ASSIGNMENT:
Respond to at least two of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned.
Support your responses with evidence-based literature with at least two references in each colleague’s response with proper citation in APA Format.
Colleagues Response # 1
Differences between Adjustments Disorders and Anxiety Disorders
Adjustment disorder (AjD) and Anxiety disorders (AD) are among the most often diagnosed mental disorders in clinical practice. AjD is recognized as a stress-response syndrome, which is defined as a maladaptive reaction to an identifiable stressor (Zelviene & Kazlauskas, 2018). It is a condition that can occur when you have difficulty coping with a specific, stressful life event – for example, a death or illness in the family, getting fired or laid off from a job, significant relationship issues like break-ups or divorce, or sudden change in social settings such as the pandemic.  Five basic diagnostic criteria of AjD are presented in DSM-5. The first criterion indicates that AjD might only be diagnosed if symptoms occurred within 3 months in the context of identifiable stressor(s). The second criterion specifies clinical significance of AjD symptoms meaning that stress reactions should be out of proportion to the normal reactions of the identified stressor according to the social or cultural context, and there should be significant disturbances in important areas of life. The last 3 criteria point out that 3) the disturbance should not meet criteria or represent a worsening condition of another mental disorder; 4) AjD should not be considered in cases of normal bereavement reactions; and 5) AjD has a tendency to dissipate during 6 months after the stressor has ended (Zelviene & Kazlauskas, 2018).
Individuals with AD often have a lengthy and consistent history of anxiety and excessive worry, whereas individuals with Adjustment Disorder only experience their symptoms in times of or in response to stress or change. Anxiety Disorder can be made worse by stressors such as change or adjusting to new routines. But if you have Adjustment Disorder, you’ll typically see a reduction in your anxiety as you adapt to the change or learn to cope with the stressor, while anxiety and related symptoms are continual for those with GAD.
Diagnostic Criteria for Generalized Anxiety Disorders (GAD)
According to the DSM IV, “GAD is defined by the following diagnostic criteria:
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance)
B. The individual finds it difficult to control the worry
C. The anxiety and worry are associated with three (or more) of the following six symptoms: Restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)” (The history of generalized anxiety disorder as a diagnostic category, 2017).
The DSM IV makes it clear that GAD is largely an exclusion diagnosis. GAD cannot be diagnosed if the anxiety is better explained by other anxiety disorders (panic, phobic, social anxiety, or obsessive compulsive disorder) (The history of generalized anxiety disorder as a diagnostic category, 2017). Also, GAD cannot be caused directly by stressors or trauma, contrary to adjustment disorders and PTSD (The history of generalized anxiety disorder as a diagnostic category, 2017).
Evidenced-based Psychotherapy and Psychopharmacologic Treatment for GAD
All patients with anxiety disorders require supportive talks and attention to the emotional problems that are associated with the anxiety disorder. Psychoeducation includes information about the physiology of the bodily symptoms of anxiety reactions and the rationale of available treatment possibilities (Treatment of anxiety disorders, 2017). Cognitive-behavioral therapy (CBT) is also one of the best-established psychotherapy treatments for GAD.
Due to their positive benefit/risk balance, selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SNRIs are recommended as first-line drugs (Treatment of anxiety disorders, 2017). SSRIs for GAD include: Escitalopram, Paroxetine and Sertraline. Pregabalin is a calcium modulator that is also effective in treating GAD (Treatment of anxiety disorders, 2017). However, there have been concerns about the abuse of pregabalin in individuals suffering from substance abuse and also withdrawal syndromes after abrupt discontinuation (Treatment of anxiety disorders, 2017). Buspirone, a 5-hydroxytryptamine receptor 1A (5HT1A) agonist, has been shown in some controlled studies to be effective in the treatment of GAD (Treatment of anxiety disorders, 2017).
