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To encourage recovery in patients, one often has to approach a specific health concern by exploring multiple factors contributing to the aggravation of a patient’s condition. Furthermore, the presence of comorbid issues is very frequent when tending to the needs of generalized audiences (American Psychiatric Association, 2013). Therefore, a healthcare provider should be capable of performing an all-embracive assessment of a patient and locate physical, biological, and psychiatric issues that may affect the latter’s well-being.
A comprehensive psychiatric evaluation is especially important when determining health issues in an adolescent patient since the latter may develop emotional and cognitive problems otherwise (National Institute of Mental Health, 2017). By conducting a physical, psychiatric, and biological assessment of an adolescent patient with a generalized anxiety disorder, one will be able to offer an effective treatment that will address multiple sociocultural factors affecting the patient negatively.
In the case under analysis, the issue of the generalized anxiety disorder (GAD) is explored. GAD is a rather common problem in adolescents. As the American Psychiatric Association (2013) clarifies, GAD is a condition that can be described by excessive anxiety, which does not pertain to any specific subject and is difficult to control. Among the key symptoms of GAD, one should mention generalized anxiety continuing for six months or more, restlessness, increased fatigue, muscle ache, and irritability.
However, the symptoms of GAD may vary depending on patient-specific factors, as well as external influences that affect a patient’s well-being. GAD is highly prevalent, with a total of 2.7% of the U.S. population being affected by it (National Institute of Mental Health, 2017). The etiological factors of the disorder include family history and exposure to stress.
X is a thirteen-year-old African American female, who has been suffering from anxiety for over a year. X is very shy and generally reserved, with the propensity toward introversion. She is raised by a single mother and has supportive grandparents. X has not had any major health complaints so far except dental issues (frequent cavity development). Last year, X’s mother had to apply for the second job due to financial constraints, which led to a drop in the amount of communication between her and X, as well as the need for X to become more independent in the management of home- and school-related concerns.
Over the past few months, X has been developing increasingly great anxiety with frequent panic attacks. At present, X experiences difficulties falling asleep and socializing, with any negative factor setting off her anxiety. For instance, X has acquired the fear of using an elevator and now prefers to use a staircase instead. X also feels tired almost all the time and has lost her enthusiasm for any activity from academic ones to her hobbies.
The observed symptoms, particularly, fatigue, sleep issues, and the continuous feeling of anxiety, are characteristic for GAD (American Psychiatric Association, 2013). Therefore, it is recommended to perform the necessary screening. In addition, the patient has difficulties breathing, which aggravate her fatigue. The observed symptoms are characteristic of asthma, which makes the need to introduce a treatment for anxiety urgent. Finally, there is a biological condition that requires addressing. Particularly, the excessive fatigue from which X suffers can also be attributed to anemia (Freeman & Morando, 2016). Thus, to manage the needs of the patient, a comprehensive treatment strategy is required.
To determine the presence of GAD in the patient, one should consider applying the Generalized Anxiety Disorder 7-item (GAD-7) scale. The specified tool allows locating the presence of key GAD symptoms and identifying the degree of GAD development. Specifically, the patient will be provided with several questions aimed at evaluating the extent to which GAD manifests itself at present (Jordan, Shedden-Mora, & Löwe, 2017). The outcomes of the assessment will inform a therapist about the strategies and treatment options that will have to be considered to meet X’s needs.
Moreover, the presence of asthma and anemia should be taken into account. To diagnose the existence of asthma in the patient, one has to apply a combination of spirometry and X-raying since the two will allow producing the most accurate outcome when combined (Yadav et al., 2015). Due to the possibility of an instance of anxiety prompting an asthma attack, the key factors causing the former will have to be determined.
Furthermore, detailed information about the irritants that prompt an asthma attack will be needed for successful treatment (Yadav et al., 2015). Finally, to diagnose anemia in the patient, the Complete Blood Count (CBC) test will be required (Freeman & Morando, 2016). The results of the specified screening will inform the strategy regarding the management of fatigue levels in the patient.
When considering the problems faced by X, one should mention that there is a common symptom for all of them. Particularly, the presence of unusually high rates of fatigue should be seen as the direct indication of the disorders. In addition, the factors such as the patient’s gender and age will have to be included in the assessment criteria. Specifically, it is important to bear in mind that adolescent patients are prone to be influenced by anxiety especially greatly due to the challenges linked to the physiological and psychological changes that they experience as a result of the transfer from one stage of development to another. Therefore, the fact that the patient is female and is 13 years old needs to be borne in mind when selecting the treatment tools.
For instance, the pressure of social standards for the way in which women are supposed to look may become especially excruciating for X. In addition, the current GAD problem may evolve to the separation anxiety disorder (SAD) since the mother is currently forced to spend less time with the patient. Similarly, the development of anemia and asthma may be enhanced by the factors associated with the patient’s age (American Psychiatric Association, 2013).
