What are common causes of PTSD, and what is the most likely cause of L.L’s condition?

You are working the afternoon shift in an
inpatient psychiatric unit. The patients
are in the TV room watching a movie when suddenly someone starts yelling. You and other staff rush to the room to find
L.L., a 48 year old male patient, crouched in the corner behind a chair,
yelling at other patients: “Get down, quick, get down!” You and the other staff are able to calm L.L.
and the other patients and take L.L. to his room. He apologizes for his outburst and explains
to you that the movie brought back memories of the Gulf War. He had forgotten
where he was and thought he was in combat again. He describes to you in detail the memory he
had of being ambushed by the enemy and watching several of his comrades be
killed. You remember hearing in report
that L.L. is a Gulf War veteran admitted with Post Traumatic Stress
Disorder. (PTSD)

1. What are common causes of PTSD, and what is the most likely cause of L.L’s condition? Discuss three criteria that must be present for a diagnosis of PTSD.

2. Discuss in detail, the difference between PTSD and acute stress disorder.

3. Which symptom(s) of PTSD did L.L. most likely experience?

4. What therapeutic measures can be done to help L.L. during your shift this afternoon?

5. Which medication is most appropriate to give to L.L. ? Thoroughly explain your answer. Why? What classification is this medication? What is it’s mechanism of action to help with anxiety?

6. What are the adverse effects of long term use of benzodiazepine anxiolytics?

7. You notify L.L.’s psychiatrist about his reaction to the movie. She writes an order to start paroxetine daily. How does paroxetine differ from
lorazepam? Be thorough in your response and be sure to include the drug
classification of paroxetine. Why is paroxetine used and not other drugs in
this classification?

8. What are some potential side effects of paroxetine? BE SPECIFIC

L.L. asks you whether there are other
things he can do, in addition to medications, to help his anxiety. He tells you
that he has heard about relaxation therapy and wants to hear more about it.

9. What would you discuss with L.L. about relaxation therapy?

10. What other treatment modalities could L.L. be referred after his hospitalization to help treat his PTSD and related problems. Give at least three and briefly describe each one.

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