Nursing Assignment: Anxiety, Therapeutic Relationships, and Medication

This assignment solution addresses a clinical scenario involving a 45-year-old patient experiencing anxiety. The response highlights the differences between generalized anxiety disorder (GAD) and panic disorder, emphasizing the former's long-term nature and the latter's intense, potentially hereditary nature. The role of empathy in fostering a therapeutic relationship between a graduate nurse and the patient is discussed, stressing its importance in building trust and encouraging open communication. The importance of effective communication skills, particularly verbal communication and active listening, is analyzed to help nurses conduct interviews and understand patients' concerns. Finally, the assignment details the medication prescribed (Paroxetine 20mg), emphasizing the nurse's role in educating the patient about the drug's effects, potential side effects, and crucial considerations for safe and effective use.

Running head: NURSING MENTAL HEALTH
NURSING MENTAL HEALTH
Name of the Student:
Name of the University:
Author note:

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Answer number 1:
This response will highlight the difference among the generalised anxiety disorder
and panic disorder. Panic disorder is included under the category of anxiety disorder,
whereas, generalized anxiety disorder (GAD) is categorized by excessive and persistent
worry regarding numerous issues and might also anticipate disaster. The individuals suffering
from generalized anxiety disorder worry or concern regarding various things namely family,
work, money or any other associated issues (Anxiety and Depression Association of America,
2019).
Generalized anxiety disorder is one of the long-term anxiety illness that primarily
occurs due to mood or anxiety disorder sad majorly affect the daily activity of their life. The
most common symptoms of GAD includes lack of handling uncertainty, overthinking,
difficulty in concentrating, lack of ability to relax, feeling restless and threatened and
persistent anxiety and loss of self-control. There are various physical symptoms of GAD
namely sweating, fatigue, irritability, nervousness, trouble sleeping, muscle aches, nausea,
and trembling. The primary cause of generalize anxiety disorder arises due to various
complex reaction among the environmental and biological factors, which includes personality
and development, genetics, difference in the brain function and chemistry (Ruscio &
Khazanov, 2017). On the other hand, panic disorders leads to panic attack in the individual
that are due to impulsive feeling of shock in the absence of any actual danger. The primary
cause of panic attack can be due to different physical reason or medication situation that
includes divorce, severe stress, loss of job and loss of loved ones. The symptoms of panic
disorders and generalized anxiety disorders (GAD) are common although the health condition
is completely different. Generalized anxiety disorders (GAD) are not included under the
Diagnostic and Statistical Manual of Mental Disorders (DSM–5), whereas, panic disorders
are included and identified under the DSM–5. The Panic disorders are more intense and

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severe and has more pertaining physical symptom that can be very harmful for the individual.
Therefore, it is evident that anxiety disorders can lead to severe panic disorders and will
further result in poor quality of life and mental health. The condition of GAD is not
hereditary whereas panic disorder sometimes runs within the family and genetics, affecting
the biological processes (National Institute of Mental Health, 2019).
Hence, it can be concluded that generalized anxiety disorder is less severe and intense
as compared to the panic disorder. Panic disorder is included under the anxiety disorder and
share the common symptoms but are also different in terms of their severity.
Answer number 2:
This response will highlight the role of empathy in developing a therapeutic
relationship between the graduate nurse and the patient in the given scenario. Therapeutic
relationship is considered as the crucial step for building healthy rapport with the patient and
assisting them to freely share their apprehension with the nurse. Empathy is thus considered
as the fundamental step towards developing a therapeutic relationship with the patients and
achieving high patient health outcome (Hojat, 2016).
In the provided scenario, the patient was suffering from anxiety disorder and was
worrying about the future issues that might never exist. Due to his bad health condition and
mental state, his health complications were increasing and it was very essential for the nurse
to build an effective therapeutic relationship with the patient. Therapeutic relationship is also
termed as the therapeutic alliance which denotes to the association among the patient and the
healthcare professionals and help the healthcare professional to effectively engage with the
patient and understand their concern, which will further help them in treating the patient
(Pazargadi et al., 2015). In this case study, peter was suffering from emotional distress and
was not at all well, hence, in order to effectively treat Peter, it is very important for the nurse

