Anxiety Disorders Flashcards
nursing intervention on anxiety
milieu, foster positive coping, strength based approach, facilitate new coping strategies = leads to adaptation, help them find their strengths to aid in coping
defense mechanisms- maladaptive
- Protect from feelings of inadequacy and worthlessness
- Prevent awareness of anxiety
- Extreme use distorts reality, interferes with interpersonal relationships, limits ability to work
- Unconscious levels, so person has little awareness or control over events
- Because of self-deception and reality distortion they usually do not help person cope realistically
what is the hormone (biochemistry) in anxiety?
norepinephrine
mild anxiety
- Associated with tension of day-to-day living
- During this stage, person is alert and perceptual field increased
- Person sees, hears, grasps more
- This kind of anxiety can motivate learning, produce growth and creativity
moderate anxiety
- Involves narrowing of perceptual field
- Focus on immediate concerns
- Person sees, hears, grasps less
- Selected areas blocked, but person can attend to more if so directed
severe anxiety
- Significant reduction in perceptual field
- Person tends to focus on specific detail and not think about anything else
- All behavior aimed at relieving anxiety
- Much direction needed to focus on another area
panic?
- Involves awe, dread, terror, disorganization of personality
- Increased motor activity
- Decreased ability to relate to others
- Distorted perceptions
- Loss of rational thought
- Inability to communicate or function effectively, even with direction
- Prolonged panic could result in death
OCD what are obsessions?
- Obsessions, compulsions or both
- Recurrent, persistent thoughts, urges or images
- Causes anxiety & disrupts life
- Attempts to ignore are unsuccessful
what are compulsions?
- Repetitive behaviours
- Behaviours are aimed at reducing anxiety or distress (but not realistically so)
- Time consuming
- Relative insight – good to poor to absent
phobias
- Marked fear about an object or situation which provokes fear immediately
- Avoidance
- Out of proportion
- Interferes with ADLs and life
- Disturbance for at least 6 months
PTSD
-Trauma and Stressor related disorders
Characteristics: Exposure to real threat (violence, death, serious injury, psychological trauma)
- Intrusive symptoms associated with event
- Begins after event occurred
- Recurrent dreams
- Flashbacks (dissociative)
- Intense prolonged psychological impact and distress
symptoms of PTSD
- Avoidance
- Alterations in mood & cognitions associated with event
- Persistent negative beliefs or expectations of self
- Persistent negative emotional state
- Feelings of detachment from others
- Occurring more than a month
- May be associated with depersonalization or derealization
Nursing care options
- Patients need to develop capacity to tolerate mild anxiety and use it consciously, constructively
- Goal is not to free patients totally from anxiety
- Relaxation Therapy
- Mindfulness Meditation
what can we do to protect the anxious patient emotionally
- Ensure safety for patient and reassure patient
- Allow patient to determine amount of stress he or she can handle at the time
- Do not force severely anxious patients into situations unable to handle
- Avoid attacking patients’ coping mechanisms - attempt to protect patients’ defenses
- Coping mechanism or symptom is attempting to deal with unconscious conflict
nursing actions to avoid
- Pressuring patient to change prematurely
- Being judgmental or verbally disapproving
- Asking patient a question that brings on defensiveness
- Focusing critically on patient’s anxious feelings with others present
- Lacking awareness of one’s own behaviors and feelings, -withdrawing from patient
how to modify the environment
- Identify and reduce anxiety-producing situations
- Set limits by assuming quiet, calm manner, decreasing environmental stimulation
- Offer supportive physical measures, e.g., warm baths or massages, that may help decrease anxiety
- Encourage patient’s interest in activities, exercise, recreation, an active hobby
medications for anxiety
Strengthen resilience and prevent relapse
Benzodiazepines: Xanax, Valium, Ativan, Librium
Noradrenergic agents: Propranolol
Anxiolytics: BuSpar
Antihistamines: Benadryl, Atarax,
Antidepressants