Colleagues Response # 2
Anxiety disorders are among the most prevalent psychiatric and mental health discoveries globally. Specific phobia is an anxiety disorder characterized by persistent fear and avoidance. Specific phobias are associated with childhood-onset (Eaton, Bienvenu, & Miloyan, 2018). It has high comorbidity with other mental health illnesses and can be highly disabling if left untreated. The most common types of specific phobias include fear of the different types of animals, fear of heights, and claustrophobia.
Adjustment disorders vs. anxiety disorders
The main cause of adjustment disorder is external stressors and life changes whereas anxiety disorder are caused by a combination of genetics, developmental, and behavioral factors. Individuals living with anxiety disorder tend to present with a repeated and persistent pattern of excessive worrying whereas those with adjustment disorders only have excessive worry when experiencing a stressful life event. Better coping and adaptation to the stressor among people living with adjustment disorder tend to reduce the excessive worry as opposed to those with an anxiety disorder as their symptoms are continuous in nature. For example, to make a diagnosis of adjustment disorder the client must present with distress that is out of proportion with expected reactions to the stressor within 3 months of the onset of the stressor (APA, 2013). When the stressor is removed, the client begins to cope and the symptoms reduce within 6 months. On the other hand, anxiety disorders is characterized by excessive fear and anxiety.
Diagnostic criteria for Specific Phobia
According to the DSM V diagnostic criteria (APA, 2013), Specific Phobia is characterized by marked fear or anxiety about a specific situation or object. The dreaded situation or object elicits
intense fear or anxiety. The phobic object or situation is avoided or at times endured with intense fear/anxiety. The fear is always excessive and out of proportion in relation to the threat of danger posed. The excessive worrying or fear must be present for a period of at least 6 months. The fear, excessive anxiety, and avoidance of the dreaded situation or object must be attributed to significant interference in the person’s social and occupational functioning among other important areas of functioning. The presenting symptoms should not be attributed to other mental disorders such as Social Phobia, OCD, PTSD, and separation anxiety disorder.
Evidence based-psychotherapy and psychopharmacologic treatment of Specific Phobia
Specific Phobia is treatable through the use of both psychotherapy and psychopharmacology. Treatment of the disorder aims at minimizing fear, phobic avoidance, and improve impaired functionality (Eaton, Bienvenu, & Miloyan, 2018). The use of psychotherapy is a first-line treatment followed by pharmacotherapy. The evidence-based psychotherapy for the disorder involves the use of Exposure Therapy which is the treatment of choice (Thng, et al., 2020). The use of Cognitive Behavioral Therapy is another psychotherapy approach used in the management of specific phobias. Exposure therapy involves gradual exposure to the feared situation/object repeatedly until the object/situation does not elicit a fear response. The use of exposure therapy is based on the rationale that continuous and gradual exposure to a safe but frightening situation or object result in reduced anxiety levels thus reducing avoidance behavior (Böhnlein, et al., 2020). Exposure therapy is also used in combination with Cognitive Behavioral Therapy for increased efficacy. CBT is essential in helping the client identify the irrational thoughts and beliefs that may contribute to symptom presentation (Eaton, Bienvenu, & Miloyan, 2018). Irrational thoughts such as catastrophizing are identified through the use of CBT thus helping the client appreciate new realistic and rational thinking.
Pharmacological treatment is used to complement exposure therapy. The various pharmacological modalities that are used in the treatment of specific phobias include beta-blockers and psychotropic medications such as benzodiazepines (Amray, et al 2019). The beta-blockers are used to control increased heart rate associated with specific phobia. The psychotropic is administered to minimize the emotional disturbance associated with the disorder.
 
