anxiety disorder phobias etc

  1. Phobias
    • fear of being in places or situation from which escape might be difficult or in which help might not be available in an event of panic like symptoms or other incapcitating symptoms
    • shops, cinemas, clubs
    • pt- may actively avoid these places or may have some go with them
  2. Phobias
    social anxiety- social phobia
    excessive fear of situations in which the affected person might do something embrassing or evaluated negatively by others
  3. phobias
    specific phobias
    • fear of specific objects or situations that could conceivable cause harm, but the person's reaction to them is excessive, unreasonable, and inappropriate
    • exposure to the phobic object produces
    • overwhelming symptoms or panic: palpitations, sweating, dizziness, and difficulty breathing
  4. Phobia
    learning theory
    • fears are conditioned responses and thus are learned by imposing reinforcement for certain behaviors
    • like my kiddies being scared of animals
    • association- child falls and a dog barks now child associated him hurting himself with a dog and now he is scared of dogs
  5. phobias
    cognitive theory
    • anxiety is the product of faulty cognition or anxiety-inducing self instructions
    • - negative self-statement
    • - irrational beliefs
    • or your avoid places cause you are scared
    • ex is fear of driving over a bridge cause you think it will collaspe
  6. Phobias
    biological aspects
    • temperment (personality)
    • characteristics with which one is born that influence how he or she responds throughout life to specific situations (ex innate fears)
  7. phobias
    early experiences may set the stage for phobic reactions later in life
  8. anxiety disorder attributed to another medical condition
    • medical conditions that may produce anxiety symptoms include:
    • CV (MVP, AFIB)- r/o cardiac issue
    • endo (hyperthyroidism)- blood or thyroid
    • respiratory COPD- can't breath
    • neurological- tourette's syndrome- worsen during stress
    • it may not be anxiety so do the work up to make sure
  9. Substance-induced anxiety disorder
    • may be associated with intoxication or withdrawal from any of the following
    • alcohol, sedatives, hypnotics or anxiolytics
    • amphetamines or cocaine
    • hallucinogens
    • caffeine- withdrawal causes anxiety
    • cannabis- emotional
    • others
    • addictive
  10. OCD
    assessment data
    • reccurrent obessions or compulsions that are severe enough to be time-consuming or to cause marked distress or significant impairment
    • continuum of anxiety- mild- severe
    • sometimes can't leave their house
    • have to perform rituals before leaving
  11. OCD
    recurrent thought, impulses, or images experienced as intrusive (interrupting thought) or stressful, and unable to be expunged by logic or reasoning
  12. OCD
    • repetitive ritualistic behavior or thought, the purpose of which to prevent or reduce distress or to prevent some dreaded event or situation
    • many people feel forced to do this even when they don't want to
    • partial relief from anxiety
  13. predisposing factors to OCD and related disorders
    • learning theory
    • conditioned responsed to traumatic event
    • passive avoidance- stay away from the source that cause anxiety
    • active avoidance- engage in behaviors to provide anxiety relief
  14. predisposing factors to OCD and related disorders
    psychosocial influences r/t trichotillomania
    • stressful situations- school
    • disturbances in mother-child relationship
    • fear of abandonement
    • recent object loss
    • possible childhood abuse or emotional neglect
  15. predisposing factor OCD
    biological aspects
    • genetics- possible with trichotillomania
    • neuroanatomy- possible abnormalities in basal ganglia and orbitalfrontal cortex w/OCD
    • physiology- some indivi with OCD have EEG changes-
    • biochemical- possible decre in serotonin w/OCD
  16. PTSD
    • reaction to extreme trauma causing pervasive distress- war, abuse
    • avoidance of stimuli associated with trauma
    • numbing of general responses
    • estranged, deattached from others
    • restricted affect (lack of spontaneity)
    • symptoms not present before trauma
    • comorbidity w/Substance abuse, anxiety, depression
    • can occur in 1-3 months have last at least a month
  17. PTSD
    symptoms of increased arousal
    • hypervigilance- always focused- always looking for someone to make a move
    • sleep disturbed nightmares
