Exam (elaborations)
NR 547 Differential Diagnosis NR_547 week 2 collab cafe.
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- Chamberlain College Of Nursing
NR 547 Differential Diagnosis
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Define treatment refractory anxiety.Treatment refractory anxiety is defined as anxiety that is unresponsive to
standard anxiety treatment (Bandelow et al., 2017) or anxiety that is
unresponsive to at least one first-line treatment/psychotherapeutic treatment
(Bookma et al., 2019) or fails to respond to at least one trial of
antidepressant treatment at adequate dose and duration (Ansara, 2020).
Describe two common comorbidities of treatment refractory anxiety.
Personality disorder is an enduring pattern of inner experience and behavior
that does not match the expectations of the person’s culture (American
Psychiatric Association, 2013). The pattern of behavior is stable across time
and consistent across situations (Burton, 2022). The onset of personality
disorder is during adolescence or early adulthood (American Psychiatric
Association, 2013). This experience directly impacts the patient’s well-being
(Burton, 2022).
Attention-Deficit/Hyperactive Disorder - this is a persistent pattern of
inattention (difficulty sustaining focus/hyperactivity (excessive motor activity
such as fidgeting)/impulsivity that impairs functioning or development
(American Psychiatric Association, 2013). ADHD begins in childhood, and the
manifestation of symptoms is present in more than one setting (American
Psychiatric Association, 2013).
Discuss two approaches to treatment for treatment refractory
anxiety.
One of the approaches to the treatment of refractory anxiety is to ensure the
diagnosis of anxiety is the correct and complete diagnosis to start with.
Misdiagnosing the disorder would lead to ineffective therapy (Roy-Bryne,
2015).
The clinician needs to consider if there are other exogenous factors such as
excessive intake of caffeine, use of over-the-counter cold medications that
contain phenylpropanolamine and pseudoephedrine, sleep deprivation, poor
support system, and financial adversity that are contributing to the
resistance of treatment of anxiety (Roy-Bryne, 2015).
Identify the most appropriate response to a client who states that
they use marijuana to manage their anxiety. Discuss the education
the PMHNP should provide.
Response: When did you start taking marijuana? Do you know the CBD/THC
content?
Education: The study of the effect of marijuana on anxiety is still in its
infancy. From the few studies done on the effect of marijuana on anxiety,
some people reported that marijuana helped their anxiety, some reported no
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