Psychiatric Nursing: Anxiety & Panic Disorders

The underlying cause of anxiety is fear of the unknown.
Gamma-aminobutyric acid (GABA), amino acids, and buteric acid are factors.
Anxiety is a coping mechanism managed through neurotransmitters.
Effective coping involves proactive and reactive responses.
Mild anxiety increases focus and learning.
Moderate anxiety enhances focus but impairs learning.
Severe anxiety significantly decreases focus and learning.
Anxiolytics such as diazepam and zolam are used.
Other medications include diazepam, lorazepam, midazolam, and benzodiazepine.
Common side effects include drowsiness, so avoid driving or operating machinery.
An overdose can lead to respiratory depression or failure, requiring flumazenil as an antidote.
Herbal remedies like Kava are for GABAergic effects.

Defined by severe anxiety without a clear stimulus, characterized by auto-priority.
Signs and symptoms include paresthesia, choking sensations, nausea, vomiting, chills, and chest pain.
Management involves therapeutic interventions and anxiolytic medications.

Characterized by irrational fears.
Agoraphobia, claustrophobia, nyctophobia, acrophobia, and arachnophobia exist.
Management involves acceptance, relaxation techniques, and systematic desensitization.

Detachment, emotional numbness, anger outbursts, depression, sleep disturbances, hypervigilance, and obvious weight loss are risk factors.
Factors war veterans, accidents, rape victims, violence, and natural disasters
Symptoms persist for over a month.
Management includes non-judgmental support, encouraging verbalization, emotional connection, and support groups.

The cause is a problem in neurotransmitters in the frontal lobe.
It is often genetic and presents in school-age children (6-12 years).
Older individuals may primarily show attention deficit.
Signs include inattention, hyperactivity, and impulsivity.
Methylphenidate (Ritalin) is used, with increased school performance indicating effectiveness.
Take safety precautions, channel productivity to productive deeds.
Medications such as Methylphenidate deplete energy.
If twice a day before breakfast and lunch and if once a day before breakfast.
Side effects include insomnia and increased blood pressure, heart rate, respiratory rate, and temperature
Regularly check height, weight, and vital signs.

Etiology is tied to developmental stage fixation and depression.
Alcohol intoxication can lead to respiratory arrest.
Alcohol withdrawal symptoms include increased vital signs and tremors.
Chlordiazepoxide (Librium) is used; delirium tremens is a severe form of alcohol withdrawal, leading to hypertensive crisis, stroke, and cardiac issues.
Disulfiram (Antabuse) can cause headache and flushing if alcohol is ingested.

Elevated mood, restlessness, risk for injury.
Irritability and demanding/manipulative behavior are exhibited.
Biological cause with increased serotonin and norepinephrine is suspected.
Manage with assertiveness and a structured, calm environment.
A faulty family dynamic contributes.
A diet high in calories, carbohydrates, and fats.
Treatment involves medication (Lithium), calm conversation, warm milk, baths, and soothing music.

There can be multifactorial causes and is due to decreased coping mechanisms and self-esteem.
Symptoms include anhedonia, decreased energy, social withdrawal, changes in sleep and appetite, and flat affect.
Major depression lasts for at least 2 weeks and is severe with appetite changes.
Persistent depressive disorder (dysthymia) can last over 30 days.
Seasonal affective disorder (SAD) typically occurs in winter.
Point out simple accomplishments, simple direction, decision maker and know the log period of medications

Dopamine imbalance which causes loss of association, insomnia, catatonia etc
Typical antipsychotics have a risk for infection and can cause Extrapyramidal symptoms
Atypical antipsychotics are new generation cause pseudoparkinsonism and dystonia.
Delusions cause thought content problems; insomnia; catatonia.
Echolalia causes repetition of word; Echopraxia causes repetition of movement.
Olanzapine, clozapine etc
Lithium toxicity, coarse tremors
Serotonin syndrome which causes extreme SNS
Neuroleptic Malignant syndrome (extreme SNS causes muscle breakdown)
Antidepressants all needs 2-4 weeks to taper dose, cannot combine.
Point out accomplishments and know the logperiod of medications