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Published by api-3859513
Psychiatric Files
Psychiatric Files

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Published by: api-3859513 on Oct 19, 2008
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\u2297Vague sense of impending doom
\u2297Subjective response to stress
\u2297Is a state of apprehension, uneasiness, uncertainty or
tension experienced by an individual in response to an
unknown object or situation.
Signs and symptoms:
\u2297Physical - \u2191PR, RR, BP, pupillary dilatation, sweating
\u2297Cognitive - Attentive and alert
\u2297Emotional - Minimal use of defenses
\u2297Physical - Nausea, Anorexia, Vomiting, Diarrhea, Constipation,
\u2297Cognitive - narrowed perceptual field & selective inattention
\u2297Emotional - use of any defense mechanism available
\u2297Physical - s/sx becomes the flow of attention
\u2297Cognitive \u2013 perceptual field is greatly narrowed, focus of attention is trivial
\u2297Emotional \u2013 defense mechanism operate

\u2297Physical \u2013 s/sx of exhaustion ignored
\u2297Cognitive \u2013 personality disorganized
\u2297Emotional \u2013 defense mechanism fail

Nursing Diagnoses:
\u2297Ineffective individual coping
Nursing Management:

\u2297Administer medications
\u2297Minimize environmental stimuli

Panic Disorder
\u2297An individual may suddenly experience frightening and uncomfortable
\u2297May include terror, sense of unreality or fear of loosing control
\u2297Attack: 1 minute and 1 hour
Phobic Disorder
\u2297Phobia is an irrational fear of an object, place, activity or situation.
\u2297Avoidance will allow the individual to be free from anxiety.
Agoraphobia - fear of open places and of being alone in public places.
Social phobia - irrational fear of criticism, humiliation or embarrassment.
Acrophobia - fear of heights
Algophobia - fear of pain
Claustrophobia - fear of enclosed place
Thanatophobia - fear of crowds
Pathophobia - fear of disease
Monophobia - fear of being alone
Generalized Anxiety Disorder
\u2297Unrealistic, excessive anxiety and is unable to control worry.
\u2297Clients may experience: fatigue, irritability, restlessness, muscle tension,
sleep disturbance
Psychiatric Nursing: Lecture Aid
Page 20
Obsessive Compulsive Disorder
\u2297Is characterized by recurrent obsessions and compulsions that interfere
with normal life.
\u2297Refers to persistent, painful intrusive thought, emotion or urge that one is
unable to suppress or ignore.
\u2297Refers to repetitious uncontrollable act and sometimes a purposeful act to
prevent a certain mistake in an event or situation.
Post-Traumatic Stress Disorder (PTSD)
\u2297Is the delayed reaction of the person who has been involved or exposed to
a traumatic events.
\u2297Symptoms of this disorder are:
intense psychological distress
feeling of detachment or estrangement from others
decreased concentration
avoidance of thoughts and feelings
recurrent distressing dreams
inability to recall an important aspect of the trauma
Nursing Interventions

\u2297Calm and nonjudgmental approach to convey acceptance.
\u2297Use short and simple sentences or words.
\u2297Help the client develop an increase tolerance to anxiety.
\u2297Help the client to:

develop a problem-solving and coping skills of the client.
develop the ability to remain calm in anxiety-producing situations.
\u2297Approach: kind-firmness
\u2297Systematic desensitization (phobic disorders)
\u2297Clients with ritualistic behavior (obsessive-compulsive disorder) should not
be prohibited or reprimanded.
\u2297Biofeedback, change of the scenery, therapeutic touch, hypnosis, massage
or relaxation exercises.
\u2297Administer medications, as ordered.
Somatization Disorder
\u2297Free floating anxiety disorder
express emotional turmoil or conflict through physical symptoms.
usually seek for repeated medical attention.
may exhibit antisocial behavior and may attempt suicide.
\u2297Associated with anxiety and depression
Conversion Disorder
\u2297A condition in which an anxiety-provoking impulse is converted
unconsciously into functional symptoms.
\u2297Conscious counterpart of malingering
\u2297Examples: Paralysis, blindness, loss of touch or pain sensation, dyspnea,
seizures or convulsions
\u2297An individual presents an unrealistic or exaggerated physical complaints.
\u2297The person becomes, preoccupied with the fear of developing or having
already a disease or illness in spite of medical reassurance.
Body Dysmorphic Disorder
\u2297Preoccupation with an imagined defect in his or her appearance.
\u2297Slight physical abnormality = excessive concern / anxiety
Dissociative Amnesia

\u2297Inability to recall extensive amount of important information
\u2297Caused by trauma
\u2297Characterized by:

Psychiatric Nursing: Lecture Aid
Page 21
Purposeless wandering
Impairment in ability to perform ADL
\u2297Rapid recovery generally occur
\u2297Are pervasive and inflexible patterns of functioning that is stable overtime,
and leads to distress or impairment.
Types of Personality Disorders:
Eccentric Personality Disorder (Type A)
\u2297Paranoid (Suspicious and distrustful)
Persons who display pervasive and long stand suspiciousness
More common in men
\u2297Schizoid (Socially distant and detached)
Pattern of detachment from social relationship
Chooses solitary activities
Topics are inanimate objects and ideas
\u2297Schizotypal (Odd and eccentric)
\u201cmild schizophrenia\u201d
Acute discomfort in close relationships
Cognitive or perceptual distortion
Dramatic-Erratic Personality Disorder (Type B)
\u2297Antisocial (aggressive and manipulative)
Pattern of disregard for the violation of the rights of others
Low self-esteem
\u2297Borderline (destructive and unstable)
Characterized by patterns of instability in relationships, self image and
Self-mutilating behavior
Affective instability
More common in women
\u2297Narcissistic (boastful / superiority complex)
Grandiosity and need for constant admiration
Exploitation of others for fulfillment of own desire
Anxious or Fearful Personality Disorder (Type C)
\u2297Avoidant (inferiority complex)
Social inhibition
Feelings of inadequacy and sensitivity
Low self-esteem
Social withdrawal in spite of a desire for affection and acceptance
\u2297Dependent(submissiv e)
Submissive clinging behavior related to excessive need to be cared for
by others
Lack of self-confidence
Perceive self as helpless and stupid
\u2297Obsessive-Compulsive(perfectio nist)
Preoccupied with orderliness, perfectionism, inflexibility, need to be in
Formal and serious interpersonal relationship
Judgmental of self and others
Intentional inefficiency
Passive resistance to demands for adequate performance in both
occupational and social functioning
Nursing Diagnosis:
\u2022Ineffective individual coping
\u2022Self-esteem disturbance
\u2297Characterized by:
Psychiatric Nursing: Lecture Aid
Page 22

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