Question

Anxiety Disorder Critical Thinking Assignment

Sarah, age 25, was taken to the emergency department by her friends. They were at a dinner party when Sarah suddenly clasped her chest and started having difficulty breathing. She complained of nausea and was perspiring profusely. She had calmed down some by the time they reached the hospital. She denied any pain, and electrocardiogram and laboratory results were unremarkable.

Sarah told the admitting nurse that she had a history of these “attacks.” She began having them in her sophomore year of college. She knew her parents had expectations that she should follow in their footsteps and become an attorney. They also expected her to earn grades that would promote acceptance by a top Ivy League university. Sarah experienced her first attack when she made a “B” in English during her third semester of college. Since that time, she has experienced these symptoms sporadically, often in conjunction with her perception of the need to excel. She graduated with top honors from Harvard.

Last week Sarah was promoted within her law firm. She was assigned her first solo case of representing a couple whose baby had died at birth and who were suing the physician for malpractice. She has experienced these panic symptoms daily for the past week, stating, “I feel like I’m going crazy!”

Sarah is transferred to the psychiatric unit. The psychiatrist diagnoses panic disorder.

Answer the following question related to Sarah:

Remember to include in-text citations and your references at the end

What would be the priority nursing diagnosis for Sarah?

What is the priority nursing intervention with Sarah?

What treatment modalities might you expect the physician to prescribe?

Answer 1

Panic disorder is composed of discrete episodes of panic attacks usually rapid, intense, escalating anxiety in which the person experiences great emotional fear as well as psychological discomfort.

NURSING DIAGNOSIS: Fear: Response to perceived threat that is consciously recognized as a danger related to mental behaviors indicative of panic.

INTERVENTIONS: The intervention includes a) Assure patient about the possible outcomes of treatments to reduce the fear about her own life b) Present and discuss reality of the situation with client in order to recognize aspects that can be changed and those cannot be changed c) Inbuilt positive thoughts in patient to reduce her emotional and negative thoughts d) Encourage the client to explore her feelings and help her to understand how to face these feelings than suppressing them e) Encourage the client to share this fear with her parents and advice them to support her to understand that these feelings are manageable.

TREATMENT MODALITIES: In this case, patient has recovered from attack and what still following her is the fear about her future and her parents. So, fear is the first source and more care needed to be treat for an effective treatment. a) Sarah should be placed on oxygen and in supine or fowlers position b) monitor continuously with pulse oximetry, electrocardiography and continuous monitoring of vital signs c) Pharmacotherapy includes benzodiazepine for a brief duration which help her to reduce her fear d) Help the patient to understand that these attacks are only due to fear and assess her to overcome her fears e) COGNITIVE- BEHAVIORAL THERAPY can help the patient to understand her false beliefs and reduces negative thoughts and help her to restore positive thoughts by her own.