Chapter 14 Anxiety & Anxiety Disorders Flashcards
Anxiety
A vague feeling of dread or apprehension
- Response to external or internal stimuli that can have behavioral, emotional, cognitive, and physical symptoms
When is anxiety considered “normal”?
When it is appropriate to the situation and dissipates when the situation has been resolved
Anxiety Disorders
Share key feature of excessive anxiety with behavioral, emotional, cognitive, and physiological responses
Fear
Feeling afraid or threatened by a clearly identifiable external stimulus that represents danger to the person
Stress
Wear and tear that life causes on the body
DSM V Criteria for Anxiety Disorder
1) The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least sixmonths and is clearly excessive.
2) The worry is experienced as very challenging to control. The worry in both adults and children may easily shift from one topic to another.
3) The anxiety and worry are accompaniedby at least three of the following physical or cognitive symptoms (In children, only one of these symptoms is necessary for a diagnosis of GAD):
- Edginess or restlessness
- Tiring easily; more fatigued than usual
- Impaired concentration or feeling as though the mind goes blank
- Irritability (which may or may not be observable to others)
- Increased muscle aches or soreness
- Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep)
(T/F) True or False: Anxiety and fear are considered to be the same feeling
False!
Panic Disorder
Recurrent, unexpected, panic attacks that cause intense apprehension and feelings of impending doom.
- With 1 or more attacks followed by at least 1 month of fear of another panic attack or significant maladaptive behavior related to the attacks.
Lasts about 15-30 minutes, peak around 10 minutes.
- Half of people with panic disorder have agoraphobia.
- Increased risk of suicidal thoughts or tendency.
Panic Disorder & The Nursing Process: Assessment
Hamilton Rating Scale for Anxiety (see Box 14.1)
General appearance and motor behavior (automatisms)
Mood and affect (depersonalization, derealization)
Thought processes and content (disorganized thoughts, loss of rational thinking)
Self-concept (self-blaming, consumed with worry)
Roles and relationships (avoidance of others)
Phobias
Intense, irrational anxiety when exposed to a specific feared object or situation
Nursing Interventions for Phobias
Acknowledge the fear: Fear is a response to external simuli
Systematic desensitization (exposure therapy): Slow exposure of the object of fear
Cognitive- Behavioral Therapy (CBT): explore the perception of threats)
Teach appropriate coping (e.g., relaxation)
Provide positive reinforcement when appropriate
Generalized Anxiety Disorder (GAD)
Persistent, generalized, and excessive anxiety and worry
- Long term, at least 6 months
- Interferes with normal activities
Nursing Interventions for GAD
Cognitive or cognitive-behavioral therapy (CBT): Identify the relationship between the stressor and anxiety
Encourage different perceptions of the stressor
Adaptive coping
Encourage exercise, deep-breathing, relaxation, biofeedback
Decrease environmental stimuli
Pharmacotherapy
- SSRIs, TCAs, Buspirone
General Nursing Interventions
Remain with a person who displays high levels of anxiety
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Outcomes for Stress & Anxiety Management
Maintains
- Adequate sleep
- Concentration
- Role performance
- Social relationships
Controls anxiety response
- Seeks information to reduce anxiety
- Decreases environmental stimuli
- Uses effective coping strategies
Monitors
- Intensity of anxiety
- Duration of episodes
- Time between episodes
- Physical and behavioral manifestations of anxiety
- Sensory perceptual distortions
Eliminates precursors of anxiety
