Podcast
Questions and Answers
A client with moderate anxiety is struggling to solve a problem. Which nursing intervention is most appropriate to aid the client?
A client with moderate anxiety is struggling to solve a problem. Which nursing intervention is most appropriate to aid the client?
- Postpone problem-solving until the client's anxiety decreases on its own.
- Provide simple, direct instructions and minimize environmental stimuli.
- Administer anti-anxiety medication to reduce anxiety to a manageable level.
- Encourage the client to verbalize feelings and explore alternative solutions. (correct)
A patient is experiencing a panic attack. What is the priority nursing intervention?
A patient is experiencing a panic attack. What is the priority nursing intervention?
- Teach the patient relaxation techniques to use during the attack.
- Speak in a calm, low voice using short, clear sentences. (correct)
- Encourage the patient to discuss the cause of the panic.
- Administer an as-needed dose of anti-anxiety medication immediately.
A patient is diagnosed with a specific phobia. Which intervention should the nurse prioritize?
A patient is diagnosed with a specific phobia. Which intervention should the nurse prioritize?
- Assist the patient in identifying triggers and relaxation techniques. (correct)
- Teach the patient about the irrationality of their fear.
- Administer anti-anxiety medication before potential exposure to the phobia.
- Encourage the patient to immediately confront the feared object or situation.
Which statement differentiates a compulsion from an obsession?
Which statement differentiates a compulsion from an obsession?
A patient with OCD is constantly washing their hands, leading to skin breakdown. What is the most appropriate nursing intervention?
A patient with OCD is constantly washing their hands, leading to skin breakdown. What is the most appropriate nursing intervention?
A patient diagnosed with hoarding disorder is facing eviction due to unsanitary living conditions. What is an appropriate initial nursing intervention?
A patient diagnosed with hoarding disorder is facing eviction due to unsanitary living conditions. What is an appropriate initial nursing intervention?
A patient with trichotillomania is seeking treatment. Which therapy is most likely to be effective?
A patient with trichotillomania is seeking treatment. Which therapy is most likely to be effective?
A nurse is caring for a patient with excoriation disorder. What is an important nursing intervention to implement?
A nurse is caring for a patient with excoriation disorder. What is an important nursing intervention to implement?
What is the rationale behind using exposure and response prevention (ERP) in treating OCD?
What is the rationale behind using exposure and response prevention (ERP) in treating OCD?
A client is diagnosed with social anxiety disorder. Which of the following would be an appropriate nursing intervention?
A client is diagnosed with social anxiety disorder. Which of the following would be an appropriate nursing intervention?
Which defense mechanism is considered maladaptive when used in excess?
Which defense mechanism is considered maladaptive when used in excess?
A patient reports feeling excessive anxiety when separated from their partner. This has started to impact their daily life. Which disorder is most likely?
A patient reports feeling excessive anxiety when separated from their partner. This has started to impact their daily life. Which disorder is most likely?
When assessing a patient with anxiety, what is the importance of determining whether the anxiety is primary or secondary?
When assessing a patient with anxiety, what is the importance of determining whether the anxiety is primary or secondary?
A patient with body dysmorphic disorder is seeking treatment. Which intervention should the nurse anticipate?
A patient with body dysmorphic disorder is seeking treatment. Which intervention should the nurse anticipate?
Which nursing intervention would be appropriate for a patient experiencing severe anxiety?
Which nursing intervention would be appropriate for a patient experiencing severe anxiety?
Flashcards
Mild Anxiety
Mild Anxiety
Heightened awareness; leverages problem-solving.
Moderate Anxiety
Moderate Anxiety
Selective inattention; thinking is somewhat impaired; sympathetic nervous system activated.
Severe Anxiety
Severe Anxiety
Greatly reduced perceptual field; confused, automatic behavior; somatic symptoms increase.
Panic
Panic
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Separation Anxiety Disorder
Separation Anxiety Disorder
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Specific Phobia
Specific Phobia
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Social Anxiety Disorder
Social Anxiety Disorder
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Panic Attack
Panic Attack
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Agoraphobia
Agoraphobia
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Obsessions
Obsessions
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Compulsions
Compulsions
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Body Dysmorphic Disorder
Body Dysmorphic Disorder
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Hoarding Disorder
Hoarding Disorder
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Trichotillomania
Trichotillomania
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Excoriation Disorder
Excoriation Disorder
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Study Notes
- Anxiety can range in severity from mild to panic levels, impacting cognitive functions and physical symptoms.
