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Anxiety DisordersPsychiatric Nursing: Contemporary Practice

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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.
________ speech involves speech loaded with irrelevant details that eventually addresses the question asked. It is a phenomenon associated with OCD.
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Circumferential speech
What is the nurse's role in successfully intervening for a patient with OCD?
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The nurse must control her own anxiety, be calm, nonauthoritative, and nonjudgmental while expressing empathy about the distress the patient experiences.
_______ is a technique where a patient is exposed to situations that are known to induce behaviors in a patient with OCD. The patient is then asked to not perform their normal ritual. Most patients improve from this technique, but few become symptom free
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Response prevention
________ is a technique taught to OCD patients to interrupt obsessional thoughts and delay the uncontrollable spiral of obsessional thinking.
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Thought stopping
___________ is a method of teaching a patient with OCD to restructure dysfunctional thought processes by defining and testing them. The goal is to alter the patient's immediate, dysfunctional appraisal of a situation and perception of long term consequences.
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Cognitive restructuring
What are cue cards and how are the used to help patients with OCD?
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They contain statements that are positively oriented and pertain to the patient's specific obsession and compulsions. They help the patient restructure thought patterns.
How can a nurse help a patient with OCD acclimate to a hospital environment?
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Explain unit routines carefully and clearly to decrease fear of the unknown
_______ is a disorder characterized by excessive worry and anxiety.
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Generalized anxiety disorder (GAD)
What is the criteria for GAD?
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The person experiences excessive worry and anxiety almost daily for at least 6 months, involving a variety of events with no control over the worry, that causes significant impairment and isn't substance induced, r/t a medical problem or psychiatric problem that is mood, psychotic or PDD related.
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How do people with GAD typically describe how they are feeling?
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Frustrated, disgusted with life, demoralized and hopeless.
What are the most common comorbid disorders with GAD?
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Major depressive disorder, social phobia, specific phobias, panic disorders and dysthymia.
Why may GAD be overdiagnosed in children?
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Children must only meet one of the three additional symptoms required by a GAD diagnosis for adults
How do GAD symptoms usually manifest themselves in children?
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Worry about their performance in school or sports despite excelling, somatic complaints, worry over trivial issues like what clothes to wear or social interactions.
What neurotransmitter dysfunctions are implicated in GAD?
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Norepinephrine dysregulation and serotonin dysfunction
________ theorists believe GAD is caused by inaccurate assessment of perceived environmental dangers which are caused by selective focus on negative details, distortions of information processing and an overly pessimistic view of coping abilities.
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Cognitive Behaviorist
_______ theorists believe GAD is caused by unresolved, unconscious conflicts.
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Psychoanalytical
What dietary changes are recommended for patients with GAD?
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Reduction/elimination of caffeine, avoidance of diet pills, amphetamines, ginseng, ma huang and OTC meds. Alcohol should be avoided, the last meal of the day should be eaten in the early evening, avoid fluids after 8:00.
What medications have been used to treat GAD?
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Buspar, benzodiazepines, beta-blockers and antidepressants like paroxetine, imipramine and venlafaxine.
What are common SE of Buspar/Buspirone?
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Dizziness, insomnia, drowsiness, nervousness, dry mouth, blurred vision and abdominal distress.
Why is it important to monitor BP for patients on venlafaxine?
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It can cause transient HTN in some patients.
  
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