Uploaded byPaul McNamara
Nursing the person who has anxiety
The document provides an overview of anxiety disorders and nursing strategies. It discusses types of anxiety disorders like panic disorder, obsessive compulsive disorder, generalized anxiety disorder, post-traumatic stress disorder, agoraphobia, social phobia, and specific phobias. For panic disorder, it outlines nursing strategies like slow breathing exercises and lifestyle modifications. For obsessive compulsive disorder, it discusses exposure therapy and response prevention. The presentation aims to educate on signs and symptoms, causes, and evidence-based treatments for different anxiety disorders.
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Nursing the person who has anxiety
- 1. Nursing the personwho has anxiety Using therapeutic techniques for anxiety Paul McNamara RGN (RAH), RPN (SAMHS), BN (Flin.), MMHN (USQ), Cert IMH (WCHN), CMHN, FACMHN @meta4RN #NS3360
- 2. Acknowledgements 2015 NS3360/NS3361/NS3362 Students +Nurses 1988-2015
- 3. Learning Outcomes typesof anxiety disorders nursing panic disorder slow breathing exercises nursing obsessive compulsive disorder
- 4. Today’s Presentation Overview/Context Anxiety Disorders Panic Disorder & Nursing Strategies Obsessive Compulsive Disorder & Nursing Strategies Generalised Anxiety Disorder Post Traumatic Stress Disorder Agoraphobia Social Phobia Specific Phobias Questions/Discussion
- 5. Today’s Presentation Overview/Context Anxiety Disorders Panic Disorder & Nursing Strategies Obsessive Compulsive Disorder & Nursing Strategies Generalised Anxiety Disorder Post Traumatic Stress Disorder Agoraphobia Social Phobia Specific Phobias Questions/Discussion
- 6. Anxiety The Human Condition vs MentalHealth Disorder
- 7. The Human Condition exam assignment jobinterview public speaking large social gathering the new/unknown
- 9. Anxiety Disorders ? trigger prolonged&/or extreme physical & psychological symptoms ↓ quality of life avoidance
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- 13. Physical S&S nausea upset stomach tremors feelinguncoordinated profuse sweating chills diarrhoea dizziness muscle aches sleep disturbances chest pain* rapid heartbeat* rapid breathing* high blood pressure* *NB “diagnostic overshadowing” can be fatal
- 14. Cognitive S&S ? ↓thinking ? ↑ thoughts preoccupation can’t make decisions ↓ problem solving confusion disorientation ↓ concentrati0n ↓ calculating ↓ memory thought blocking distressing dreams
- 15. Emotional S&S anxiety fear guilt grief depression feeling lost feelingabandoned feeling isolated worry about others wanting to hide wanting to avoid others anger/irritability feeling numb anhedonia startled/shocked helplessness despair
- 17. Stress & Anxiety Stress= The Human Experience positive vs negative stress
- 18. Stress Response autonomic sympathetic nervoussystem = “fight or flight”
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- 21. Today’s Presentation Overview/Context Anxiety Disorders Panic Disorder & Nursing Strategies Obsessive Compulsive Disorder & Nursing Strategies Generalised Anxiety Disorder Post Traumatic Stress Disorder Agoraphobia Social Phobia Specific Phobias Questions/Discussion
- 22. Anxiety Disorders excessive &/orprolonged ↓ social & occupational functioning specific & recurrent overvalued/strange/irrational
- 23. Facts & Stats ♀> ♂ 9.7% population/year all cultures early onset & chronic course disability+++ ↑ suicide co-morbidity with substance & mood disorders
- 24. Co-morbidities 50-65% = MajorDepression 20-30% = Substance & Alcohol Thyroid disorders Asthma Diabetes Anaemia Ischemic Cardiac Disease
- 25. Treatment medication is notfirst line non-medication interventions effective ↑ response rate for majority
- 26. Interventions Psychoeducation Cognitive Behavioural Therapy(CBT) eCBT (eg: ecouch.anu.edu.au) Acceptance and Commitment Therapy (ACT) Exposure vs Avoidance Supportive Counselling Psychotherapy Pharmacotherapy
- 27. Interventions Slow Breathing Guided Visualisation ProgressiveMuscle Relaxation Mindfullness “Hack the Brain” (my client’s description) Eye Movement Desensitisation Reprocessing Method (EMDR) ? Neuro-linguistic Programming (NLP)
- 31. Today’s Presentation Overview/Context Anxiety Disorders Panic Disorder & Nursing Strategies Obsessive Compulsive Disorder & Nursing Strategies Generalised Anxiety Disorder Post Traumatic Stress Disorder Agoraphobia Social Phobia Specific Phobias Questions/Discussion
- 32. Panic Disorder Acute Unpredictable Sudden Onset RapidEscalation Distressing+++
- 33. Panic Statistics ♀ >♂ ~ 20% lifetime ~ 2% population/year 10% - 30% general medical patients ~ 60% cardiac patients
- 34. Managing Panic slow breathingexercise parasympathetic nervous system = “rest & repose”
- 35. Managing Panic ↓ coffee ↓nicotine ↓ coca-cola ↑ exercise ?yoga/meditation to assist slow breathing
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- 37. Today’s Presentation Overview/Context Anxiety Disorders Panic Disorder & Nursing Strategies Obsessive Compulsive Disorder & Nursing Strategies Generalised Anxiety Disorder Post Traumatic Stress Disorder Agoraphobia Social Phobia Specific Phobias Questions/Discussion
- 38. OCD obsessive thoughts compulsive behaviours exposure= trigger response = ritual
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- 41. OCD 2 - 3% ♂= ♀ ♂ 6 - 15 y.o.a. vs ♀ 20 - 29 y.o.a. 5% = 0 S&S
- 42. Causes of OCD Multifactorial Geneticvulnerability Neuropatholigical Biochemical Psychological Social Behavioural
- 43. Managing OCD control vscure education exposure therapy & response prevention CBT ? medications
- 44. Today’s Presentation Overview/Context Anxiety Disorders Panic Disorder & Nursing Strategies Obsessive Compulsive Disorder & Nursing Strategies Generalised Anxiety Disorder Post Traumatic Stress Disorder Agoraphobia Social Phobia Specific Phobias Questions/Discussion
- 45. Generalised Anxiety Disorder persistentand excessive anxiety > six months disproportionate ↓ ability to function
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- 47. Agoraphobia phobia = fear placesor situations .: avoidance with panic disorder > without
- 48. Social Phobia specific socialor performance situations phobia = embarrass selves or -ve judgement thoughts = trigger insight intact
- 49. Today’s Presentation Overview/Context Anxiety Disorders Panic Disorder & Nursing Strategies Obsessive Compulsive Disorder & Nursing Strategies Generalised Anxiety Disorder Post Traumatic Stress Disorder Agoraphobia Social Phobia Specific Phobias Questions/Discussion
- 50. Specific Phobias Animal Type NaturalEnvironment Type Blood-Injection-Injury Type Situational Type Other Type
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- 59. Today’s Presentation Overview/Context Anxiety Disorders Panic Disorder & Nursing Strategies Obsessive Compulsive Disorder & Nursing Strategies Generalised Anxiety Disorder Post Traumatic Stress Disorder Agoraphobia Social Phobia Specific Phobias Questions/Discussion