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    Anxiety

    Is a vague uneasy feeling of

    discomfort or dread

    accompanied by an autonomicresponse

    A feeling of apprehension

    caused by anticipation of anger. Response to stress.

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    TYPES OF ANXIETY

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    Perception

    Mild

    -increased

    Moderate

    -selective inattention

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    Perception

    Severe

    -distorted perception

    -may experience presence

    of hallucinations and

    delusions Panic

    -disorganized

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    Physiologic

    Severe

    -severe

    headache-nausea

    -diarrhea-trembling

    -vertigo

    -pale

    -tachycardia-chestpain

    -increasedBP,RR,PR

    -dilated pupil

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    Physiologic

    Panic

    -may bolt and run

    -totally immobile and mute

    -dilated pupils

    -increased BP and PR-flight/fight or freeze

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    Behavioral

    Mild

    -alert

    -energetic

    -confident

    -enhance learning

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    Behavioral

    Moderate

    -difficulty in concentrating

    -easily distracted

    -decreased span of attention

    -increased rate in speech-pacing

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    Behavioral

    Severe

    Difficulty focusing

    even with

    assistance.

    Ineffective

    reasoning and

    problem solving

    Disorientation

    Loud and rapid

    speech

    Confused

    communication

    Crying Inability to think

    abstractly

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    Behavioral

    Panic

    Immobilization

    Out of contactwith reality

    Hysterical or

    mute

    Disorganized or

    irrational

    reasoning

    Desperation

    and may result

    to suicide

    Feeling

    overwhelmed

    and out of

    control

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    Anxiety disorders

    Diagnosed when anxiety

    becomes chronic and

    impairs individuals majorfunctions resulting to

    maladaptive behavior and

    emotional disability.

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    TYPES OF ANXIETYDISORDER

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    Phobia

    Is an illogical, intense,

    persistent fear of a specific

    object or a social situationthat causes extreme

    distress and interferes with

    normal functioning.

    Onset-adolescent

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    Social phobia

    fear of being humiliated or embarrassed so

    they avoid social situations.

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    SPECIFIC PHOBIA-persistent irrational fear other than the

    above

    Arachnophobia

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    Acrophobiafear of heights

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    Specific Phobia

    Zoophobia- animals

    Genophobia-dirt

    Androphobia-man

    Acrophobia-height Pyrophobia-fire

    Xenophobia-

    strangers

    Ailurophobia-cats Belonophobia-needle

    Hematophobia-blood

    Nyctophobia-dark

    Xynophobia-woman

    Kaikorrhaphobia-

    failure

    Claustrophobia-

    enclosed places

    Mysophobia-

    contamination or

    germs

    Ochlophobia-crowds

    Pathophobia-disease

    Astraphobia-storms,

    thunder and lightning

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    Nursing Intervention

    Systematic desensitization-gradually expose

    client to the feared object in a safe setting until

    the clients anxiety decreases

    Flooding- abrupt exposure to the feared object,

    rapid desensitization

    Help client to describe her feelings prior to a

    response for a phobic object.

    Help client identify alternative coping strategies.

    Practice relaxation technique with the client.

    Teach client about medications as part of the

    treatment plan.

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    Panic Disorder

    Composed of discrete episodesof panic attacks, 15-30 minutes

    of rapid, intense, escalating

    anxiety in which the personexperiences great emotional

    fear as well as physiologic

    discomfort.

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    Panic Disorder

    Onset- young adult and rarely

    begins after age 35

    More common in women than men.

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    At least one of the attacks has been

    followed by one month of the ff.

    symptoms

    1.Persistent concern of having

    additional attacks

    2.Worry about consequences

    3.Significant change in behavior

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    Nursing Intervention

    Provide a safe environment and ensure

    clients privacy during an attack

    Remain with the client during a panic

    attack Help client to focus on deep breathing

    Talk to the client in a calm reassuring

    voice. Cognitive-behavioral technique

    Deep breathing and relaxation

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    Generalized Anxiety

    Disorder

    Characterized by chronic

    anxiety interfering with dailylife

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    Nursing Intervention

    Stay with the client and provide support.

    Keep demands on the client to a

    minimum.

    Limit environmental stimuli

    Encourage physical activity to release

    energy.

    Teach client about medications as partof the treatment plan.

    Assist the client in performing relaxation

    exercise.

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    Post-traumatic Stress

    Disorder

    Development of characteristic

    symptoms after exposure totraumatic life experience

    Duration-may last few monthsor years

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    Acute Stress Disorders

    Development of anxiety,

    dissociation and other

    symptoms within one monthof exposure to an extremely

    traumatic stressors

    Lasts from 2 days to 4

    weeks

    Symptoms of Post-Traumatic

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    Symptoms of Post-TraumaticStress Disorder/Acute Stress

    Disorder

    1.Persistently re-experiencing the

    events

    2.Increased arousal

    3.Avoidance of stimuli associated

    with trauma

    Categories that may cause post-

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    Categories that may cause post-

    traumatic disorders/acute stress

    disorder

    1.Natural disaster

    2.Accidental man-made disasters

    3.Intentional man-made disasters

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    Obsessive-Compulsive

    Disorder

    Repetitive thoughts and acts

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    Obsessive-Compulsive Disorder

    Obsession

    Refers to recurrent

    persistent ideas,thoughts, images or

    impulse that are

    experience as

    intrusive and

    senseless.

    Compulsive

    Ritualistic behavior

    that the individualfeels compelled to

    perform

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    Impulse Control Disorder

    Intense drive

    Psychodynamic1.A cry for help

    2.Need attention and love

    3.Need to release anger

    4.Learned theory

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    Types of Impulse Control

    Disorder

    Kleptomania-intense drive to steal

    Megalomania-intense drive to

    acquire power Pyromania-intense drive to set fire

    Trichotillamania-intense drive to

    pull someones hair

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    Nursing Intervention

    1.Reduce anxiety

    2.Redirect clients attention away

    from self3.Use empathy

    4.Increase socialization activities

    5.Set limit on patients

    unacceptable behavior