Nursing 212

Health Differences Across the Lifespan 2 Study Guide Anxiety increases if obsessive thoughts and compulsions are interrupted. Depression and/or substance abuse may occur as a complication. Treatments include relaxation and cognitive behavioral techniques. Nurses should assist the patient to identify situations that increase anxiety, explore the meaning and purpose of thoughts and behavior, and support the patient in attempts to decrease obsessions and compulsions. Nurses should also conduct teaching immediately after the completion of a ritual when the patient is least anxious. Several medications have been proven effective in helping people with OCD including clomipramine, fluoxetine, fluvoxamine, and paroxetine. ECT has been used to treat depressive symptoms associated with OCD. Post-Traumatic Stress Disorder Post-traumatic stress disorder (PTSD) is an extremely debilitating condition that can occur after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include violent personal assaults, such as rape or mugging, natural or human-caused disasters, accidents, or military combat. Clients with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. Other signs and symptoms include emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. Feelings of intense guilt are also common. Patients may exhibit apathy, social withdrawal and isolation, along with restlessness and amnesia for certain aspects of trauma. Treatments include providing a nonthreatening environment, encouraging the patient to discuss the traumatic event and associated feelings, and assessing and acknowledging feelings of guilt, grief, and shame. Nurses should encourage and reinforce appropriate coping strategies, teach new coping strategies, and assist the patient in resuming regular activities. Cognitive-behavioral therapy, group therapy, and exposure therapy, in which the patient repeatedly relives the frightening experience under controlled conditions to help him or her work through the trauma, have also been effective treatments. Medications, such as SSRIs, especially Zoloft (sertraline), seem to have some effect in treating PTSD. Phobias A phobia is a persistent, irrational fear of a specific object or situation. Phobias develop when an unconscious conflict is displaced onto an external object. It is also related symbolically to conflict. A diagnosis is often made when avoidance of feared stimuli drastically interferes with routineactivities. There are several types of phobias, including: • Specific (simple) phobia: an unreasonable fear of specific circumstances or objects, such as traffic jams or snakes • Social phobia: extreme fear of looking foolish or unacceptable in public that causes people to avoid public occasions or areas

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