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to develop a healthy relationship with him and motivate him to share all his concern and
issues. Further, understanding the concern of Peter, the nurse can identify the treatment
approaches that is beneficial for Peter such as group counselling or private therapies. The
nurse can adapt empathy to develop the therapeutic relationship with the patient. Empathy
will aim to deliver positive influence among the patient’s mind and help the patient to think
positively and acquire a correct balance by maintaining his present and future surrounding.
Hence, the nurse will exhibit an empathic attitude or behaviour towards the patient and
exhibit correct nonverbal and verbal signals for communicating with the patient (Crawford,
Roger & Candlin, 2018). Hence, in case of Peter, the nurse can exhibit this empathic attitude
and make the patient feel comfortable and emotionally stable that will further enhance his
health condition and reduce the psychological distress that he was suffering from.
Hence, it can be concluded that the nurse must build a therapeutic relationship with
the patient who is suffering from an emotional or psychological distress and assist the patient
in improving their health condition, where empathy is considered as the fundamental aspect
of developing therapeutic relation and treating the patient.
Answer number 3:
This response will highlight the benefit of identifying an appropriate communication
skills that will help the nurse to interview the patient and understand the health concern of the
patient. In the provided, case scenario, the patient was suffering from intense emotional or
psychological distress and it is very crucial for the nurse to practice appropriate
communication skills and identify the primary cause of the patient ill-health (Kee et al.,
2018).
Communication is considered as the two ways method, where two individuals are
involved in sending and receiving the messages which are important and they should know.

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The communicator must adapt the skills of empathy and confidence as it will help them to
understand the perspective of the other person in a more systemic way. The nurse in this
scenario, will adapt the verbal mode of communication associated with active listening skills,
because the patient was psychologically distressed and was also confused regarding his
imagination. Hence, the nurse will conduct an interview where, the nurse will verbally
question the patient regarding the issues that the patient is experiencing in his life and
through the response of the patient, the nurse will gain relevant knowledge regarding the
primary cause or triggering factor which was leading to his poor health condition (Little et
al., 2015). It was very important that after asking the question, the nurse will adapt actively
listening skill and will patiently listen to the answer and observe the reaction of the patient to
achieve an enhanced patient health outcome. In the case study, it was evident that the patient
was worrying about the future issues and the common thought of “what if” that might not
even exist and hence it was important for the nurse to interview him and understand why he
was getting this feeling and which treatment strategy can be adopted to manage the health
issues of Peter. Hence, the nurse would adapt verbal communication skill and pay attention to
every answer of the patient that will help the nurse to identify the triggering factor for the
poor health condition of Peter and accordingly identify the treatment strategy to assist Peter
in overcoming from his bad health condition (Nayebi & Majd, 2015).
Hence, it can be concluded that the nurse will practice and implement verbal
communication skill associated with patiently listening to the patient and assisting the patient
to feel motivated and overcome form his psychological illness and lead a healthy life.
Answer number 4:
This response will highlight the medication of the patient and also what information
should be shared with the patient regarding the medicine prescribed to him. Paroxetine 20mg

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was prescribed to the patient and since, the patient was not aware of the medicine, it was the
responsibility of the nurse to educate him and increase his awareness regarding the medicine
that will reduce any future health complication (Medicines.org.uk, 2019).
Paroxetine 20mg belongs to the selective serotonin reuptake inhibitors class of drugs,
which increase the quantity of serotonin hormone within the patient body and help the
hormone to reach the brain and assist the patient to manage the symptom of depression,
anxiety, stress and compulsion. Hence, this medicine is prescribed to the patient in order to
treat any type of depressive illness, panic disorders, generalized anxiety disorder, post-
traumatic stress disorder and obsessive-compulsive disorder. Since, Peter was suffering from
huge emotional and psychological distress, it was important for the nurse to prescribe him an
appropriate medicine that will effectively help the patient in overcoming form the illness and
lead a healthy life (Albert et al., 2016). Along with prescribing the medicine, the nurse must
also educate the patient regarding the warnings or the side-effects that the medicine might
have on the patient’s health. The nurse explained Peter that consuming this medicine will
trigger the suicidal notion and self-harm during the initial few days of treatment and the
patient must visit the healthcare professional in such case. Therefore, it is necessary that the
patient is alerted regarding the possible risk that might initially affect him. Paroxetine
medicine releases serotonin hormone and hence, can lead to serotonin syndrome when given
with any other medicine. Hence, the nurse will educate the patient and warn him to not
consume any other medicine with Paroxetine to reduce any possible risk of deteriorating
health condition. The nurse will also educate the patient regarding the crucial consideration
that the patient must remember while consuming the medicine such as time, dose, storage or
side-effects. The nurse will explain the patient regarding the direction of consuming the
medicine and also increase his awareness to yield enhanced patient health outcome
(Procyshyn, Bezchlibnyk & Jeffries, 2015).

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Hence, it can be concluded that the nurse is completely responsible for increasing the
awareness of the patient regarding his medicine and also educate the patient to follow the
directions that will reduce any chance of future health complications.

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References
Albert, U., Carmassi, C., Cosci, F., De Cori, D., Di Nicola, M., Ferrari, S., ... & Fiorillo, A.
(2016). Role and clinical implications of atypical antipsychotics in anxiety disorders,
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disorder-gad
Crawford, T., Roger, P., & Candlin, S. (2018). The consequences of diverse empathic
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Hojat, M. (2016). Empathy and patient outcomes. In Empathy in health professions
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National Institute of Mental Health. (2019). NIMH » Panic Disorder: When Fear
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