 
 
RubricDetailBlackboardLearn

Make sure it is in APA 7 format and at least 3-4 paragraphs and references.
Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.
In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.
To Prepare:

• Reflect on the Resources related to digital information tools and technologies.
• Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
• Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.

By Day 3 of Week 6

Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.

By Day 6 of Week 6

Respond to at least two of your colleagues* on two different days, offering additional/alternative ideas regarding opportunities and risks related to the observations shared.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.
In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.
To Prepare:

• Reflect on the Resources related to digital information tools and technologies.
• Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
• Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.

By Day 3 of Week 6

Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.

By Day 6 of Week 6

Respond to at least two of your colleagues* on two different days, offering additional/alternative ideas regarding opportunities and risks related to the observations shared.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
*Note: Throughout this program, your fellow students are referred to as colleagues.
I will be adding two discussions that will need replies. At least 2-3 references each and 2 paragraphs also for each.
Mike’s  discussion
With the advent of high speed data and network interface with surging speeds, the introduction of the electronic health record system to the hospital network and the adoption of informatics into the health care sector, some of the noticeable technological trends fostered by the aforementioned developments includes but is not limited to the use of zoom calls for conferences and meetings, the use of information technology to offer opportunities in telephone or video medicine. “An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care.” (HealthIT.gov., 2018c)
Given the ease at which the health care sector thrives in the wake of technological and data advancement due to innovation and research, the infrastructures surrounding the smooth running of these innovative ideas are sometimes faced with challenges associated with their use. Some of the potential challenges associated with the use of these ground breaking innovations include but is not limited to adequate man power and staffing to man the system, monitor it and also do necessary repairs when the need arise, the problem of lack of an emergency back up should the primary system experience a problem requiring extensive repairs and or replacement, the need for data collection, inspection, interpretation and utilization presents with an issue if no qualified personnel is available to undertake the duties described above.
Given the premise of the ease of use and the need to pursue enhancement in technology and innovation with regards to the health care sector and patient care safety, one potential benefit associated with data safety, legislation and patient care is the ease at which a patient can get attended to by a physician or a mid level provider at the comfort of their home using either a tele conference approach or a video platform like zoom. The down side or potential risk concomitant with this mode of patient care is associated to cases that require the physical presence of a provider or a physician in cases of emergency where the situation requires a one on one attention as in the case of doing invasive procedures or extensive surgeries. “Telehealth is still a new and evolving technology; while the offsite interventions or contacts often lead to less time being wasted on non – care oriented task because of the efficiencies offered by the technology applications, its use must never be associated with less care.” (McGonigle, 2017, p361)
Following from the disruption in the normal work flow of the health care sector due to the COVID 19 pandemic, some of the health care technology trends I believe are most promising for inputting health care technology in nursing practice include the use of advancements in tele medicine which presents with advantages in no over head or staff to maintain, no rent or space to pay in the case of stand alone private clinics whose owners pay a premium to utilize an assigned space for their respective practices. Given our present global circumstance of COVID 19 pandemic, I will say for the time being, the use of zoom calls and advancements in tele medicine is the best alternative to a face to face contact with a patient, since quite a lot can be accomplished using a phone line and or a video call with the exception of limitations to cases that require invasive approach or emergency intervention like the need to intubate a patient. “In a connected care environment, more citizens are engaging in their health care through mobile apps and social media tools. Given this growing health care engagement, it is important for health care professionals to have the knowledge and skills to evaluate and recommend appropriate digital tools.” (Skiba, 2017)
References
HealthIT.gov. (2018c). What is an electronic health record (EHR)? Retrieved from 
            https://www.healthit.gov/faq/what-electronic-health-record-ehr
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. 
Dea’s Discussion
Main Post
Some of the healthcare technology trends that I have observed in my nursing practice are telehealth and electronic MAR. This electronic technology was created for providers to get information in real-time and it is only accessible to qualified staff. (HealthIT.gov, 2018c). We still paper chart at our detox, mental health hospital so these two technologies are used at work. We have only had electronic MARs for a few years but it does collect data that we use for clinical decisions. One of the challenges of the e-MAR is the lack of knowledge on how to use the system. This is more of a physician problem than a nursing problem although new nurses or PRN nurses who have never used the system or have not been trained enough on the system can find it challenging. When physicians do not know how to use the system correctly they typically put in orders wrong, especially when a patient is on a detox medication taper. This is dangerous because if you have a new nurse or a PRN nurse and a physician who does not know how to use the system, then medication errors can and do happen.
One benefit to the e-MAR is data safety. With the e-MAR, we can scan their armband or look a patient up by their name and date of birth. Once this information is entered by a nurse, the patient’s e-MAR profile comes up and this is where you can go over medications, allergies, or any other important information that needs to be verified. There are also risks when it comes to e-MARs. For example, data safety can be a concern. Even though technology has their patient’s data information as a priority, there are security and privacy issues. For example, how consent is obtained and patient trust plays a part in the safety of data. If trust is not kept, then patients may not be willing to give important information when seeking care (McGonigle & Mastrian, 2017 pp. 284-285).
Another benefit to e-MARs is due to legislation. There is legislation in place to protect patient information. The government uses the American Recovery and Reinvestment Act as legislation. It protects patients by addressing development, adoption, and implementation (McGonigle & Mastrian, 2017 p.149). A risk for data safety for the e-MAR is if a nurse leaves the computer up and on a patient’s profile. Another patient can easily see what is on the screen. This does not provide privacy for the patient. When you are done with the computer, you are supposed to log out of the patient’s file. This is one-way data is not safe.
Lastly, the benefit of having an e-MAR is patient care. The e-MAR allows staff to stay on task with medication distribution. The e-MAR lets the nurses know what medication is due and what the dose is. The e-MAR also provides safety to the patient. If the wrong medication is scanned the system does not allow the nurse to go any further. This allows the nurse to verify what she is scanning is correct. This provides safety in patient care. On the other hand, a risk to patient care is if the system does not have the right allergies put into the system and the wrong medication is given. Many of the patients that come into the hospital are not in the right mind at the time of admission. As a hospital, we rely on the data collected and entered into the system before they receive medications. Collecting data can be a risk to the patient which would lead to poor patient care.
In today’s world, many people in the community are taking responsibility for their healthcare and that is being done by using mobile apps and social media (Skiba, 2017). These technology trends are most promising for impacting nursing practice and impacting patient outcomes. Mobile apps and social media impact nursing practice because they provide a tool to help in educating patients. For example, as you educate your patients, you can guide them to the Center for Disease Control and Prevention (CDC) for further information. Many times, patients do not have questions until a later time and this will allow them to take initiative in their care. These trending technologies are a great tool for nurses to utilize in their practice and will continue to impact their nursing practice. Technology is not going anywhere soon so as nurses, we need to embrace these tools and use them to our advantage. When nurses provide reliable resources, the patients will be less like to surf the web for the answers to their health questions. There are a lot of mobile apps and social media outlets that can lead patients down the wrong path. As nurses, it is our job to know what apps and social media outlets will lead to improving patient outcomes. That being said, it seems that technology trends, the impact of nursing practice, and improving patient outcomes are intertwined.
References
HealthIT.gov. (2018c). What is an electronic health record (EHR)? Retrieved from https://www.healthit.gov/faq/what-electronic-health-record-ehr
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32-40.