anxiety disorders

Question 1

you walk into the room and your patient, Billy, is pacing back and forth, wringing his hands, visibly diaphoretic, and shaking. He tells you “There’s an elephant on my chest, I can’t breathe”

what level of anxiety is Billy experiencing?

what are interventions you as the RN will implement?

Answer 1

Billy is experiencing panic level/panic attacks which are sudden episodes of intense fear or panic that come without warning

interventions are:
stay with Billy and provide a calm, safe, nonjudgmental atmosphere.
Help Billy with his breathing when he is ready. Speak in a calm, yet normal tone. Offer a PRN anxiolytic.
etc.

Question 2

what is the range of anxiety levels

Answer 2

mild to panic

Question 3

what is a fear

Answer 3

a fear is an identifiable stressor

Question 4

eitology of anxiety disorders

Answer 4

Biochemical: GABA, may result from low rates
Norepi: may be activated by inappropriate fight or flight response
serotonin (low)

interpersonal
behavioral
familial

Question 5

panic disorders (panic attacks)

Answer 5

see card about billy but still they are sudden, intense episodes of panic that peak at about 10 minutes yet have no warning.

Question 6

phobias

Answer 6

extreme fear of a person, place or thing

aracnophobia (scared of spiders)
agorophobia (fear of spaces where espace is difficult)
etc.

Question 7

OCD

Answer 7

characterized by unwanted repetitive anxious thoughts, which become obsessions, sometimes accompanied by actions (compulsions) to relieve the thought, as people suffering from OCD use these behaviors to relieve intense and unbearable anxiety.

Question 8

PTSD

Answer 8

Following exposure to a traumatic event (e.g., assault, natural or manmade disaster, war) manifestations include:

flashbacks, hyperarousal (on edge, can’t stay asleep, exaggerated startle reflex), persistent avoidance of repeated stimuli and emotional numbing (depersonalization)

acute: symptoms less than three months
chronic: 3 months or more

Question 9

GAD

Answer 9

Chronic, unrealistic, and excessive anxiety or worry
Characterized by excessive worry, feeling on edge, fatigue, difficulty concentrating, muscle tension, or sleep disturbances

Question 10

Dissociative Disorders

Answer 10

Dissociative Identity Disorder
Following profound childhood trauma
Presence of two or more distinct aspects of self that dominate one’s behavior