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Anxiety DisordersPsychiatric Nursing: Contemporary Practice

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What class of medication should patients with sleep apnea and panic disorders not be prescribed?
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Benzodiazepines
What group of patients should benzodiazepines be prescribed cautiously for and why?
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Elderly patients because they decrease rate and depth of respirations.
What are the usual side effects of benzodiazepines?
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Headache, confusion, dizziness, disorientation, sedation, and visual disturbances.
__________ can increase the clearance of benzodiazepines.
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Smoking
What are the main goals of the nurse when treating a patient for anxiety disorders?
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Help the patient identify triggers and counter them using distraction, positive self-talk, panic control treatment, exposure therapy, implosion therapy and cognitive behavioral therapy.
How can a nurse help a patient during an acute panic attack?
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Be consistent, supportive, offer reassurance that the panic is temporary. Once the attack has passed, allow the patient to vent their feelings.
What are useful interventions during for a patient with a mild degree of anxiety?
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Encourage learning
What are useful interventions during for a patient with a moderate degree of anxiety?
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Encourage them to talk, focus on one experience, describe it fully, create generalizations.
What are useful interventions during for a patient with a severe degree of anxiety?
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Allow relief behaviors, don't ask about them. Encourage the patient to talk and vent ideas.
What are useful interventions during for a patient with a panic degree of anxiety?
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Stay with the patient, maintain a calm demeanor and reassure them you will not leave, the episode will pass and that they are safe. Walk or pace with the client if needed. Provide no content inputs to the patient's thinking, be direct, use few words, don't touch the patient.
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When is distraction useful for a patient who experiences anxiety?
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When they are capable of identifying early symptoms of a panic attack.
Initiating conversation with a nearby person, engaging in physical activity like a walk, snapping a rubber band against the wrist, counting backwards from 100 by threes or counting objects is what therapeutic behavior for people with panic disorders?
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Distraction
Saying planned, rehearsed positive coping statements like I can handle these symptoms while experiencing a state of increased anxiety or panic is an example of?.
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Positive self-talk
_________ treatment involves intentional exposure (through exercise) to panic-invoking sensatins such as dizziness, hyperventilation, tightness in the chest and sweating and learning to use breathing training and cognitive restructuring to manage the response.
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Panic control treatment
_________ treatment is the treatment of choice for agoraphobia and involves repeatedly exposing a patient to a real or simulated anxiety provoking situation until they become desensitized and anxiety subsides.
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Exposure therapy
_________ is an exposure method of treatment that exposes the patient to a hierarchy of feared situations from least feared to most feared while being taught muscle relaxation.
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Systematic Desensitization: requires special training and may be most used by home health psych nurses.
________ therapy treats agoraphobia by having the therapist identify phobic stimuli for the patient and then presenting highly anxiety-provoking imagery to the patient, describing the feared scene as dramatically and vividly as possible.
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Implosion therapy
_________ is a technique used to desensitize a patient to the fear associated with a particularly anxiety proviking simulus by presenting the feared objects or situations repeatedly until the anxiety dissipates.
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Flooding
What are the goals of Cognitive Behavioral Therapy when treating anxiety disorders?
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To help the patient manage their anxiety and correct anxiety provoking thoughts through cognitive restructuring, breathing training and psychoeducation.
What are some topics that might be covered during psychoeducation with a client with an anxiety disorder?
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The difference between panic attacks and heart attacks, differences between panic disorders and other psych disorders, and effectiveness of various treatments.
What intervention is useful in helping a patient with an anxiety disorder in their social life?
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Time management skills should be taught to ensure the patient has time for rest, relaxation and family time.
  
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