Kirby’s Health Assessment and Careplan
Kaelii Cunningham
Department of Nursing, Delaware Technical Community College
NUR320-501 Health Assessment
Professor: Kristen Bell, MSN, RN
November 29, 2024
Introduction
The interplay between mental and physical health is a crucial consideration in contemporary healthcare, particularly for patients like Kirby, who presents with Generalized Anxiety Disorder (GAD) and is at risk for prehypertension. This essay examines Kirby's case through the lens of the Generalized Anxiety Disorder-7 (GAD-7) scale, assessing both subjective and objective data. It outlines evidence-based interventions and establishes short- and long-term outcomes for managing his conditions. We can illustrate how integrated care can enhance patient well-being and promote better health outcomes by emphasizing the importance of comprehensive assessments and targeted strategies.
Assessment and Management of Anxiety
The Generalized Anxiety Disorder-7 (GAD-7) scale is a well-validated instrument used clinically to assess anxiety severity and treatment response. This essay discusses a patient's subjective and objective data; Kirby explores various interventions and explains short- and long-term outcomes as evidence-based practices demonstrated. It also covers Kirby's prehypertension, including risk factors and management strategies. The use of assessment and GAD-7
Assessment and Risk Factors
The GAD-7 is a short, self-administered screening tool of seven questions assessing anxiety symptoms in the past 2 weeks, scored on a 0–3 scale. Scores vary from 0 to 21, with cutoffs for no anxiety (0–4), mild anxiety (5–9), moderate anxiety (10–14), and severe anxiety (15–21). You may be at risk of GAD and, therefore, need more assessment or intervention (Barry et al., 2023) if your total score is 10 (or greater). In Kirby’s case, a score of 11 denotes moderate anxiety, which she finds manifests in the form of frequent stress-eating, irritability, and trouble grappling with new obligations. There are also biological factors that contribute to anxiety. Responsive implicated in maintaining high anxiety levels include amygdala overactivity, prefrontal cortex under activation, and a problematic balance between different neurotransmitters, especially serotonin and GABA (Munir & Takov, 2022). While he did not present symptoms such as tachycardia or gastrointestinal distress, both psychogenic and biological factors would need to be addressed while developing a management plan.
Interventions
Research-supported treatments for GAD include relaxation techniques, exercise, journaling, and developing a sleep routine. This practice will not only help Kirby learn to calm himself down, but it can also serve as a relaxation technique that he can use in different situations to decrease anxiety symptoms. These practices engage the parasympathetic nervous system, leading to reduced physiological arousal and increased calmness (Barry et al., 2023). Kirby will be encouraged to practice these techniques regularly to manage acute anxiety episodes. Exercise: Regular physical exercise, including brisk walking or yoga, can reduce stress hormones and increase endorphins, improving mood and anxiety symptoms. Therefore, as highlighted by studies, moderately exercised aerobic exercise reduces anxiety severity and improves quality of life (American Heart Association, 2023).
Kirby will be counseled to participate in at least 150 minutes of moderate weekly activity. Expressive Writing and Talk Therapy: Journaling and cognitive behavioral therapy (CBT) offer guided methods for processing emotions and suppressing rumination. 2023); these methods are all established strategies for dealing with anxiety and avoiding relapses. Kirby will be encouraged to keep a journal but also attend counseling sessions to identify anxiety triggers and develop coping mechanisms. Sleep Hygiene: Poor sleep compounds anxiety, which creates a vicious cycle. — Following sleep hygiene and treating insomnia with cognitive behavioral therapy for insomnia (CBT-I) can affect anxiety symptoms (Barry et al., 2023). Kirby will be advised to use regular sleep patterns and engage in calming behaviors before bed.
Outcomes
Short-Term Goals: Within one week, Kirby will name one anxiety trigger and employ a coping mechanism, like deep breathing. In one of the sessions, Kirby will also demonstrate two relaxation techniques.
Within one month, Kirby will have 50% foot off the GAD-7 score, meaning that his anxiety symptoms will decrease significantly. For three months, Kirby will regularly practice preventative measures like journaling and physical exercise. Outcomes Relaxation techniques and lifestyle changes can produce significant improvements in anxiety. These interventions will manifest their effectiveness through decreased levels of stress hormones and enhanced mood. Follow-up assessments using the GAD-7 scale to monitor Kirby’s progress ensure we measure outcomes accurately.
Assessment and Management of Prehypertension
Prehypertension of stage 1 is defined by systolic blood pressure of 120–129 mm Hg and diastolic pressure of less than 80 mm Hg. While often asymptomatic, prehypertension increases the risk of hypertension and cardiovascular disease. A high-sodium diet, sedentary lifestyle, and Kirby’s already high blood pressure readings put them in danger at 136/72.
Assessment and Risk Factors
Several factors, such as high BMI, unhealthy eating habits, and a family history of hypertension, are risk factors for prehypertension. A significant component is excessive sodium intake (derived from salt or dietary) in amounts more significant than 2,300 mg/day, coupled with inadequate physical activity (Carey et al., 2021). Laboratory studies, including lipid panels and kidney function tests, are used to evaluate further cardiovascular risk (Whelton et al., 2018).
Interventions
Limit Salt: Salt increases blood pressure by increasing vascular resistance. Kim will learn to decrease sodium to less than 2,300 mg daily and be introduced to incorporating whole fruits and vegetables into her diet (American Heart Association, 2023).
Regular Exercise: At least 150 minutes of moderate aerobic exercise weekly improves vascular health and decreases systemic inflammation (Carey et al., 2021). Kirby will be advised to introduce activities like walking or swimming slowly into his schedule.
Monitoring Blood Pressure: Educating Kirby to monitor his blood pressure at home will help identify trends, allowing him to hold himself accountable (Whelton et al., 2023). Weight Loss: Losing 5–10% of body weight can bring blood pressure down considerably. 1:4 Start tracking his monthly weigh-in progress is tracked, and Kirby is encouraged to form a well-balanced, heart-healthy diet (American Heart Association, 2023)
Outcomes
Short-Term Goals: For three days a week, Kirby will take blood pressure readings. Within a month, Kirby would replace processed foods with healthier options and reduce sodium intake.
Long-term Goals: Kirby's blood pressure will be under 130/80 mm Hg for three months. He will lose 5–10% of his weight during the first six months.
Conclusion
Managing Generalized Anxiety Disorder (GAD) and prehypertension can seem daunting, but with a comprehensive approach, Kirby can take significant strides toward better health. By incorporating relaxation techniques, regular exercise, dietary changes, and routine monitoring into his daily life, Kirby can alleviate symptoms and enhance his overall well-being.
Evidence-based strategies are powerful tools that can lead to transformative physical and mental health outcomes. Embracing this journey will provide Kirby with a sense of reprieve and lay the foundation for ongoing recovery, helping him avoid potential future complications.
To kickstart this positive change, Kirby must follow up on the referral information provided in his care plan. Reaching out to Behavioral Health, Cardiology, and outpatient therapy is crucial in ensuring that his path to wellness begins without delay.
References
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American Heart Association. (2023). Managing Blood Pressure with a Heart-Healthy Diet. Www.heart.org. https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-blood-pressure-with-a-heart-healthy-diet
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