A patient is being evaluated for a possible diagnosis of panic ...

[panfilo]

A patient is being evaluated for a possible diagnosis of panic disorder with agoraphobia. Which nursing assessment findings support this diagnosis? Select all that apply.
 
  a. Patient states, I've had these fears for more than 6 years.
  b. Patient describes having a panic attack several times a month.
  c. Patient is embarrassed by the limitations the disorder causes.
  d. Stated, I never even think about going shopping in a crowded mall.
  e. Condition began after beginning treatment for a chronic intestinal problem.

Question 2

A patient with OCD tells the nurse, Thinking these thoughts and doing all my rituals is beyond being silly.
 
  I have few friends and I know others laugh behind my back. I sometimes think I can control things, but I always find I can't. I don't know if I can continue to live this way. Which assessment question shows the nurse has an understanding of this patient's priority risk?
  a. Are you feeling hopeless?
  b. Do you think you are socially isolated?
  c. Have you been thinking about hurting yourself?
  d. Do the rituals affect how you feel about yourself?

[fur]

Answer to Question 1

ANS: A, B, C, D
To meet the first DSM-IV-TR criterion for panic disorder with agoraphobia, the person must experience recurrent, unexpected panic attacks, with at least one attack followed by one of the following for a month: (1) persistent concern about having additional attacks; (2) worry about the implications of the panic attacks; or (3) a significant change in behavior as a result of the attacks. The second criterion is that the individual experiences agoraphobia. Agora-phobic fears typically involve being in a crowd. The third criterion is that the person avoids agoraphobic situations or has anxiety about having a panic attack. This person will not go to an area or event where he or she has experienced an agoraphobic reaction. The fourth criteri-on states that panic attacks are not caused by the direct effects of a substance, a medication, or a medical condition.

Answer to Question 2

ANS: C
Patients with anxiety disorders should always be assessed for the presence of depression and suicidal ideation, the priority risk to safety. This patient has admitted feeling powerless to control the symptoms, in addition to wondering if she can continue to live the way she has been. There is ample reason for asking about suicidal ideation. The remaining options address hopelessness, social isolation, and low self-esteem. While appropriate nursing concerns, they don't have the priority self-harm has for this patient.

[panfilo]

Thanks for the timely response, appreciate it

[chereeb]

Excellent