Levels of Anxiety
- Mild anxiety can be helpful, enhancing problem-solving and information processing.
- Moderate anxiety involves selective inattention and hampered thinking, accompanied by sympathetic nervous system symptoms.
- Severe anxiety significantly reduces the perceptual field, leading to difficulty concentrating and automatic behavior, along with increased somatic symptoms.
- Panic involves markedly disturbed behavior, an inability to process reality, and impulsivity.
Defense Mechanisms
- Defense mechanisms can be adaptive in managing anxiety or maladaptive if overused, especially immature defenses.
Separation Anxiety Disorder
- Developmentally inappropriate concern over being away from significant others.
Specific Phobias
- Persistent, irrational fear of specific objects, activities, or situations, leading to avoidance.
Social Anxiety Disorder
- Intense anxiety or fear of negative evaluation in social or performance situations.
Panic Disorder
- Panic attacks involve a sudden surge of intense fear or discomfort that peaks within minutes.
Agoraphobia
- Excessive anxiety about being in situations where escape might be difficult or embarrassing.
Assessment for Anxiety
- A psychosocial assessment helps identify causes and differentiate between primary and secondary anxiety.
Implementation for Anxiety
- Treatment options include group therapy and counseling.
During Panic-Level Anxiety
- During panic episodes, it's important to speak in a low, calm voice using short, clear sentences and minimize environmental stimuli.
Biological Treatments for Anxiety
- Pharmacotherapy includes antidepressants and anti-anxiety drugs.
- Selective Serotonin Reuptake Inhibitors (SSRIs) like Prozac and beta-blockers like propranolol may be used in children.
Integrative Medicine for Anxiety
- Yoga, reading, and journaling can be beneficial.
Psychological Therapies for Anxiety
- Behavioral therapy includes modeling, flooding, and systematic desensitization.
- Cognitive-behavioral therapy (CBT) is another effective approach.
Obsessive-Compulsive Disorder (OCD) Diagnostic Criteria
- Presence of obsessions, compulsions, or both.
- Symptoms are not due to a substance or medical condition.
- Symptoms are not better explained by another psychiatric disorder.
- Symptoms are time-consuming (over 1 hour per day).
Body Dysmorphic Disorder
- Involves false assumptions about appearance, fear of rejection, and perfectionism.
Hoarding Disorder
- Characterized by the obsessive accumulation of objects and distress when discarding items, leading to alienation.
Trichotillomania and Excoriation Disorder
- Body-focused repetitive behaviors including hair pulling (trichotillomania) and skin picking to the point of damage (excoriation disorder).
Other Compulsive Disorders
- These can be medication/substance-related or due to a medical condition.
Nursing Interventions for Compulsive Disorders
- Focus on promotion of self-care activities.
- Monitor skin integrity for excoriation or trichotillomania.
- Health teaching, including the importance of bathroom breaks.
- Monitor for urinary tract infections and create a regular schedule for bathroom use.
Advanced Practice Nursing Interventions
- Flooding.
- Cognitive-behavioral therapy.
- Exposure-and response prevention.
Biological Treatments for OCD
- SSRIs are FDA-approved for OCD.
- Other medications include Clomipramine (TCA) and Venlafaxine (SNRI).
- Some antipsychotics may be used.
- These medications are generally not used for body dysmorphic disorder, hoarding disorder, trichotillomania, or excoriation disorder, unless obsessive-compulsive features are present.
Surgical Treatments for OCD
- Gamma Knife: creates lesions to disrupt overactive brain circuits.
- Deep brain stimulation (DBS): uses a low-dose current to reduce symptoms.
Psychological Therapies for OCD
- Exposure and response prevention is a first-line cognitive-behavioral intervention that exposes patients to triggers of OCD symptoms, teaching that anxiety subsides even if rituals are not completed.
- Flooding: exposes patients to large amounts of a trigger to extinguish the response.
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