Case Study For Treating Patients With Anxiety Disorders Discussion

Case Study For Treating Patients With Anxiety Disorders Discussion

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Anxiety or a sense of unease affects people of all ages regardless of their age or socioeconomic status. Common anxiety disorders include panic attacks, social phobia, and generalized anxiety disorder (GAD) (Cheung et al., 2018). Because of stress, GAD has a long-term effect on a patient’s thinking and behaviour; elevated anxiety increases dopamine, serotonin, and histamine levels in the body. Acute and long-term stress is characterized by chest tightness, perspiration, coughing, paraesthesia, fear of death, shaking, and dizziness (Maron & Nutt, D. 2022)Case Study For Treating Patients With Anxiety Disorders Discussion. Drug abuse, alcoholism, psychotropics, stressful work environments, early traumas, and severe disease contribute to generalized anxiety disorder (Cheung et al., 2018). A patient’s history, mental state, and an anxiety assessment instrument are all utilized to diagnose anxiety disorders because there are no specialized diagnostic tests.

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A clinician assesses anxiety levels using the Hamilton Rating Scale for Anxiety, the GAD-7, the Personal Health Questionnaire, and the Beck Depression Inventory. Concerning anxiety, the Hamilton scale goes from not present to severe, indicating low to moderate to extreme stress (Gale et al., 2019). The racing heart, tightness in the chest, and fast breathing are all symptoms of this patient’s generalized anxiety disorder. In addition to the stress of working long hours and caring for his elderly parents, the combination of these factors has caused him to become anxious (Cheung et al., 2018)Case Study For Treating Patients With Anxiety Disorders Discussion. As a result, he is tense and downcast. In terms of Hamilton’s Anxiety Scale, he is in the moderate to severe range. GAD is treated with antidepressants, anti-anxiolytics, and psychotherapy. Three therapy alternatives and ethical considerations are discussed in this study to help us communicate and treat the patient better.

Decision one

I will administer 50 mg of Zoloft daily to the patient.

Why did you select this decision?

Zoloft is an effective SSRI used to treat the symptoms of generalized anxiety disorder. First-line GAD treatment options include SSRIs, SNRIs, benzodiazepines, and buspirone (Cheung et al., 2018). Because it addresses many issues, Zoloft is the most proper anxiety medication available.

Why did you not select the other two options provided in the exercise?

Imipramine, a tricyclic antidepressant, is not approved to treat GAD due to its lower efficacy and tolerability compared to SSRIs. Because it is a sedative antidepressant, taking imipramine while drinking is not recommended. The patient takes up to four beers each night. Zoloft’s side effects include arrhythmia, abrupt death, and liver failure (Carpenter & Schatzberg, 2017). Studies show that comparing Zoloft to Imipramine improves its ability to treat anxiety disorders (Carpenter & Schatzberg, 2017). Buspirone has minor side effects, such as headaches, tiredness, discomfort, faintness, and vomiting, when used as a supplement to SSRIs or SNRIs (Carpenter & Schatzberg, 2017)Case Study For Treating Patients With Anxiety Disorders Discussion. The medications can take two to six weeks to start working to lower anxiety. The patient must comply with his doctor’s instructions to have a successful therapy.

What were you hoping to achieve by making this decision?

The objective was to reduce the patient’s anxiety levels by 50.0% after taking Zoloft. Four weeks later, the patient was back in the clinic without any breathing issues or pressure in the chest, as well as decreased work-related anxiety. His HAM-A score has dropped from 26 to 18, indicating improvement in his symptoms. My next step is to assume that the customer is not worried about the drug’s adverse effects.

How ethical considerations may impact your treatment plan and communication

Ethical principles highlight the expected healthcare standards utilized by nurses to make positive decisions. They include justice, consent, beneficence, non-maleficence, and patient autonomy. Justice and informed consent are the primary ethical considerations at this juncture; the nurse exercises respectful communication while assessing the patient after getting consent to initiate the treatment process.

Decision Two

I will increase the Zoloft dosage to 75mg per day next.

Why did you select this decision?

I increased the dosage because the client did not have any side effects. Zoloft’s side effects include insomnia, dry mouth, nausea, and erectile dysfunction (Carpenter & Schatzberg, 2017)Case Study For Treating Patients With Anxiety Disorders Discussion.

Why did you not select the other two options provided in the exercise?

It is best to wait a few days before raising the dosage from the recommended starting dose of 25 mg per day to as much as 200 mg per day. To keep an eye out for any side effects that would make it difficult for the client to stick to the treatment plan. Consequently, I reduced the dosage from 100mg to 75mg.

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What were you hoping to achieve by making this decision?

Clients’ HAM-A and anxiety levels should be reduced. Increased patient compliance and minor symptoms are expected due to the second solution offered. In just four weeks, the client’s HAM-A score dropped 61 percent. The present dose of medication is tolerated by the patient with no reported adverse effects.

