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Anxiety DisordersPsychiatric Nursing: Contemporary Practice

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Question Answer
__________ theorists believe obsessions in OCD are a contioned stimuli and compulsions develop as the individual discovers behaviors that reduce obsessional anxiety.
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Behavioral
Infection with ________ has been linked to the development of OCD.
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Beta hemolytic streptococci
What is the priority assessment for a patient with OCD?
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Suicide risk
What is the most common obsession in patients with OCD?
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Fear of contamination
___________ is a dissociative-type symptom common in OCD in which the individual loses the sense of personal identity and feels strange or unreal.
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Depersonalization
What should be investigated if OCD has a late onset or occurs with a fever?
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Cerebral pathology
What is it important to inspect the skin and assess for joint pain in patients with OCD?
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Obsessive hand washing causes lesions and skin breakdown and rituals/routines can lead to osteoarthritic joint damage
Psychosurgery uses stereotactic surgical techniques to produce lesions of the cingulum bundle or anterior limb of the internal capsule (near the thalamus/cortex) to treat symptoms of ________.
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OCD
Radiotherapy and deep brain stimulation (electrical current is applied through an electrode inserted into the brain) are used to treat the symptoms of ________.
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OCD
What interventions can help maintain skin integrity in a patient who obsessively washes their hands due to OCD?
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Use tepid water, encourage hand cream after washing, replace abrasive soaps with moisturizing ones, work with the patient to get them to agree to a time schedule for hand washing (reducing frequency) and a limit to the time spent washing.
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How is dosing of antidepressants impacted when used to treat OCD?
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The doses are typically much higher
How long do antidepressants take to decrease obsessions and compulsions associated with OCD?
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Several weeks or months to reduce compulsions and even longer to decreased obsessions.
Clomipramine, when given for OCD, is titrated over _______. The maximum dose for adults is _____, and for children is ______.
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Titrated over 2 weeks, maximum adult dose is 250 mg and for children 10 and over 200 mg.
When should a patient be instructed to take clomipramine?
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At night due to its sedative effect.
What is the maximum dose of Sertraline to treat OCD?
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200 mg daily
What is the maximum dose of Fluvoxamine to treat OCD?
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300 mg daily, in divided doses. Children under 11, 200 mg.
What is the maximum dose of Paroxetine to treat OCD?
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60 mg daily (titrated over weeks)
What is the maximum dose of Fluoxetine to treat OCD?
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80 mg daily
When teaching a patient with OCD about their medications, what is important to make sure they understand?
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The side effects can become the focus of obsession, so the patient will need frequent reassurance that they are not becoming physically ill and that side effects are common.
What are common SE of Clomipramine?
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Sedation, anticholinergic effects, increased risk for seizures, dizziness, tremors, and headaches.
What sometimes happens to patients with OCD in the hospital? How does this impact nursing care.
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They experience a transient reduction in symptoms. Time must be allowed for an accurate assessment.
  
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