    • irritability, reckless/self-destructive behavior
    • poor concentration
    • exaggerated startle response
  18. Acute stress disorder
    differs from PTSD
    • Duration of ASD is shorter- up to a month if s/s occur after this then it is PTSD
    • time from trauma (ASD) to develoment of symptoms are shorter than PTSD which is one month
    • ASD and PTSD can occur witnessing or experiencing the event
  19. ASD more
    • dissociative symptoms occur both PTSD and ASD
    • suicide is a real danger in both
    • resolves with in four weeks or becomes PTSD
    • 491
  20. Hair pulling disorder
    • assessment:
    • the recurrent pulling out of one's own hair that results in noticeable hair loss
    • preceding by incr tension and results in sense of release or gratification
    • the disorder is not common, but it occurs more often in women than in men
  21. diagnoses and outcome identification
    • nursing dx commonly associated w/anxiety, OCD, and other related disorders
    • - panic anxiety- (panic disorder, GAD)
    • - powerlessness- (panic disorder, GAD)
    • - fear (phobia)
    • - social isolaton (agoraphobia)
  22. dx/outcomes identification
    • nursing dx
    • ineffective coping (OCD)
    • ineffective role performance OCDineffective impulse control hair pulling
  23. outcomes
    • client-
    • is able to recognize signs of escalating anxiety and intervene before reaching panic level (GAD)
    • is able to maintain anxiety at managable level and make independent decisions about life situation
  24. outcomes 2
    • client -
    • functions adaptively in the presence of phobia object/situation without experiencing panic anxiety
    • verbalizes a future plan of action for responding in the presence of the phobic object or sitation without developing panic anxiety (phobic disorder)
  25. outcomes
    • is able to manage anxiety at a manageable level without having to perform rituals
    • demonstrates more adaptive coping strategies for dealing with anxiety than ritualistic behaviors
  26. outcomes hair pulling
    verbalizes and demonstrates more adaptive strategies for coping with stressful situations
  27. planning/implementations
    • relief of acute panic symptoms
    • helping client take control of his/her own life situation and accept those situations over which they have no control
    • teaching
    • recognize triggers
    • finding ways to cope
    • support
  28. planning/implementation
    dec fear and inc ability to function in the pressence of the phobic stimulis or situation without experiencing anxiety
  29. planning/implementation OCD
    • helping the client maintain anxiety at a manageable level without having to resort to ritualistic behavior
    • developing more adaptive methods of coping w/anxiety
  30. Planning/implementation
    hair pulling
    • helping the client discontinue the maladaptive behavior by
    • assisting with habit reversal training
    • learning more adaptive stress management technique- like tactile
  31. client/family education
    • nature of illness:
    • what is anxiety
    • what might it be related to
    • what is ocd
    • what is trichotillomania
    • symptoms of these disorders
  32. client fam education
    med management
    • management of illness
    • med management
    • - possible advere effectt
    • - length of time it takes effect
    • - what to expect from the med
  33. client/fam education
    stress management
    • management of illness
    • stress management
    • - teach ways to interrupt escalating anxiety
    • - teach relaxation techniques- meditation, guide imagery, music, excerise, yoga
  34. client/fam ed
    support services
    • crisis hotline
    • support groups
    • indivi psychotherapy
    • - collab w/social worker
    • - psychotherapist
  35. nx process eval
    is measure by fulfillment of the outcome criteria- nursing intervention did it work
  36. eval 1
    • can the client recognize s/s of escalating anxiety, and interrupt before it reaches panic level
    • can the client demonstrate activities that can be used to maintain anxiety at a manageable level
    • can the client discuss the phobic object/situation without becomes anxious
  37. evaluation 2
    • can client function in the pressence of phobic object/situation
    • can ocd client stop performing rituals when anxiety level rises and demonstrate substitute behaviors to mantain anxiety at a managame level
    • can client with trich refrain from pulling hair during stress
Card Set
anxiety disorder phobias etc
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