How ethical considerations may impact your treatment plan and communication

The nurse should consider the non-maleficence and beneficence ethical principles. Beneficence entails positive actions to improve the patient’s clinical outcomes; the nurse adjusts the medication’s dosage to optimum levels to attain the treatment goal. On the other hand, non-maleficence entails protecting patients from harm; the nurse ensures the drug dosage does not exceed the maximum level to adverse outcomes.

Decision Three

The customer took 75mg of Zoloft daily without experiencing adverse side effects. Thus, waiting for the drug to have its full impact is my only option if the patient’s symptoms do not improve after 12 weeks Case Study For Treating Patients With Anxiety Disorders Discussion.

Why did you select this decision?

Increasing the dosage to 100mg may cause side effects that make it difficult for the patient to adhere to the treatment plan, given the patient’s 61 percent reduction in dosage. Zoloft 50 mg lessened depressed symptoms and adverse effects for the patient. A 25-mg dosage increase or a switch from an SNRI to an SSRI are other options for the client.

Why did you not select the other two options provided in the exercise?

I would have changed the prescription if the patient had not responded and had already taken the maximum dose of Zoloft. Even without generating unpleasant side effects, the medicine looks to be working. SNRIs can be used as a second or third-line treatment option for children with depression (Koechlin et al., 2018). According to studies, SSRIs are more cost-effective and safer than SNRIs (Locher et al., 2107). All dosage options would be exhausted with this patient’s first-line SSRI.

What were you hoping to achieve by making this decision?

Taking 75 mg of Zoloft daily, I anticipated that it would be 75-100 percent effective with few side effects. In terms of pharmacological response, the client was pleased. A dose of 50 mg daily was maintained after a positive reaction to Zoloft and a four-week review period. A dose of 75 mg daily was re-evaluated if the medication did not eliminate the patient’s depression symptoms. Despite the risks, increasing the dosage can alleviate depression symptoms. The dosage can be reduced if the patient cannot tolerate the higher potency. The client accepted and responded positively to Zoloft. Therefore, an SNRI was not necessary Case Study For Treating Patients With Anxiety Disorders Discussion.

How ethical considerations may impact your treatment plan and communication

The patient’s condition is better, as indicated by the reduced Hamilton Anxiety Rating Scale scores and improved symptoms. Thus, the patient should undergo psychotherapy to improve his behaviors and actions. However, no one should compel him to decide according to the autonomy principles.

Conclusion

Generalized anxiety disorder creates a widespread sense of unease, affecting people of all ages. A common symptom is a fear of uncertainty. Other symptoms include chest pain, palpitations, perspiration, choking, paresthesia, dread of death, and shivering are common symptoms in people with GAD. Stress, trauma, and substance abuse can all contribute to the development of generalized anxiety disorder. The Hamilton rating scale is one of the most widely used clinician-based questionnaires for grading anxiety symptoms from light to moderate to severe. A study found that using Paxil for as little as eight weeks helped patients feel better and less disabled. Antidepressants such as tricyclic antidepressants can cause delirium and seizures, as well as agitation, disorientation and confusion, while anticholinergic activities increase the risk of dementia. Buspirone is the other possible medication option to treat generalized anxiety disorder. Ethical principles serve as a guide for constructive decision-making by supporting desired norms Case Study For Treating Patients With Anxiety Disorders Discussion.

References

Cheung, A. H., Zuckerbrot, R. A., Jensen, P. S., Laraque, D., Stein, R. E., Levitt, A., … & GLAD-PC STEERING GROUP. (2018). Guidelines for adolescent depression in primary care (GLAD-PC): Part II. Treatment and ongoing management. Pediatrics, 141(3).

Gale, C., Glue, P., Guaiana, G., Coverdale, J., McMurdo, M., & Wilkinson, S. (2019). Influence of covariates on heterogeneity in Hamilton Anxiety Scale ratings in placebo-controlled trials of benzodiazepines in generalized anxiety disorder: systematic review and meta-analysis. Journal of Psychopharmacology, 33(5), 543-547.

Koechlin, H., Kossowsky, J., Gaab, J., & Locher, C. (2018). How to address the placebo response in the prescription SSRIs and SNRIs in children and adolescents. Expert opinion on drug safety, 17(6), 537-540.

Locher, C., Koechlin, H., Zion, S. R., Werner, C., Pine, D. S., Kirsch, I., … & Kossowsky, J. (2017). Efficacy and safety of selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and placebo for common psychiatric disorders among children and adolescents: a systematic review and meta-analysis. JAMA psychiatry, 74(10), 1011-1020.

Maron, E., & Nutt, D. (2022). Biological markers of generalized anxiety disorder. Dialogues in clinical neuroscience.

Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt patients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, patients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with anxiety disorders.

To prepare for this Assignment: Case Study For Treating Patients With Anxiety Disorders Discussion

Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring anxiolytic therapy.

