anxiety and obessive compulsive disorder Flashcards
anxiety
apprehension, uneasiness, uncertainty, or dread from real or perceived threat
fear
reaction to specific danger
normal anxiety
necessary for survival
mild anxiety
Everyday problem-solving leverage
Grasps more information effectively
- tense, bitting nails, shaking legs
moderate anxiety
- Selective inattention
- Clear thinking hampered
- Problem solving not optimal
- Sympathetic nervous system symptoms begin
- heart racing, tension, rr increase, sweat, symmatic symptoms present due to anxiety to physical, belly aches, diarrhea,
severe anxiety
- Perceptual field greatly reduced
- Difficulty concentrating on environment
- Confused and automatic behavior
- Somatic symptoms increase: headache, nausea, insonmina
- concentration inpared
- difficulty problem solving, elevated hr
panic
- Markedly disturbed behavior—running, shouting, screaming, pacing
- Unable to process reality; impulsivity
- cant breath, hallucinated, withdrawn
defence mechanisms
- Automatic coping styles
- Protect people from anxiety
- Maintain self-image by blocking
+Feelings
+Conflicts
+Memories - Can be healthy or unhealthy
- splitting, regression, impression
- maladaptive; not good
seperation anxiety disorder
Developmentally inappropriate levels of concern over being away from a significant other
- impacts family member
- gi upset, headache, sleep disturbance, innappropirate
panic disorder
Panic attacks- the sudden
onset of extreme apprehension
of fear, usually associated with
feelings of impending doom
agoraphobia
Excessive anxiety or fear about being in places or situations from which escape might be difficult or embarrassing
social anxiety disorder
Severe anxiety or fear provoked by exposure to a social or a performance situation that will be evaluated negatively by others
- how someone will perceive them
- fear of public speaking
generalized anxiety disorder
Excessive worry that lasts for months
obsessions
Thoughts, impulses, or images that persist and recur, so that they cannot be dismissed from the mind
- “I’m a bad person”
compulsions
Ritualistic behaviors an individual feels driven to perform in an attempt to reduce anxiety
Obsessive-compulsive disorder:
symptoms occur on a daily basis and may involve issues of sexuality, violence, contamination, illness, or death
assessment
- Sound physical and neurological exam
- Determine source of anxiety (primary vs. secondary)
- Determine current level of anxiety
- Assess for potential self-harm
- Complete psychosocial assessment
+Ask patient about causes they can identify - Self-assessment: you ask the nurse, how you engage, put own bias away, address those feelings
nursing diagnosis and outcome identification Anxiety
Self-monitors intensity; uses reduction techniques; maintains role performance
nursing diagnosis and outcome identification ineffective coping
Identifies ineffective and effective patterns; asks for assistance and information; modifies as needed
- help to find ways to manage it
nursing diagnosis and outcome identification chronic low self esteem
Verbalizes self-acceptance and increased confidence
Nursing Diagnoses and Outcome Identification self mutilation
Identifies predictive feelings; practices self-restraint
planning
- Patients do not usually require inpatient admission
- Planning involves selecting community-based interventions
- Encourage active participation in planning to increase positive outcomes
- Patient experiencing severe levels may not be able to participate in planning
- pt. should be involved and engaged in health outcome
application of the nursing process
Implementation - Mild to moderate levels of anxiety - Severe to panic levels of anxiety Counseling Teamwork and safety Promotion of self-care activities
implementation
- Pharmacological interventions \+Antidepressants \+Anti-anxiety drugs \+Other classes - Psychobiological interventions - Integrative therapy - Health teaching: coping mechanism, relaxation techniques, side effects from meds, reduce anxiety, keeping pt. safe
advanced practice interventions
- Cognitive therapy: help reconstruct thoughts
- Behavioral therapy
+Relaxation training
+Modeling: model correct behavior
+Systematic desensitization: introducing whats fearful graudually
+Flooding: exposing them to stimuli (direct)
+Response prevention: OCD set limits for ritual behaviors
+Thought stopping: stop negative thoughts - Cognitive-behavioral therapy
evaluation
- Is the patient experiencing a reduced level of anxiety?
- Does the patient recognize symptoms as anxiety-related?
- Does the patient continue to display signs and symptoms such as obsessions, compulsions, phobias, worrying, or other symptoms of anxiety disorders? If still present, are they more or less frequent? More or less intense?
- Is the patient able to use newly learned behaviors to manage anxiety?
- Does the patient adequately perform self-care activities?
- Can the patient maintain satisfying interpersonal relations?
- Is the patient able to assume usual roles?
SSRI
lexapro: first line of treatment
