Transcript Chapter_14

Chapter 14
Anxiety Disorders
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
F
Mental health continuum for anxiety disorders
(Fig. 14-1)
Slide 14-2
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
PET scan: Obsessive-Compulsive Disorder
(Fig. 14-3)
Slide 14-3
From Lewis Baxter, MD, University of Alabama. Courtesy of the National Institutes of Mental Health.
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
B
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F
Panic Disorder: Interventions
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Instruct to take slow, deep breaths
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Keep expectations minimal and simple
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Help connect feelings with attack onset
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Help client recognize symptoms as anxiety, not a physical
problem
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Identify therapies
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Teach abdominal breathing and positive self talk

Psychoeducation: medication
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Phobia: Interventions

Determine type of phobia and onset
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Have client list consequences of contacting feared object
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Identify therapies for phobias
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Teach relaxation techniques

Model unafraid behavior
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Obsessive-Compulsive Disorder: Interventions

Anticipate needs, especially for information
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Focus on client rather than on rituals
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Monitor nutrition/sleep; encourage meals/rest
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Avoid hurrying client
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Do not arbitrarily forbid rituals; give positive reinforcement
for non-ritualistic activity

Psychoeducation: medication, interrupting obsessive
thoughts
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Generalized Anxiety Disorder: Interventions

Stay with client
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Speak slowly, using short and simple sentences
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Assure client that nurse can assist him/her
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Give brief explanations
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Decrease stimuli
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Administer anxiolytic if warranted
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Encourage discussion of antecedent events
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Encourage to link behavior to feelings
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Teach cognitive therapy principles
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Generalized Anxiety Disorder: Interventions,
cont.

Question to clarify and dispute illogical thinking
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Have client give alternative interpretations

Identify relief behaviors
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Assist to reframe situation
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Monitor own feelings
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Post-Traumatic Stress Disorder: Interventions

Assess type of trauma, immediate action, and later coping
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Assess pre-trauma functioning, including drug and ETOH
use
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Assess post-trauma functioning, including drug and ETOH
use
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Explore shattered assumptions
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Promote discussion of possible meanings of event

Suggest that client not responsible for event, but is
responsible for coping
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Identify social support and encourage use of support group
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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