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Anxiety Disorders

Characteristics of various anxiety disorders and nursing interventions

QuestionAnswer
Nursing approaches for mild and moderate anxiety -Pt. can still have open-ended convo -Do not change subject -Nurse should be calm, listening -Encourage pt. to talk about feelings -Provide distraction- through activity -Identify past coping skills
Nursing approaches for severe to panic levels of anxiety -Person is not always in control -Pt. unable to problem solve -Nurse should be calm -Benzos prn. P.O. or I.M. -Short, simple sentences -Reduce stimuli- remove crowd, audience -Never leave the pt. alone -Safety 1st! -Can't be logical w/ pt.
Symptoms of Panic Disorder -Tension -Irritability -Sleep disturbances -Increased HR -Dizziness -Fear going to die -Nausea -Chest pain -Choking
Nursing interventions for a pt experiencing panic -Stay w/ pt. -Speak slowly and softly -Decrease stimuli -No tight clothing around pt's neck -Slow, deep breaths, into bag...have them make eye contact and breathe w/ you
Nursing interventions for phobia -Identify phobia -Allow pt. to fully express fears -Teach relaxation techniques -Give only as much help prn to avoid secondary gains -Common fears w/ phobias (losing control, appearing inadequate, not being perfect, and fear of dying) -Desensitization
Defense mechanisms used in phobia Displacement, Repression, Symbolism
Defense mechanisms used in OCD Undoing, Reaction formation, Intellectualization (to cover up compulsion)
Nursing interventions for OCD Asses level of anxiety, determine how much behavior interferes w/ life, **provide schedule of activities, modify enviro so behavior can be accomplished (initially), safety measures, set limits on destructive rituals
Drugs used in OCD Anafranil and Luvox
Nursing interventions for PTSD Night lights, relaxation at bedtime, massage. Asses drug and alcohol use. Encourage support groups. Journal keeping. Be honest, don't judge. Listen. Group, 1:1. Suicide precautions. Previous coping.
Defense mechanisms used in PTSD Isolation. Repression.
Nursing interventions for somataform disorder Offer explanations & support during Dx testing, avoid further reinforcement after tests completed. Do NOT ask "how are you feeling?" Compliment when not talking about symptoms. Don't ignore/avoid. Spend unexpected time w/ pt. Don't tell them it isn't real
Key areas of assessment for any pt. w/ anxiety Assess level of anxiety. Focus on feelings. Offer self. Open ended communication (exception w/ somataform). Distract w/ activities. Be firm to encourage participation in activities. Meds are for short term use only.
4 categories of drugs used to treat anxiety Benzodiazepines, Beta blockers, antihistamines, anticonvulsants.
First choice drug in treating acute anxiety Benzo's
First choice drug in treating chronic anxiety Antidepressants
Created by: fulk_90