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Anxiety Disorders and Stress-Related Illness
Chapter 13-Psych Nursing
26
Nursing
Not Applicable
01/22/2012

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Term
What is anxiety?
Definition
a feeling of dread or apprehension; does not always have an identifiable cause
Term
What does anxiety feel like?
Definition
nervousness, increased heart rate, sweating, butterflies
Term
How does anxiety differ from fear?
Definition
Fear is caused by a threat from an identifiable stimulus, even thought it may not be logical.
Term
Levels of anxiety: Mild
Definition
sense that something is different and warrants special attention; can be a motivator towards a goal.
Term
Levels of Anxiety: Moderate
Definition
More noticeable on the outside; the person can still process info and be directed
Term
Levels of Anxiety: Severe and Panic
Definition
has difficulty concentrating, uncontrollable emotions, survival skills kick in, fight-or-flight is activated, adrenaline surge, increased vitals, may exhibit anger, can not focus...anxiety level has to be reduced before individual will respond to teaching or redirection.
Term
Working with Anxious Clients
Definition
-be aware of own anxiety level
-assess the pt anxiety level
-speak in short simple sentences
-lower anxiety level to mild or moderate before proceeding
-talk in low calm voice
-ensure safety during panic level anxiety
-remain with client until panic recedes
-anxiolytics should be used short-term
-be cautious of touch if pt is in panic level as it may be perceived as threatening
Term
What are anxiety disorders?
Definition
-group of conditions that share a key feature of excessive anxiety with ensuing behavioral, emotional, cognitive, and physiologic responses
-demo unusual behavior such as panic w/o reason, unwarranted fear, uncontrollable and repetitive actions, excessive worry
-impair daily routines, social lives, and occupations for at least 6 months
-usually secondary to dementia in the elderly
Term
Incidence of Anxiety Disorders
Definition
-most common psychiatric disorder affecting 25% of adults.
-more prevalent in women and those younger than 45 years old
-more common in divorced and separated persons
-more common in those with lower socioeconomic status
Term
Cultural Considerations Associated with Anxiety Disorders
Definition
-Asian cultures express anxiety through somatic symptoms
-Hispanics express anxiety as sadness, agitation, and weight loss and symptoms believed to occur b/c of supernatural spirits or "bad air"
Term
Anxiety and the Elderly
Definition
-often associated with depression, dementia, physical illness, med toxicity or withdrawal
-agoraphobia and GAD are the most common late-life anxiety disorders
-Elderly treated with SSRI's
-Loss of independence leads to depression
Term
Treatment of Anxiety Disorders
Definition
-combo of meds and therapy
-Cognitive-behavioral therapy includes positive reframing, decatastrophizing, and assertiveness training
Term
What is a panic disorder?
Definition
-composed of discreet episodes of panic attacks, usually 15-30 minutes of rapid, intense and escalating anxiety
-displays 4 or more of the following symptoms: palpitations, sweating, tremors, SOB, sense of suffocation, chest pain, nausea, abdominal distress, dizziness, chills or hot flashes
Term
Clinical Course of Panic Disorders
Definition
-Onset peaks in late adolescence and the mid 30's
-can lead to avoidance behavior or agoraphobia
-Primary and Secondary gain are present
-primary gain is the relief of anxiety
-secondary gain is the attention received from others as a result of the behaviors
Term
Panic Disorders: The Nursing Process
Definition
Assessment
-Hamilton rating scale for anxiety
-reports several panic attacks
-may appear normal
-anxious, worried, tense, depressed, serious, or sad
-fears losing control or going insane
-confused or disoriented
-poor judgement during attack
-self-blaming statements
-alterations to social life, family, or work
-problems sleeping or eating
Term
Panic Disorders: The Nursing Process
Definition
Diagnosis
-Risk for Injury
-Anxiety
-Situational Low Self-esteem
-Ineffective coping
-powerlessness
-ineffective role performance
-disturbed sleep pattern
Term
Panic Disorders: The Nursing Process
Definition
Patient Outcomes (The Client will...):
-be free from injury
-verbalize feelings
-use effective coping techniques
-manage own anxiety response
-verbalize sense of personal control
-re-establish adequate nutritional intake
-sleep at least 6 hours per night
Term
Panic Disorders: The Nursing Process
Definition
Interventions:
-promote safety and comfort
-using therapeutic communication
-managing anxiety
-providing client and family education
Term
Panic Disorders: The Nursing Process
Definition
Evaluation:
-Does the client understand prescribed meds and are they committed to adhering to it?
-Have the clients episodes of anxiety decreased in frequency or intensity?
-Does the client understand various coping mechanisms and when to use them?
-Does the client believe that his or her quality of life is satisfactory?
Term
What is a phobia?
Definition
-A phobia is an illogical, intense, persistent, fear of a specific object or social situation that causes extreme distress and interferes with normal life functioning.
Term
Agoraphobia
Definition
Fear of being outside
Term
Specific Phobia
Definition
an irrational fear of an object or situation
Term
Social Phobia
Definition
anxiety provoked by certain social or performance situations
Term
Onset and Clinical Course of Phobias
Definition
-specific phobia's usually occur in childhood or adolescence
-phobias that persist into adulthood are lifelong in 80% of cases
Term
Treatment of Phobias
Definition
-Psychopharmacology (includes anxiolytics, SSRI's, beta blockers)
-Behavioral Therapies (include systemic desensitization and flooding)
Term
Generalized Anxiety Disorder (GAD)
Definition
-Excessive worry and anxiety that is unwarranted more days than not
-symptoms include uneasiness, irritability, muscle tension, fatigue, difficulty thinking, and sleep alterations
-seen most often by family physicians
-treated with SSRI antidepressants and buspirone
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