Panic and Phobias (Sherpath)

The interdisciplinary health care team recommends systematic desensitization therapy for a patient diagnosed with specific phobia. Which statement made by the patient indicates an understanding of this therapy?

"This therapy teaches me how to relax when exposed to stimuli that provoke anxiety." Rationale Systematic desensitization therapy progressively exposes the patient to anxiety-provoking stimuli, while teaching relaxation techniques to alleviate anxiety.

Which patient factors are included in the mental status exam (MSE) nursing assessment?

Affect The patient's affect and outward appearance are part of the MSE. Mood The patient's mood and behavior are part of the MSE. Speech The patient's word choices and pattern of speech are part of the MSE.

Which type of phobia can lead to the phobic patient becoming homebound for years?

Agoraphobia Rationale Patients with agoraphobia can experience such intense feelings of fear of open spaces that they remain home for years.

In which area of the brain is the fear center located?

Amygdala Rationale The amygdala is the part of the brain that regulates emotions and is the location of the fear center. Feelings of panic are generated in the amygdala.

Which types of medications are used to treat panic disorder?

Anxiolytics Anxiolytics are used to treat the somatic symptoms associated with panic disorder. Antidepressants Antidepressants are used to prevent and manage panic disorder; they are also used to treat the symptoms of depression that may accompany panic disorder.

Which type of therapy is recommended to help a patient understand the connection between the patient's feelings of impending doom and the symptom of difficulty breathing?

Cognitive behavior therapy Rationale Cognitive behavior therapy helps the patient understand the connection between thoughts or feelings and behaviors, such as how feelings of impending doom cause difficulty breathing.

Which type of therapy is most beneficial in treating panic disorder?

Cognitive behavior therapy Rationale Cognitive behavior therapy is most beneficial for patients who experience panic attacks, because it highlights the relationship between thoughts and feelings and behavior patterns.

Which nursing intervention is most important to the patient experiencing escalating anxiety related to a panic attack or phobia?

Encouraging use of relaxation techniques Rationale Encouraging use of relaxation techniques, such as deep breathing, helps reduce the patient's anxiety associated with a panic attack or phobia.

Which types of therapy are most beneficial in treating phobias? Select all that apply.

Exposure therapy In exposure therapy, the patient is progressively exposed to the factor that causes fear in order to develop a tolerance to the phobia-inducing factor. Exposure therapy is beneficial in treating phobias. Systematic desensitization Systematic desensitization is used to progressively expose the patient to anxiety-provoking stimuli and to teach relaxation techniques to help manage the anxiety. Systematic desensitization is beneficial in treating phobias. Cognitive behavior therapy Cognitive behavior therapy is most beneficial for patients who experience phobias because it highlights the relationship between thoughts and feelings and behavior patterns.

Which nursing diagnosis is most appropriate for the patient with panic disorder or phobias?

Fatigue Rationale Patients with panic disorder or phobias experience high levels of stress and anxiety that lead to fatigue.

Match the type of phobia with its corresponding characteristic.

Fear of open spaces = Agoraphobia Specific fear of enclosed spaces = Claustrophobia Fear of interacting with others= Social phobia Specific fear of objects or situations=Specific phobia

When are phobias developed?

Immediately after a traumatic event Rationale Phobias develop when a traumatic event is experienced (when a person is bitten by a spider); phobic reactions then appear during future similar traumatic events (whenever person sees a spider).

Which feelings might a patient experience when having a panic attack?

Impending doom A patient having a panic attack may have a feeling of impending doom or a sense of foreboding. Separation from self A patient having a panic attack can feel as if he or she is imaginary or separated from self. Disorganized surroundings A patient having a panic attack can feel as if the surroundings are disorganized or even imaginary.

The nurse assesses a male patient diagnosed with panic disorder and observes the patient sitting on the edge of the seat, wringing his hands, and clenching his jaw. Which assessment tool is most effective for the nurse to use when further assessing this patient?

Mental status exam Rationale The mental status exam is used to assess the patient's behavior, affect, and thought processes. This is most effective for determining the overall mental state of the patient.

Which physical symptoms are associated with panic attacks?

Nausea Nausea is a physical symptom associated with a panic attack. Sweating Patients with experiencing a panic attack are prone to sweating. The stress response triggers sympathetic nervous system activity. The sweat glands are innervated by the sympathetic nervous system and are part of the fight or flight response system. Shortness of breath Hyperventilation (deeper and rapid breathing), which can occur during a panic attack, can lead to shortness of breath, rapid heartbeat, chest pain, and numbness or tingling of hands and feet.

Which patient goal is most realistic for Wendy? CASE STUDY DETAILS

Patient verbalizes two techniques to improve problem-solving ability at discharge. Rationale This goal is realistic for Wendy because it involves her identifying techniques in a realistic timeframe instead of requiring her to change behavior in a short amount of time.

A patient with several complex medical conditions informs the health care team that he has an upcoming presentation to deliver at work and that public speaking makes his heart race and palms sweat. Which medication is recommended for this patient?

Propranolol Rationale Propranolol is a beta blocker that is specifically used to block the symptoms of anxiety associated with specific phobias, such as public speaking or flying in an airplane.

Citalopram is which type of antidepressant commonly used in the treatment of phobias?

Selective-serotonin reuptake inhibitor (SSRI) Rationale SSRIs are the most common type of antidepressants used to treat phobias, and this includes citalopram.

The nurse develops nursing diagnoses for a patient diagnosed with an anxiety disorder. Which nursing diagnosis requires immediate intervention by the nurse?

Stress overload Rationale Stress overload can cause the patient to act impulsively and irrationally that may lead to self-harm

A patient is diagnosed with social phobia that causes limited interactions with work colleagues and peers. Which nursing intervention is most effective for this patient?

Suggest the patient join an online chat group Rationale If the patient has social phobia that limits physical interaction with others, an online chat group can help the patient connect with others to decrease isolation without having to physically be around other people.

Which statement regarding panic disorder is true?

The diagnosis of panic disorder does not include panic attacks caused by substance withdrawal. Rationale To make the diagnosis of panic disorder, panic attacks cannot directly or physiologically result from substance use (intoxication of withdrawal), medical conditions, or another psychiatric disorder.