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illnesses treated Women twice as likely as men People with primary diagnosis of depression often have anxiety disorders Degrees of Anxiety Mild Moderate Severe Panic Panic Disorder Extreme, overwhelming form of anxiety; experience in real or perceived life-threatening situations Chronic condition Sudden onset, peak at ~ 10 minutes Physical and Cognitive S/S of Panic Attacks/Anxiety Palpitations Chest discomfort Rapid pulse Nausea Dizziness Sweating Trembling/ Shaking SOB Disorganized thinking Irrational fears Depersonalization Decreased communication Feeling of doom or death Assessment Determine that symptoms are not medical Ask questions as on page 384 Mental status exam Work, family and interpersonal relationships Substance abuse Cultural factors Nursing Diagnosis Anxiety Ineffective Individual Coping Impaired Social Interaction Fear Hopelessness Social Isolation Risk for Injury Powerlessness Ineffective Family Coping Nursing Interventions For panic- interventions are aimed at relief Reduce anxiety Stay with patient Use short, simple sentences Repetitive activity Move to quite environment Meds Interventions Assess for characteristics/feelings/name it Teach relaxation techniques/ deep breathing exercises Nutritional Education Increased Physical Activity Distraction Positive Self-talk Empower over Anxiety Interventions Exposure Therapy Systematic Desensitization Implosive Therapy Cognitive Behavior Therapy Psychoeducation Emergency Care Obsessive-Compulsive Disorder Obsessions: thoughts or impulses that occur repetitively causing severe anxiety and distress Compulsions: repetitive actions/behaviors Interferes with ADLs Obsessions are recognized by person but cannot be controlled OCD May begin in childhood Often occurs with Tourette’s syndrome Personality disorders in 80% Rates similar in both men and women Assessment Suicide risk Increases rate of physical disease Neatly dressed, well groomed, cooperative, eager May be distracted, speech full of irrelevant details 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