edited anxiety 5

8/8/2019 Edited Anxiety 5

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ANXIETY

and

anxiety-related disorders


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Anxiety In Everyday Life

What are the object of your worries?

Are there personal worries

stemming from your societal role &duties?

Do you have personal fears

associated with activities orobjects?


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ANXIETY Effective subjective response to an

imagined or real internal or external

threat.


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Stages of anxiety


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Levels of Anxiety


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INTERVENTIONS

1. Identify anxious behavior and anxiety

level and institutes measures to

decrease anxiety.

2. Provide appropriate environment.

3. STAY. Do not leave client alone.

4. Establish person-to-person

relationship & maintain an accepting

attitude.

5. Anti-anxiety as ordered.


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TIPSFOR MANAGINGSTRESS

1. Keep a POSITIVE attitude & believe in yourself 2.ACCEPT there are events you cannot control

3. COMMUNICATE assertively with others

4. Learn to RELAX

5. EXERCISE regularly

6. Eat a WELL-BALANCED meals

7. LIMIT intake of caffeine

8. Get ENOUGH REST & sleep 9. Set REALISTIC GOALS & EXPECTATIONS

10. Learn STRESS MANAGEMENT techniques


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ANXIETY DISORDERS

1. Panic Disorders

2. Phobias

3. Obsessive Compulsive Disorder 4. Posttraumatic Stress Disorder

5. Acute Stress Disorder


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..

Have you ever experiencedsudden, intense fear for no

reason?


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PANIC DISORDERS

Severe, recurrent, intermittent

anxiety attacks lasting for 5 to 30

minutes.


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Assessment findings

1. choking sensation

2. labored breathing

3. pounding heart

4. chest pain

5. dizziness

6. nausea

7. blurred vision 8. feelings of IMPENDING DOOM


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NURSING INTERVENTIONS Attend to physical symptoms

Assist the client to identify the thoughts that aroused

the anxiety and its basis

Assist to change unrealistic thoughts to more realistic

thoughts

Use COGNITIVE RESTRUCTURING

Administer ANXIOLYTICS as prescribed

.

ANTIDOTE for benzodiazepine intoxication : FLUMAZENIL

(ROMAZICON)

SIDE-EFFECTS: drowsiness, mental confusion, habituation &

increased tolerance, withdrawal symptoms d (high doses and

prolonged use > 6 mos.)


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..

Are there certain things,places, or activities that

you usually or always find

fearful?


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PHOBIAS

Extreme anxiety & apprehension

experienced by an individual

when confronted with fearedobject/situation.


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..

Do you find yourself

uncomfortable in placeswhere you cant get helpor escape, such a walking

alone, or on a bridge, or ina crowded area?


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SOCIAL PHOBIA

Person becomes severely anxious to

the point of panic or incapacitation when

confronting situations involving people.

Rooted in LOW SELF-ESTEEM and

concern about others JUDGMENT.

Developed afterPUBERTY.


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PHOBIA FILE ABLUTOphobia fear of washing

ACHLUOphobia fear of darkness

AILUROphobia fear of cats

ARACHNOphobia fear of spiders

ASTRAPOphobia fear of lightning

BATHMOphobia fear of stairs BROMIDROSIphobia fear of body smells

CACOphobia fear of ugliness

CATAGELOphobia fear of being ridiculed

DEMOphobia fear of crowds

DIDASKALEINOphobia fear of going to school

DOMATOphobia fear of houses

EISOPTROphobia fear of mirrors

ENOCHLOphobia fear of crowds

FRIGOphobia fear of cold or cold things


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PHOBIA FILE GAMOphobia fear of marriage

GERASCOphobia fear of getting old GLOSSOphobia fear of speaking in public

GYNEphobia fear of women

HELIOphobia fear of the sun

HETEROphobia fear of the opposite sex

HIPPOphobia fear of horses

HYPSIphobia fear of height

IATROphobia fear of doctors

ICHTHYOphobia fear of fish

IOphobia fear of poison

KAINOphobia fear of novelty

KAKORRHAPHIOphobia fear of failure

LEVOphobia fear of objects to the left

LILAPSOphobia fear of hurricanes


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PHOBIA FILE MACROphobia fear of long waits

MAGEIROCOphobia fear of cooking MAIEUSIOphobia fear of childbirth

MEDOMALACUphobia fear of losing an erection

MYCTOphobia fear of darkness

NEOPHOphobia fear of anything new

NEPHOphobia fear of clouds

NOCTIphobia fear of the night

OCHLOphobia fear of crowds or mob

OCHOphobia fear of vehicles

OENOphobia fear of wines PAGOphobia fear of ice or frost

PANphobia fear of everything

PHALACROphobia fear of becoming bald

POTAMOphobia fear of rivers

PYROphobia fear of fire


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PHOBIAFILE RANIDAphobia fear of frogs

