anxiety disorders

anxiety

uncomfortable feeling of apprehension or dread in response to internal or external stimuli

acute stress disorder

3 days to month after trauma

may become PTSD

social anxiety disorder

intense, persistant fear of being watched and judged by others

seperation anxiety disorders

excessive fear of being separated from home or loved ones

panic

extreme, overwhelming form of anxiety often experienced in a real or perceived life threatening situation

panic attacks

sudden, discrete periods of intense fear or discomfort accompanied by physical or cognitive symptoms

diagnostic criteria for panic disorder

recurrent and unexpected panic attacks 1 month or more after either of these:

1. persistent concern or worry about having another attack

2. worry about implications of attack or consequences

3. significant changes in behavior because of fear of the attacks

with or without agoraphobia

epidemiology for panic disorder

risks- female, middle-aged, low socioeconomic status, widowed, separated, or divorced, family history, substance use/abuse, smoking tobacco, severe stressors

higher in white people

several anxiety symptoms + experience of separation anxiety during childhood = this

symptoms of a panic attack

shortness of breath

increase pulse/pounding in chest

dizziness, unsteadiness, faintness

trembling or shaking

feeling of choking

sweating

nausea or abdominal distress

dissociation

numbness, pain tingling

hot/cold flashes

pain in chest/back

fear of dying

emergency care for panic disorder

stay with the patient

reassure him or her that you will not leave

give clear, concise directions

assist the patient to an environment with minimal stimuli

walk or pace with the patient

administer PRN anxiolytic medications

afterward allow patient to vent feelings

nursing assessment

rule out life-threatening medical causes

substance use

sleep patterns

physical activity

nursing concerns

anxiety

risk for self harm

social isolation

powerlessness

ineffective family coping

nursing interventions for the biologic domain

breathing control

nutritional planning

relaxation techniques

increased physical techniques

nursing interventions for the psychological domain

trigger identification

distraction techniques

positive self talk

panic control treatment

exposure therapy

CBT

psycheducation

nursing management for the social domain

lifestyle reevaluation

time management

prioritizing or lists

generalized anxiety disorder (GAD)

feelings of frustration, disgust with life, demoralization, hopelessness

sense of ill-being or uneasiness and fear of imminent disaster

diagnostic criteria for GAD

excessive worry and anxiety for at least 6 months

anxiety related to a number of real life activities or events

little to no control over worry

significant impairment in life

3 of these in addition to excessive worry:

1. sleep disturbance

2. easy fatiguability

3. restlessness

4. poor concentration

5. irritability

6. muscle tension

etiology of GAD

biologic- neurochemical or genetic

psychological- inaccurate danger assessment, unresolved unconscious conflicts

sociologic- high stress lifestyle, multiple stressful events

specific phobia

persistant fear of clearly discernible, circumscribed objects or situations leading to avoidance behavior

social phobia

persistant fear of social or performance situation in which embarrassment may occurr

characteristics of phobias

irrational, persistant, rapid onset, poses little or no threat