J.J. asks you whether there are other things he can do, in ...

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J.J. asks you whether there are other things he can do, in addition to medications, to help his anxiety. He tells you that he's heard about relaxation therapy and wants to hear more about it.
 
  What would you discuss with J.J. about relaxation therapy?
 
  To what other treatment modalities could J.J. be referred after his hospitalization to help treat
  his PTSD and related problems?

Question 2

While you are in J.J.'s room, he states that he would like to rest for a while, and he requests something to calm his nerves. you check his medical record see these PRN (as needed) medications listed.
 
  PRN Medications
  Acetaminophen(Tylenol)650mgPOevery6hoursp rnpainorfever
  Alprazolam(Xanax)orallydissolvingtab let,0.5mgbymouthevery4hrprnanxiety
  Zolpidem(Ambien)extendedrelease,12.5mgPOatbedtimeifneeded
 
  Which medication is most appropriate to administer at this time? Explain.
 
  What are the adverse effects of long-term use of benzodiazepine anxiolytics?
 
  You decide to notify J.J.'s physician about his reaction to the movie. The physician writes an
  order to start paroxetine (Paxil). How does this medication differ from alprazolam?
 
  Which of these are potential side effects of paroxetine? Select all that apply.
  a. Nausea
  b. Constipation
  c. Postural hypotension
  d. Headache
  e. Tinnitus

[micaelaswann]

Answer to Question 1

It would be important to tell him that relaxation therapy is the use of techniques to encourage and
elicit relaxation to reduce anxiety. You can provide him with written information about relaxation
techniques, but it would be more effective to demonstrate and have him practice relaxation
techniques with you. Discuss with J.J. the need to anticipate when the need for relaxation may occur,
and how to evaluate whether the techniques are helpful.

 Cognitive or behavioral therapy
 Exposure therapy or systematic desensitization (i.e., combat focus groups)
 Psychoeducational group therapy
 Supportive therapy
 Couples or family therapy
 Substance abuse relapse prevention

Answer to Question 2

Alprazolam, a benzodiazepine anxiolytic, would be the most appropriate choice for anxiety. The
acetaminophen is appropriate for mild to moderate pain or for fever. The zolpidem is a sleeping
pill (hypnotic), and J.J.'s flashback incident occurred in the afternoon. It is too early in the day for a
sleeping pill.

Addiction: the need for more medication to get desired effect, withdrawal on abrupt cessation.
Long-term use can also cause depression and insomnia.

Alprazolam (Xanax) is a benzodiazepine anxiolytic and is useful when a quick onset is needed for
reducing symptoms of anxiety. It should be used only on a short-term basis until other medications
or treatments are helpful.
Paroxetine (Paxil) is a selective serotonin reuptake inhibitor (SSRI) that is approved for use in
patients with PTSD. It has a calming effect when used in patients with anxiety disorders but can
take a few weeks to become effective. It is designed for long-term use in patients with anxiety
disorders.

Answer: a, c, d

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TYSM

[Animal_Goddess]

Excellent