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08/13/2020 Panic Disorder - Coggle Diagram
08/13/2020 Panic Disorder
Behavioral Interventions
Caffeine containing products, such as coffee, tea, and colas, should be discontinued.
Behavioral therapy involves sequentially greater exposure of the patient to anxiety-provoking stimuli; over time, the patient becomes desensitized to the experience.
Cognitive therapy helps patients understand how automatic thoughts and false beliefs/distortions lead to exaggerated emotional responses, such as anxiety, and can lead to secondary behavioral consequences.
Nursing Interventions
Administer tranquilizing medication, as ordered by physician; assess medication for effectiveness and for adverse side effects.
When level of anxiety has been reduced, explore with client possible reasons for occurrence; recognition of precipitating factors is the first step in teaching client to interrupt escalation of anxiety.
Encourage client to talk about traumatic experience under nonthreatening conditions; help client work through feelings of guilt related to the traumatic event; help client understand that this was an event to which most people would have responded in like manner.
Reassure client of his or her safety and security; this can be conveyed by physical presence of the nurse; do not leave client alone at this time.
Maintain a calm, nonthreatening manner while working with client; anxiety is contagious and may be transferred from staff to client or vice versa.
Patient Education
Be sure to follow your healthcare provider's treatment plan.
Learn as much as you can about anxiety, panic attacks, and panic disorder. This will help you recognize the signs of a panic attack.
Avoid smoking and caffeine.
Learn deep-breathing exercises, which can lessen some symptoms of panic attacks.
Yoga, meditation, and muscle relaxation exercises can help you cope with stress in your life.
Pathophysiology
A panic attack is a sudden, intense fear or anxiety that may make you short of breath or dizzy or make your heart pound. You may feel out of control. An attack usually lasts from 5 to 20 minutes. But it may last even longer, up to a few hours. You have the most anxiety about 10 minutes after the attack starts. If these attacks happen often, they are called a panic disorder.
Important Assessments
Primary Care Evaluation of Mental Disorders
The Body Sensations Questionnaire
Folstein Mini-Mental Status Examination
Mental Status Examination
Assess for increased sympathetic state signs like hypertension, tachycardia, mild tachypnea, mild tremors, and cool, clammy skin
Rule out cardiac disorders using electrocardiography or treadmill ECG
Chest radiography is useful in excluding other causes of dyspnea with chest pain
Hyperthyroidism is one of the most common medical causes for anxiety related to a medical condition
Medication
Selective serotonin reuptake inhibitors
fluoxetine
paroxetine
sertraline
Serotonin and norepinephrine reuptake inhibitors
venlafaxine
Benzodiazepines
alprazolam
clonazepam
Antipsychotic agent