Therefore, when developing an assessment framework, the specified aspects of X’s condition will have to be taken into account. Indeed, recent data shows that female patients are especially prone to the development of GAD (National Institute of Mental Health, 2017). Furthermore, the current socioeconomic position of the patient and her mother implies that the former is unlikely to get immediate access to the required tools and treatment for health maintenance (Jordan et al., 2017). Therefore, it is imperative for a healthcare provider to introduce a communication framework for maintaining the consistent dialogue with X and her mother.
For X to recover successfully, she will have to develop a range of skills and acquire substantial knowledge for addressing the issue associated with her current condition. Specifically, one will have to create an elaborate system of patient education. The required process will have to be twofold since it will imply both the improvement in the delivery of key messages and the use of better data management tools.
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Specifically, a nurse will have to utilize the strategies that will allow for a more effective patient learning process. These will include interactive media, visual aids, and applications that will provide the patient with immediate access to the available health management data.
Furthermore, the patient will have to receive detailed guidelines regarding the management of anemia and the prevention of asthma attacks. Specifically, a change in the current dieting choices made by X will be needed to address the anemia problem. As far as the asthma issue is concerned, X will have to receive clear and accurate instructions concerning the identification of threats, particularly, potential irritants, and avoiding them. In addition, the patient will require medications that will reduce the effects of allergens and prevent the development of breathing problems.
Because of the socioeconomic and personal anxieties that X currently has, she is under the influence of numerous risk factors that may aggravate her GAD. Particularly, the fact that X’s mother had to reduce the time spent with her daughter in order to improve the financial situation may become a problem for the further recovery. Despite the fact that the girl also receives extensive support from her grandparents, she may lack interactions with her mother, which may aggravate her condition to an even greater degree.
Therefore, it is highly advised that the mother should improve the quality of communication with X, as well as incorporate the communication tools that will allow her to maintain the dialogue with X consistently. Furthermore, the exposure to the factors that may induce the development of an asthma attack should also be seen as a risk factor. The patient will have to learn to avoid the irritants that may incite tan asthma attack, as well as cope with the anxieties that she may develop due to the psychological pressure.
In order to manage the problems described above, one will need to consider a therapy that is expected to assist in reducing the levels of anxiety in a child, as well as remove the factors that cause it in the first place. Therefore, the use of cognitive behavioral therapy (CBT) will be required. The proposed technique will allow introducing the patient to the possibility of controlling the levels of her anxiety. Particularly, the use of the CBT tool will imply both the provision of specific guidelines concerning the management of the specified issue and the general education of the patient.
The suggested technique is expected to affect not only X’s ability to manage the disease and avert the threats that may entail an anxiety attack. In addition to the specified skill, the patient will also receive an opportunity to get an insight into the nature of the disease. In addition, the use of the CBT approach will help the patient to understand the connections between her anxiety disorder and the rest of the conditions that affect her. Specifically, she will learn about the link between her GAD and asthma. Particularly, the fact that an instance of GAD may entail an asthma attack will have to be made explicit to the patient. As soon as X recognizes the connection between the conditions by which she is affected, one will be able to introduce a positive shift in her dynamics.
Furthermore, the fact that X’s anemia may cause an even greater rise in the fatigue levels and affect the patient’s well-being will also have to be addressed when promoting patient education. Therefore, the application of a complex approach toward the management of X’s current state is critical to the further well-being of the patient. By introducing the therapy that will allow incorporating several frameworks for treatment, one will ensure a faster recovery and an enhanced promotion of patient education.
Because of the influence of a range of factors that define the presence of GAD, anemia, and asthma in the patient, one will have to adopt a framework for taking each of the specified factors into account. A multifaceted approach toward handling the issue of GAD is critical since X also suffers from anemia and asthma, each being linked to GAD due to the mechanics of the disorders. Therefore, X will require a complex treatment along with an elaborate patient education technique.
One has to ensure that the patient is aware of the connection between the disorders and the factors that cause them. In addition, a nurse will have to build the levels of preparedness in X so that she could be able to prevent a dangerous situation or address the problem once it starts developing. As a result, the current issue will be addressed adequately. The problem of communication with the mother as one of the factors that may cause the development of anxiety in the patient will have to be handled along with the lack of patient education. Therefore, a combination of CBT, medications, and patient education will have to be regarded as essential.
American Psychiatric Association. (2013). The diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
Freeman, A. M., & Morando, D. W. (2016). Anemia, screening. Web.
Jordan, P., Shedden-Mora, M. C., & Löwe, B. (2017). Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory. PloS One, 12(8), 1-14. Web.
National Institute of Mental Health. (2017). Generalized anxiety disorder. Web.
Yadav, A., Corrales-Medina, F. F., Stark, J. M., Hashmi, S. S., Carroll, M. P., Smith, K. G.,… Mosquera, R. A. (2015). Application of an asthma screening questionnaire in children with sickle cell disease. Pediatric Allergy, Immunology, and Pulmonology, 28(3), 177-182. Web.