Question

A 37-year patient comes into the urgent care and presents with chest pain and hyperventilation. During the assessment process, his vitals are recorded, a brief health history is recorded, he is inspected visually from head to toe, asked about current medications and his chief complaints are addressed. Asking him to breathe through pursed lips or into cupped hands alleviates his hyperventilation. He was also given the option to hold his breath for 10-15 seconds at a time. After lying down for a few minutes, there was little relief for his chest pains therefore an ECG was conducted Recurring panic attacks and high levels of anxiety characterize panic disorder. Panic attacks can occur without warning or stressor however the patient mentioned being stressed due to taking on more responsibilities at work. He was diagnosed with panic attacks and prescribed paroxetine daily and lorazepam prn.

Two stress reducing techniques are medication and psychotherapy or cognitive behavior therapy. CBT is a model that challenges negative thinking and behaviors. It is rooted in the idea that attitude impacts behavior (Plehn, 2002). The meditation was not effective whereas the cognitive behavior therapy proved effective. I believe CBT helped because it allowed the patient to share his feelings in a structured yet intimate environment opposed to being alone with meditation. The patient was reminded that each treatment plan is personalized, to remain compliant with his medications, and continue to ask questions.

Respond and explain if you agree or disagree with how they would handle a client who was having severe anxiety. If you do not agree, please provide how they could have approached the client differently, and provide supporting rationale and citations. in 5 paragraph

Answer 1

Not agreeing because anxiety treatment consists of a combination of both medication and therapy(cognitive behavioural therapy)

Anxiety is a very common problem. We refer to it by many names: fear, worry, nervousness, tension, dread, panic, or a “nervous breakdown.” We also express anxiety in different ways: avoiding situations, constantly worrying, or having physical symptoms, to name a few. When these symptoms get so bad that they interfere with your life, anxiety becomes a medical problem.

When dealing with anxious patients, the most important skill to learn is to listen. Most patients just want to know that you are listening to their concerns, Do not tell someone who is anxious to relax. IT DOESN’T WORK. Instead, ask them what you can do to help them relax, do hourly rounding and explain the plan of care, Prepare ourself for stressful situations, Be empathetic and should know how to manage this stressful situation.

Here the patient came with chest pain due to stress and anxiety. So we should not tell them to relax. Because the patient is having severe anxiety and stress it doesn't works. If they are unable to tell their needs then wecan teach them some relaxation techniques.

Reassure them, Speak to them in positive, supportive terms, Encourage them to focus on their breathing and breathe calmly and slowly, in and out through their nose and out of their mouth, to reduce the amount of carbon dioxide being lost.Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms.all medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. So we can't say effectiveness of medicine in first dose itself.