The Assignment: 5 pages

https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6630/DT/week_05/index.html

Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature)Case Study For Treating Patients With Anxiety Disorders Discussion.
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting Case Study For Treating Patients With Anxiety Disorders Discussion

Rubric

Grid View
List View

	Excellent Point range: 90–100	Good Point range: 80–89	Fair Point range: 70–79	Poor Point range: 0–69
Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.	9 (9%) – 10 (10%) The response accurately, clearly, and fully summarizes in detail the case for the Assignment. The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient.	8 (8%) – 8 (8%) The response accurately summarizes the case for the Assignment. The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient.	7 (7%) – 7 (7%) The response inaccurately or vaguely summarizes the case for the Assignment. The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.	0 (0%) – 6 (6%) The response inaccurately and vaguely summarizes the case for the Assignment, or is missing. The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.
Decision #1 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.	18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided.	16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided.	14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided.	0 (0%) – 13 (13%) The response inaccurately and vaguely explains the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing.
Decision #2 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.	18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided.	16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided.	14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided.	0 (0%) – 13 (13%) The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing.
Decision #3 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.	18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. ORDER HERE A PLAGIARISM-FREE PAPER	16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided.	14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided.	0 (0%) – 13 (13%) The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing.
Conclusion (1 page) • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.	14 (14%) – 15 (15%) The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient. The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided.	12 (12%) – 13 (13%) The response accurately summarizes the recommendations on the treatment options selected for this patient. The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided.	11 (11%) – 11 (11%) The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient. The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided.	0 (0%) – 10 (10%) The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing. The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.	5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.	4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.	3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.	0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.	4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors.	3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) grammar, spelling, and punctuation errors.	0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.	5 (5%) – 5 (5%) Uses correct APA format with no errors.	4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors.	3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) APA format errors.	0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors.

Excellent

Point range: 90–100

Good

Point range: 80–89

Fair

Point range: 70–79

Poor

Point range: 0–69

Introduction to the case (1 page)

Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

9 (9%) – 10 (10%)

The response accurately, clearly, and fully summarizes in detail the case for the Assignment.

The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient.

8 (8%) – 8 (8%)

The response accurately summarizes the case for the Assignment.

The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient.

7 (7%) – 7 (7%)

The response inaccurately or vaguely summarizes the case for the Assignment.

The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.

0 (0%) – 6 (6%)

The response inaccurately and vaguely summarizes the case for the Assignment, or is missing.

The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.

Decision #1 (1–2 pages)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

18 (18%) – 20 (20%)

The response accurately and clearly explains in detail the decision selected.

The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected.

The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients.

Examples provided fully support the decisions and responses provided.

16 (16%) – 17 (17%)

The response accurately explains the decision selected.

The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected.

The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.

The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.

The response accurately explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided support the decisions and responses provided.

14 (14%) – 15 (15%)

The response inaccurately or vaguely explains the decision selected.

The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected.

The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided may support the decisions and responses provided.

0 (0%) – 13 (13%)

The response inaccurately and vaguely explains the decision selected.

The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing.

The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.

Examples provided do not support the decisions and responses provided, or is missing.

Decision #2 (1–2 pages)

18 (18%) – 20 (20%)

The response accurately and clearly explains in detail the decision selected.

The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected.

The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients.

Examples provided fully support the decisions and responses provided.

16 (16%) – 17 (17%)

The response accurately explains the decision selected.

The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected.

The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.

The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.

The response accurately explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided support the decisions and responses provided.

14 (14%) – 15 (15%)

The response inaccurately or vaguely explains the decision selected.

The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected.

The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided may support the decisions and responses provided.

0 (0%) – 13 (13%)

The response inaccurately and vaguely explains in detail the decision selected.

The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.

Examples provided do not support the decisions and responses provided, or is missing.

Decision #3 (1–2 pages)

18 (18%) – 20 (20%)

The response accurately and clearly explains in detail the decision selected.

The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected.

The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients.

Examples provided fully support the decisions and responses provided.

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16 (16%) – 17 (17%)

The response accurately explains the decision selected.

The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected.

The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.

The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.

The response accurately explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided support the decisions and responses provided.

14 (14%) – 15 (15%)

The response inaccurately or vaguely explains the decision selected.

The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected.

The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided may support the decisions and responses provided.

0 (0%) – 13 (13%)

The response inaccurately and vaguely explains in detail the decision selected.

The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.

Examples provided do not support the decisions and responses provided, or is missing.

Conclusion (1 page)

• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

14 (14%) – 15 (15%)

The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient.

The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided.

12 (12%) – 13 (13%)

The response accurately summarizes the recommendations on the treatment options selected for this patient.

The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided.

11 (11%) – 11 (11%)

The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient.

The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided.

0 (0%) – 10 (10%)

The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing.

The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.

3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided.

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation

5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors.

4 (4%) – 4 (4%)

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3.5 (3.5%) – 3.5 (3.5%)

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 (0%) – 3 (3%)

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 (5%) – 5 (5%)

Uses correct APA format with no errors.

4 (4%) – 4 (4%)

Contains a few (1 or 2) APA format errors.

3.5 (3.5%) – 3.5 (3.5%)

Contains several (3 or 4) APA format errors.

0 (0%) – 3 (3%)

Contains many (≥ 5) APA format errors.

Total Points: 100

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