Characteristics of various anxiety disorders and nursing interventions
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| 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
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| 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.
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| Symptoms of Panic Disorder | -Tension
-Irritability
-Sleep disturbances
-Increased HR
-Dizziness
-Fear going to die
-Nausea
-Chest pain
-Choking
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| 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
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| 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
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| Defense mechanisms used in phobia | Displacement, Repression, Symbolism
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| Defense mechanisms used in OCD | Undoing, Reaction formation, Intellectualization (to cover up compulsion)
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| 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
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| Drugs used in OCD | Anafranil and Luvox
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| 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.
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| Defense mechanisms used in PTSD | Isolation. Repression.
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| 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
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| 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.
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| 4 categories of drugs used to treat anxiety | Benzodiazepines, Beta blockers, antihistamines, anticonvulsants.
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| First choice drug in treating acute anxiety | Benzo's
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| First choice drug in treating chronic anxiety | Antidepressants
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