Hi there, I needed help writing an assignment. For a Nursing course of Psychiatr

Hi there, I needed help writing an assignment. For a Nursing course of Psychiatric for nurse practitioners. Masters level. I have to reply to this posting by classmate, where I agree or disagree; from reading I agree with this posting. Responses should be a minimum of 250 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required past 10-years. Please include DIO with references.
SOAP Note #1
Patient: AB
Date of Appointment: 8.29.2023
Subjective:
A.B. is a 35 year old female here for follow up visit for maintenance of her medications and psychiatric conditions. She has a history of generalized anxiety disorder and major depressive disorder. She is currently taking Xanax and Sertraline for both and both seem to be working for her. She takes the Sertraline for maintenance and the Xanax for break through anxiety. She has no additional complaints and is currently out of town for the hurricane but also trying to celebrate her birthday. A.B. denies anhedonia, sadness, depression, racing thoughts, rumination, repetitive behaviors, distractibility, lack of focus, impulsivity, obsessions, compulsions, insomnia, fatigue, panic, changes in sleep, appetite, or mood. AB also denies suicidal ideation or homicidal ideation or delusions or hallucinations. She does, however, endorse increased anxiety recently that she describes as situational.
She states she recently started seeing a new dentist and that the first appointment not only did he do a root canal but he set her up for a lot of dental work she did not know she needed. She is suspect of the dentist’s intentions and is going to get another opinion but is also complaining of severely increased anxiety thinking about all of the dental work she is supposed to have done and the cost if indeed, she needs the work.
Objective:
A.B. seems to be a very pleasant individual and other than when talking about her experience with the dentist, she appears very happy to be out of town celebrating her birthday. She is well dressed and in casual attire today. She appears to be in a comfortable place for today’s visit and is out of town due to the storm but in a safe place. She is actively participating during the exam and has a logical thought process. She is absent of any abnormal muscle movements or ticks. Her speech is neither rapid nor pressured and she is pleasant. She is well groomed and dressed appropriately. Her respirations are even and unlabored. She is not in any obvious acute distress physically and only mild emotional distress at time of interview and again only when discussing her recent visits to the dentist.
Assessment:
• Generalized Anxiety Disorder (F41.1)
• Major Depressive Disorder (F32.9)
Current Medications:
• Xanax 0.5 mg po bid prn anxiety
• Sertraline 75 mg po q day
Plan:
• Continue Sertraline 75 mg po q day
• Continue Xanax 0.5 mg po bid prn anxiety
• Will monitor side effects and if worsening or improving symptoms as more time with medications passes.
Rationale:
• Major Depressive Disorder (ICD F32.9). The individual must have at least five of nine primary symptoms. The symptoms must have occurred in the same two week period. Depressed mood or loss of pleasure or interest must make up at least one of the five symptoms present. And these symptoms must be taking place for at least two weeks. A.B. has verbalized symptoms that qualify for a diagnosis of major depressive disorder in the past but is doing much better now on her medications (Dziegielewski, 2015).
• Generalized Anxiety Disorder (F41.1). Some of the diagnostic criteria that A.B. was able to demonstrate for General Anxiety Disorder are that the patient must have a history of being more worried than not for the past six months (American Psychiatric Association, 2022). Additionally, there is a loss of control to the worrying and the worrying and anxiety are accompanied by at least three of the following:
o Restlessness and/or uneasiness
o Fatigue or growing tired easily
o Irritability
o Falling asleep is difficult
o Muscle soreness and fatigue
o Inability to concentrate well.
• Alprazolam (Xanax). Xanax binds to the benzodiazepine receptors and the inhibitory effects of GABA are enhanced. It is indicated for anxiety and panic disorder as well as general anxiety disorder. Can be used short term or long term but does have potential for abuse. Should not stop suddenly after long term use and is often used as an as needed medications for breakthrough anxiety (Stahl, 2021).
• Sertraline (Zoloft). Works by boosting the neurotransmitter serotonin and also blocks the serotonin reuptake pump. It’s indicated for major depressive disorder as generalized anxiety disorder and is for maintenance rather than as needed. It is a first line treatment for depression and is also indicated for GAD. (Stahl, 2021).