Anxiety Disorders - Arkansas Tech University
Anxiety Disorders
Kay Cox
NUR 4206
Anxiety
Uncomfortable feeling of apprehension and dread
Occurs in response to stimuli
Normal anxiety is of realistic intensity and duration
Can interfere with work and relationships
Can cause physical and emotional changes
Anxiety Disorders
Most common of psychiatric illnesses treated
Women twice as likely as men
People with primary diagnosis of depression often have anxiety disorders
Degrees of Anxiety
Mild
Moderate
Severe
Panic
Panic Disorder
Extreme, overwhelming form of anxiety; experience in real or perceived life-threatening situations
Chronic condition
Sudden onset, peak at ~ 10 minutes
Physical and Cognitive S/S of Panic Attacks/Anxiety
Palpitations
Chest discomfort
Rapid pulse
Nausea
Dizziness
Sweating
Trembling/ Shaking
SOB
Disorganized thinking
Irrational fears
Depersonalization
Decreased communication
Feeling of doom or death
Assessment
Determine that symptoms are not medical
Ask questions as on page 384
Mental status exam
Work, family and interpersonal relationships
Substance abuse
Cultural factors
Nursing Diagnosis
Anxiety
Ineffective Individual Coping
Impaired Social Interaction
Fear
Hopelessness
Social Isolation
Risk for Injury
Powerlessness
Ineffective Family Coping
Nursing Interventions
For panic- interventions are aimed at relief
Reduce anxiety
Stay with patient
Use short, simple sentences
Repetitive activity
Move to quite environment
Meds
Interventions
Assess for characteristics/feelings/name it
Teach relaxation techniques/ deep breathing exercises
Nutritional Education
Increased Physical Activity
Distraction
Positive Self-talk
Empower over Anxiety
Interventions
Exposure Therapy
Systematic Desensitization
Implosive Therapy
Cognitive Behavior Therapy
Psychoeducation
Emergency Care
Obsessive-Compulsive Disorder
Obsessions: thoughts or impulses that occur repetitively causing severe anxiety and distress
Compulsions: repetitive actions/behaviors
Interferes with ADLs
Obsessions are recognized by person but cannot be controlled
OCD
May begin in childhood
Often occurs with Tourette’s syndrome
Personality disorders in 80%
Rates similar in both men and women
Assessment
Suicide risk
Increases rate of physical disease
Neatly dressed, well groomed, cooperative, eager
May be distracted, speech full of irrelevant details
Nursing Diagnosis
Anxiety
Impaired skin integrity or other diagnoses related to specific compulsion
Interventions
Psychopharmacology
SSRIs
TCAs
ECT
Response Prevention
Thought Stopping
Cognitive Restructuring
Psychoeducation
Generalized Anxiety Disorder
Characterized by excessive worry and apprehension
Chronic worriers
Mild depressive symptoms
Somatic complaints
Trembling, twitching, muscle aches and soreness
Comorbid conditions
Nursing Diagnosis
Anxiety
Powerlessness
Sleep pattern disturbance
Low self-esteem
Ineffective coping, individual or family
Interventions
Similar to Anxiety/panic disorders
Meds: Benzodiazepines most common
Also, antidepressants and Buspar
Psychoeducation
Other Anxiety Disorders
Phobias
Agoraphobia
Social Phobia
Post Traumatic Stress Disorder
Dissociative Disorders
Splitting of self
Multiple personality disorder
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