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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
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