A slide share on the topic Anxiety Disorder, types of anxiety disorder, causes, signs and symptoms and its nursing diagnosis and nursing management.

1. Anxiety Disorders

2.  Defined as a vague uneasy feeling and the source is often
unspecific or unknown to the individual.
 Generally, an unpleasant emotional state accompanied by
physical arousal and the cognitive element of apprehension, guilt
and a sense of impending disaster.
 It is a state of uneasiness, apprehension or fearfulness stemming
from anticipated danger.
 Anxiety disorder are among the most common of all psychiatric
illnesses. They are common in women than in men.

3.  Sensation of apprehension.
 Critical perception of discomfort.
 It is perceived by the conscious aspect of the personality

4.  Formally called neurosis: characterized by anxiety as the
prominent symptom.
 Includes panic disorder, phobic disorder, obsessive
compulsive disorder and post traumatic stress disorder.
 The main symptoms are panic, fear, stress and worry.
 These symptoms can be used to group the anxiety disorders.

5. 1. Panic
 Panic attack- can occur in any of the anxiety disorders.
 Panic disorder without agoraphobia
 Panic disorder with agoraphobia
2. Fear
 Agoraphobia- fear of being in places or situation from which
escape might be difficult.
 Social phobia- an excessive fear of situations in which a person
might do something embarrassing or evaluated negatively by
others.

6. 3. Stress
 Adjustment disorder with anxiety.
 Acute stress disorder.
 Post traumatic disorder.
4. Worry
 Generalized anxiety disorder.
 Obsessions and rituals.
 Obsessive compulsive disorder.

7. I. Generalized anxiety disorder.
II. Acute stress disorder
III. Obsessive compulsive disorder
IV. Panic disorder
V. Post traumatic stress disorder
VI. Phobias
VII. Substance induced anxiety disorder

8.  Persist for at least 6 months.
 Symptoms are:
 Motor tension( eg. Trembling, restlessness, inability to relax
and fatigue)
 Autonomic hyperactivity( eg. Sweating, palpitation, cold
clammy hands, urinary frequency, increase pulse and fast
breathing)
 Apprehensiveness (eg. Worry, fear, insomnia and inability to
concentrate)
 Hypervigilence (scanning the environment and distractibility)

9.  Person has been exposed to a traumatic event either witnessed
or experienced. Duration of 2 days to 4 weeks
 Symptoms are:
 Feeling of numbness
 Absence of emotional responsiveness
 Feeling dazed
 Derealisation
 Depersonalization
 Amnesia or loss of memory

10.  Preoccupation with persistent intrusive thoughts
(obsessions)
 Repeated performance of rituals designed to prevent some
event (compulsion) or both
 Anxiety occurs if obsessions or compulsion are resisted
and from feeling powerless to resist the thoughts and
rituals.

11.  Recurrent unexpected anxiety attacks
 Sudden onset with intense apprehension and dread
 Symptoms are:
 Dyspnea, chest discomfort, dizziness, hot or cold flashes,
tingling of hands or feet.
 Feeling of unreality, palpitations, syncope, trembling, fear
of losing control, going crazy or dying.

12.  After experiencing psychologically traumatic event (eg. Rape,
some sort of abuse, bombings, kidnapping), the person re-
experience the event through recurrent dreams and flashbacks.
 Emotional numbness, detachment and estrangement may be
used to defend against anxiety.
 May experience sleep disturbance, guilt about surviving, poor
concentrating and avoidant of activities that trigger the
memory of the event.

13.  Irrational fear of an object or situation that persist, although the
person may recognize it as unreasonable.
 The types may include:
 Agoraphobia- fear of being alone in open or public places
where escape maybe difficult.
 Social phobia- fear of the situation where one might be seen
and embarrassed or criticized, fear of eating in public, public
speaking or performing
 Specific phobia: fear of a single object, situation, or activity
that cannot be avoided.

14.  Prominent anxiety, panic attacks or obsessions of compulsion
dominate.
 Symptoms developed within one month of substance
intoxication or withdrawal.
 Medication used is according to disturbance.
 The disturbance does not occur exclusively during the course
of delirium.
 Significant distress or impairment in social and occupational
functioning results.

15.  Anxiety is a subjective sense of impeding disaster or a
need for readiness to defend oneself against an
unknown threat

16. 1.Panic- vague uneasy feeling that signal impeding danger and
enable individual to deal with threat.
Goal- client will verbalize ways to intervene in escalating panic
and also to recognize symptoms of onset of anxiety and intervene
before reaching panic stage.
Nursing intervention-
 Maintain a calm, non threatening manner while working with
client. Client develops feelings of security in presence of calm
staff.

17.  Reassure the client of his or her personal safety and security.
Do not leave the client alone.
 Use simple words and brief messages, spoken calmly and
clearly, to explain hospital experiences to client.
 In case of fast breathing, light headedness, rapid heart rate,
shortness of breath and numbness or tingling sensation in the
hands or feet ask the client to take deep breaths using
diaphragmatic muscles.

18.  Keep immediate surrounding low in stimuli (dim light and
few people) it may decrease level of anxiety.
 Administer medication as ordered by the doctor. Assess for
the effectiveness and adverse side effects.
 Teach the client how to interrupt panic
progression(relaxation technique, deep breathing exercise,
jogging and meditation)

19. Response to perceive threat that is consciously recognized as danger.
Causes- phobic stimulus – being in place or situation from which escape might be
difficult. Causing embarrassment to self in front of others.
Goal- client will discuss the phobic object or situation with the nurse and also after
the treatment, patient will be able to function in the presence of the object or
situation without any panic attack or anxiety.
Nursing Interventions:
 Explore the client’s perception of threat to physical integrity or threat to self
concept. To understand his or her perception of the phobia to help in the
desensilisation process.

20.  Discuss reality of the situation with client in order to recognize
aspects that can be changed and those that cannot.
client must accept the reality of the situation( aspects that cannot
change)
 if the client elects to work on elimination of the fear, the techniques
of desensitization may be employed- gradual exposure of the client
to the object or situation( either in reality of fantasizing) until fear is
no longer experience
 Encourage client to explore underlying feelings that may be
contributing to fears.

21. Inability to form a valid appraisal of the stressors, inadequate choices of
practiced responses, and or inability to use available resources.
Goal- ability to cope effectively or increased dependency.
Nursing Interventions
 Encourage limit setting on ritualistic behaviour as part of established
treatment plan.
 Assist patient in listing all objects and places that trigger anxiety as part
of exposure response prevention programs.
 Use cognitive strategies, such as refraining, to assist patient in placing
thoughts and feelings on a different perspective.

22.  Help client learn ways of interrupting obsessive thoughts and
ritualistic behaviors such as physical exercise, relaxation
techniques. Knowledge and technique will help the client and
let go of maladaptive responses.
 Intervene as needed and obtain emergency assistance when
patient is in immediate danger.

23.  Client to be able to:
 Recognize signs of escalating anxiety and intervene before reaching panic
level.
 Maintain anxiety at manageable level and make independent decisions
about life situation.
 Functions adaptively in the presence of the phobic object or situation
without experiencing panic attack.
 Verbalizes a future plan of actions for responding in the presence of the
phobic object or situation without panic anxiety.
 Maintain anxiety at a manageable level without resorting to ritualistic
behavior.

24.  Demonstrate more adaptive coping strategies for dealing
with anxiety and ritualistic behavior.
 Verbalizes a realistic perception of his or her appearance
and express feelings that reflect a positive body.
 Verbalizes and demonstrate more adaptive strategies for
coping with stressful situations.

25. THANK YOU