., Vender, S., & Callegari, C. (2018). Efficacy and tolerability of two different kinds of titration of paroxetine hydrochloride solution: An observational study. Psychopharmacology Bulletin, 48(3), 33–41. https://www.ncbi.nlm.nih.gov/pubmed/29713104
Santomauro, D. F., Purcell, C., Whiteford, H. A., Ferrari, A. J., & Vos, T. (2023). Grading disorder severity and averted burden by access to treatment within the GBD framework: a case study with anxiety disorders. The Lancet. Psychiatry, 10(4), 272–281. https://doi.org/10.1016/S2215-0366(23)00037-8
Stahl, S. M. (2021). Chapter 8, “Anxiety, Trauma, and Treatment.” In Essential Psychopharmacology Series: Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (3rd ed., pp. 359–378). Cambridge University Press.
U.S. Food and Drug Administration. (2014). Prescribing information: PAXIL® (paroxetine hydrochloride) tablets and oral suspension. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020031s074lbl.pdf
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre, 30(1), 17–28. https://doi.org/10.1159/000509119
Frequently Asked Questions (FAQs)
When approaching a 500-word essay, it’s essential to understand the nuances of this compact form of writing. These frequently asked questions will guide you through the process of crafting a concise and impactful essay.
How many pages is a 500-word essay typically?
A 500-word essay usually spans about one page if single-spaced or two pages when double-spaced, with standard margins and a 12-point font size.
Can you provide examples of a well-structured 500-word essay?
Certainly, to see the structure and flow of a well-written essay, you might want to take a look at a student’s writing guide that provides insights and examples.
Are there specific formatting guidelines for a 500-word essay?
Formatting guidelines typically involve using a legible font like Times New Roman or Arial, size 12, with double-spacing and one-inch margins on all sides. Check any specific requirements your instructor might have provided.
What are some effective strategies for writing a personal essay of 500 words?
For a personal essay, focus on a singular event or characteristic, ensuring your ideas are clear and you reflect on the significance of the subject matter. Use concise language and powerful imagery to maximize impact.
What topics are suitable for a concise 500-word essay?
Choose topics you can thoroughly address within the word limit, such as a personal anecdote, a critical analysis of a poem, or a focused argument on a singular point or issue.
How much time should you allocate to write a 500-word essay effectively?
Depending on your familiarity with the topic and writing proficiency, allocate anywhere from one to several hours for planning, drafting, and revising to ensure a well-presented essay.
