Anxiety Disorders

OUT LINE:
Definition

of ANXIETY DISORDERS.
Developmental considerations.
Type of anxiety.
Levels of Anxiety.
Nursing care of anxiety.

Anxiety Disorders)DEFINTION):
Anxiety

is a psychological and physiological

state characterized by cognitive, somatic,
emotional, and behavioral components.
NANDA Definition is uneasy feeling of
discomfort or dread accompanied by an
autonomic response, with the source often
nonspecific or unknown to the individual; a
feeling of apprehension caused by
anticipation of danger.

Type of anxiety:
Generalized

Anxiety Disorder:
*is the most common and widespread type of
anxiety. GAD affect tens of millions of people
throughout the world.
*the most common problems associated with
GAD(restlessness, fatigues easily, difficulty
concentration, thought blocking , irritability,
muscle tension, sleep disturbance).

 Social

Phobia: is when the shyness is intense

and the idea of socializing or speaking with the
public, strangers, authority figures, or possibly
even your friends causes you noticeable
anxiety and fear.
* Those with social phobia often live with two or
more of the following issues (Feeling hopeless,
Severe fear of public speaking, Anxiousness
about the idea of social situations..)

 Panic

Disorder: is when you experience

severe feelings of doom that cause both
mental and physical symptoms that can be
so intense that some people become
hospitalized, worried that something is
dangerously wrong with their health.
* Panic disorder is characterized by two
things: Panic attacks , fear of getting panic
attacks, rapid heartbeat.)

 Agoraphobia:

is the fear of going out in

public, either the fear of open spaces or
the fear of being in unfamiliar places.
*the more common symptoms of the type
(Obsessive fear of socializing with groups
of people, Severe stress, , preventing
you from going out and living life
because of that fear)

 Specific

Phobias: Phobias are intense

feelings of fear because of objects,
scenarios, animals, etc. Phobias
generally bring about disaster thinking
(believing that the worst will happen) or
avoidance behaviors (doing whatever it
takes to avoid the phobia).

 Post

Traumatic Stress Disorder (PTSD):As a

human being, there are always risks that put your
life in danger.
*PTSD is an anxiety disorder that comes after the
traumatic event has occurred.
*PTSD---characteristics:
(Intense fear /helplessness/horror upon
exposure,Dreams,flashbacks,Physical/psychologi
cal distress over reminders of the event, Avoids
memory provoking stimuli,Feeling detached)

 Obsessive

Compulsive Disorder (OCD):

Identify the situation that precipitates the behavior
*Do not interrupt compulsive behaviors
*Allow time for compulsive rituals
*Provide safety related to behaviors
*Provide schedule to distract behaviors
*Set limits on rituals that may interfere with client
well-being
*Decrease frequency of compulsive behaviors.

Levels of Anxiety
Hildegard

Peplau Interpersonal
Relations in Nursing 1952 identified
Four stages of anxiety on a continuum
Mild
Moderate
Severe Panic
Panic

Behavioral & Physiologic

changes in Mild Anxiety
Perceptual field
widens
awareness &
motivation
problem solving &
learning
Irritable
Related client Needs:

Restlessness
butterflies in
stomach
sleep disturbance
More sensitive to
noise

Behavioral & Physiologic

changes Moderate Anxiety
Immediate task
oriented
Attentive to
immediate task
Difficulty
w/concentration,but
can be redirected

V/S normal
increased
Frequent urination
Dry mouth/muscle
tension
rate of speech
diaphoretic

Behavioral & Physiologic

changes in Severe Anxiety

Narrowed perceptual
field-one detail
Difficulty completing
task or solving problems
Cannot learn effectively
Feelings of dread/doom
Crying
Ritualistic behaviors ie.
Rocking

Headache/nausea&
vomiting
Vertigo
Pale
Tachycardia
C/o chest pain
Rigid stance

Nursing Care Plan: Anxiety

Assessment

data:

Appearance,Behavior,Conversation.
Wringing

hands,decreased
communication ,restlessness , irritability
,pacing ,decreased attn.
Identify stressors- intra ,inter ,
extrapersonal
Identify lines of defense

Goals/expected outcomes:
Short

term:
The client will: be free of injury
Discuss

feelings of dread or anxiety

Response to relaxation techniques
Demonstrate ability to perform relaxation

Implementation: anxiety
Remain with client at all times if level is
severe or panic(safety important)
Remove client to Quiet area( client is not able
to deal with excessive stimuli)
Remain calm upon approaching client(client
will feel more secure if you are in control of
situation)

Nursing interventions:
Educate client re use of caffeine, nicotine etc.
(prevents/minimizes cardiovascular
Provide instruction regarding anxiety
reduction strategies.

Progression relaxation techniques

Listening to smoothing music or relaxation tapes