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Basic observations
Published in Barbara Smith, Linda Field, Nursing Care, 2019
This refers to the depth/volume of the breath and is known as the tidal volume (TV). The TV is usually about 500 mL per breath (Blows, 2001). The TV increases during strenuous exercise to as much as 1500 mL per breath and also varies according to gender and weight. For example, a woman weighing 50 kg may have a TV of 500 mL, and a man weighing 75 kg may have a TV of 700 mL. Prolonged, rapid, deep ventilation is called hyperventilation. This can occur in a person having an anxiety attack. When the breathing becomes slow and shallow, this is called hypoventilation and results in inadequate gaseous exchange. It is important to note whether both sides of the chest are expanding equally on inspiration. If the person has sustained a chest injury, then the lung on the affected side could have deflated. Similarly, if the lung has collapsed as a consequence of infection, this leads to absence of lung expansion on the affected side. Furthermore, lung collapse can lead to pneumothorax, an emergency situation that requires urgent medical intervention.
Anxiolytics: Predicting Response/Maximizing Efficacy
Published in Mark S. Gold, R. Bruce Lydiard, John S. Carman, Advances in Psychopharmacology: Predicting and Improving Treatment Response, 2018
Histories from many panic disorder patients reveal that full-fledged spontaneous attacks are only the tip of the iceberg of endogenous anxiety which these patients experience. Commonly, they also experience partial spontaneous panic attacks, and these may also reinforce secondary apprehension and avoidance. The “minor endogenous anxiety” attacks consist of one or two symptoms of a complete panic attack, such as tachycardia, shortness of breath, hyperventilation, paresthesias, hot flashes, nausea, tremor, depersonalization, sweating, alterations of sensory perception of sound, light, apprehension, etc. These minor attacks can be confused with cardiac, respiratory, gastrointestinal, or other neuroendocrine diseases as well as exogenous anticipatory anxiety which panic patients also experience. Proper identification of them as endogenous anxiety attacks can be assured by noting that they occur spontaneously and have an instantaneous onset. The patient is surprised by the event. If patients have only minor attacks, three in 3 months, Sheehan classifies this as Minor Endogenous Anxiety.24 If patients have three major attacks in 3 months, and have minor attacks also, the patients have Major Endogenous Anxiety. It is important to note that panic disorder often presents with minor endogenous attacks years before major attacks or phobic avoidance occurs.
Session 2
Published in Richard Bryant-Jefferies, Time Limited Therapy in Primary Care, 2017
She’s going into a panic attack, Martin realised, as he saw Mandy begin to tremble and start gasping for breath. ‘Mandy, you’re having an anxiety attack. Please listen to my voice if you can. You need to breathe slowly. Don’t breathe in so deeply. And focus on my voice.’ He was deliberately keeping his voice clear but calm. He needed to reassure her. ‘It’s OK, Mandy, it’s OK. You have had a shock but it is going to be OK.’ He could see how tense she was, her shoulders had risen and she was gripping the arms of the chair. ‘Close your eyes and breathe slowly and rhythmically, and try to gently loosen your grip on the arms of the chair. Try and imagine the tension in your body dropping away, dropping to the floor.’
Anxiety Sensitivity and Panic Disorder: Evaluation of the Impact of Cognitive-Behavioral Group Therapy
Published in Issues in Mental Health Nursing, 2021
Andressa da Silva Behenck, Ana Cristina Wesner, Luciano Santos Pinto Guimaraes, Gisele Gus Manfro, Carolina Blaya Dreher, Elizeth Heldt
According to the DSM-5 criteria (APA, 2014), panic disorder (PD) is an anxiety disorder characterized by anxiety attacks accompanied by physical symptoms (e.g., tachycardia, diaphoresis, dizziness, trembling, shortness of breath, abdominal discomfort, and depersonalization) and by affective symptoms (e.g., fear of death, fear of becoming insane, and fear of losing control), which appear abruptly and reach peak intensity within minutes. These attacks tend to be followed by anticipatory anxiety, i.e., fear of suffering another crisis and/or persistent apprehension about the consequences of PD. Agoraphobia is also common, characterized by fear and avoidance of places or situations from which it would be difficult to escape or where it would be difficult to obtain help if another attack occurred (APA, 2014).
Coping with bereavement: The experience of a Filipino who lives life using a wheelchair
Published in World Federation of Occupational Therapists Bulletin, 2021
Daryl Patrick G. Yao, Peter Bontje, Kaoru Inoue, Aoi Tanaka, Jeana Lacsamana-Manalaysay
The participant is the corresponding author (JLM), a 56-year-old female, of middle socioeconomic status, with SCI paraplegia. She has had this condition for 26 years. She lives in an urban community situated in the city of Las Pinas, Metropolitan Manila, Philippines. She works as a dentist. Other roles she assumes are that of a wife (of a man, 59-years of age, who serves as her full-time assistant at their dental clinic), a mother of two sons, an advocate for accessibility and empowerment, and a resource speaker/ trainer. Though she struggles with anxiety attacks, her family, advocacy work, and acceptance from her patients were instrumental in helping her combat the anxiety. Hence, JLM describes herself as successful in reintegrating to society by practising her profession and being a prominent speaker. She is often invited by the Department of Tourism to promote the department’s action towards ‘barrier-free tourism’ through the sharing of her personal travel experiences. Various local government units would invite her to discuss how to access government budget through activating organisations for people with disabilities (PWD). However, she admits that she still experiences anxiety attacks and periods of feeling emotionally low, which she developed during her early years of having SCI. This period has been more pronounced as she is coping with her mother’s death in August 2019.
Adrenal disorders in pregnancy, labour and postpartum – an overview
Published in Journal of Obstetrics and Gynaecology, 2020
Madhavi Manoharan, Prabha Sinha, Shabnum Sibtain
The signs and symptoms of pheochromocytoma mimic those of severe pregnancy-induced hypertension. This can be associated with other sympathetic symptoms and signs such as palpitations, tachycardia, sweating, seizure disorders, anxiety attacks, chest pain, dyspnoea, nausea and vomiting, pallor, and flushing. Pheochromocytoma should be considered in cases of refractory hypertension in pregnancy and appropriate investigations should be carried out to differentiate from pre-eclampsia. The presence of paroxysmal hypertension after 20 weeks of pregnancy with orthostasis and absence of proteinuria and oedema helps in differentiating from other causes of hypertension in pregnancy. It is also necessary to distinguish from hyperthyroidism, where significant diastolic hypertension is not seen.