RHYPOphobia fear of defecation

RHYTIphobia fear of getting wrinkles RUPOphobia fear of dirt

SCIOphobia fear of shadows

SCOLECIphobia fear of worms

SELACHOphobia fear of sharks

SIDERODROMOphobia fear of trains SYNGENESOphobia fear of relatives

THANATOphobia fear of death

THALASSOphobia fear of the sea

TRISKAIDEKAphobia fear of the number 13

TRYPANOphobia fear of injections

VESTIphobia fear of clothing

XANTHROphobia fear of the color yellow or the word yellow

XENOphobia fear of the strangers

XYROphobia fear of razors

ZELOphobia fear of jealousy

ZOOphobia fear of animals


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ASSESSMENT FINDINGS

Anxiety when faced with objects/situation that

threatens sense of safety and security

Shortness of breath, feeling of suffocation,

hyperventilation, diaphoresis, vertigo,

faintness, fluttering in the stomach, trembling

and heart palpitations

Altered life-style : feelings of helplessness and

out of control


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NURSING INTEVENTIONS

Recognize clients feelings about phobic object orsituation

Avoid confrontation and humiliation

Do not focus on getting patient to stop being afraid

Provide relaxation techniques

Behavioral therapy : SYSTEMIC DESENSITIZATION

Anti-depressants as ordered


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OBSESSIVE COMPULSIVEDISORDER


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OBSESSIVE-COMPULSIVE DISORDER

OBSESSIONS Recurrent, persistent, intrusive & unwanted

thoughts, images or impulses that cause

marked anxiety & interfere with interpersonal,

social or occupational function.

COMPULSIONS Are ritualistic or repetitive behaviors or mental

acts that a person carries out continously in anattempt to neutralize anxiety.


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Common RITUALS CLEANING

Provoked by the fear that real or imagined germs,

dirt, or chemicals will CONTAMINATE them.

REPEATING

The urge to utter name, phrase, or behavior

repeatedly to dispel anxiety.

COMPLETING

Performs series of complicated behaviors in an

exact order or repeat them again and again until

they are done perfectly.

CHECKING

The fear of harming oneself or others by forgetting

to lock the door or turn off the gas stove.


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COMMON RITUALS

BEING METICULOUS Develops an overwhelming concern about how

things should be arranged.

AVOIDING

Compulsive avoiders stay away from the causeof their anxiety and anything related to it.

HOARDING

Constant collection of useless items.

SLOWNESS Uncommon compulsion that strikes mostly

men, causes people to do certain tasks very,

very slow.


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Assessment findings

Ritualistic rigid & inflexible

Difficulty in making decisions demonstrates striving at perfection

Use intellectual and verbal defenses


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NURSING INTERVENTIONS Provide for physical safety

Accept and allow ritualistic activity DO NOT

INTERFERE with it

Provide structured environment minimize choices

Provide socialization group therapy

Administer CLOMIPRAMINE (ANAFRANIL) as ordered

SIDE EFFECTS / ADVERSE REACTIONS : agranulocytosis,

hypotension, tachycardia, cardiac arrest, dizziness, tremors,

seizures, constipation, dry mouth, diaphoresis.


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..

Have you ever foundyourself re-experiencing aviolent, catastrophic event

through dreams orwakingflashbacks?


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POSTTRAUMATICSTRESSDISORDER

Occurs in a person who has witnessed an

extraordinary terrifying & potentially deadly

event (war, rape, fire, disaster).


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Assessment findings:

Flashbacks

Nightmares

Depression or irritability / outburst ofanger

Exaggerated startle response poor

impulse control Avoidance inability to maintain

intimacy


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Nursing Interventions

Encourage verbalization about painful experience /memories with details

Show empathy Be NON-JUDGMENTAL

Rational emotive therapy ALLOW TO GRIEVE

Help client identify, label and express feelings safety

Enhance support systems self-help groups, family

psychoeducation, socialization


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END


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Do you find yourself

worrying about a numberof different things, such asthe way things are going

for you at home, work, orschool?


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MAJOR ANXIETYDISORDERS

ENERALIZED ANXIETY DISORDER

anxiety focused on a variety of life

events or activitiesSymptoms: restlessness, fatigue,

difficulty in concentrating,

irritability, muscle tension, sleep

disturbance


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CAUSESOF ANXIETYDISORDER

PSYCHOANALYTICTHEORY comes from unconscious processesthat originate in early childhood

experiences COMMONSENSETHEORY

-ADVERSITY is a measure of how

strong a given stimulus forr anxietyis


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TRAIT ANXIETY - is an abstract but

measurable personality characteristics

based on the everyday observation that

some quite normal individuals experiencemore anxiety than do others.

- Persons who admit to feeling more anxious

are said to have high levels of train

anxiety


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TREATMENT

PHARMACOLOGY

Antidepressants (Mirtazapine,

Venlafaxine) Buspirone

Beta blockers

Benzodiazepines


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NURSINGINTERVENTIONS

The nurse must fully understand the

nature of the clients anxiety

Building trust nurse accepts client as he

is, show atmosphere of caring, supportive

presence

modeling the clients world entering

into the clients perspective & bainginteractions on the nurses understanding

of the clients subjective experience

edited anxiety 5

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