Page 2254 - Saunders Comprehensive Review For NCLEX-RN

i. Sense of unreality and helplessness
j. Fear of being trapped
k. Fear of dying

3. Interventions

a. Remain with the client.
b. Attend to physical symptoms.
c. Assist the client to identify the thoughts
that aroused the anxiety and identify
the basis for these thoughts.
d. Assist the client to change the
unrealistic thoughts to more realistic
thoughts.
e. Use cognitive restructuring to replace
distorted thinking.
f. Administer antianxiety medications if
prescribed.
III. Post-traumatic Stress Disorder

A. Description: After experiencing a psychologically

traumatic event, the individual is prone to re-experience the event
and have recurrent and intrusive dreams or flashbacks.
B. Diagnosis: Symptoms last at least 1 month and can occur months
to years after the traumatizing events.
C. Stressors
1. Natural disaster
2. Terrorist attack
3. Combat experiences
4. Accidents
5. Rape
6. Crime or violence
7. Sexual, physical, and emotional abuse
8. Re-experiencing the event as flashbacks
D. Assessment
1. Avoidance or numbness
2. Irritability or outbursts of anger
3. Detachment
4. Depression that may involve suicidal thoughts
5. Anxiety
6. Sleep disturbances and nightmares
7. Flashbacks of event
8. Hypervigilance and exaggerated startle response
9. Guilt about surviving the event
10. Poor concentration and avoidance of activities that
trigger the memory of the event
E. Interventions (Box 65-2)

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