The symptoms of OCD cause significant distress and interfere with daily activities. Cognitive-behavioral therapy (CBT) using exposure and response prevention (ERP) has been found to be an effective treatment for OCD. However, not all individuals who receive ERP for OCD show complete symptom reduction.
Full Answer
How should a nurse deal with a client with obsessive-compulsive disorder?
The nurse should identify that the client is using the defense mechanism of intellectualization when discussing the rituals of obsessive-compulsive disorder in detail while avoiding discussion of feelings.
What is the first line of treatment for obsessive-compulsive disorder?
The client who is beginning treatment for OCD is prescribed the selective serotonin reuptake inhibitor depressant fluvoxamine as a first-line choice. Clients with treatment-resistant OCD may respond to second-generation antipsychotics such as risperidone, quetiapine, and olanzapine.
Which symptom pattern is commonly exhibited by clients with obsessive-compulsive disorder?
Trichotillomania (hair pulling), hoarding, and nail biting are all symptom patterns commonly exhibited by clients with obsessive-compulsive disorder.) Which symptom pattern is NOT indicative of a client with obsessive-compulsive disorder? (One of the risk factors for developing OCD is childhood sexual abuse.
How will cognitive-behavioral therapy help a client with obsessive-compulsive disorder?
Cognitive-behavioral therapy will assist the client with lessening feelings of shame and anxiety.) A client asks the nurse how cognitive-behavioral therapy will help her to manage her obsessive-compulsive disorder.
What is the role of the client in a drawer?
C. The client folds and refolds clothing in a drawer before each meal.
What is fluoxetine prescribed for?
A client is prescribed fluoxetine (Prozac) for treatment of obsessive-compulsive disorder. During the latest office visit, the client washes the hands while counting to 10 and repeats the process every 5 minutes. Which is the priority assessment for the nurse to complete for this client?
How many steps does a client take while walking?
A. While walking, the client counts 13 steps and then reverses the direction and repeats the process.
How effective is behavioral therapy for OCD?
Although there are a variety of behavioral therapies for treating OCD, almost all of them focus on exposing you to those things that you fear most, such as germs or an upsetting thought. While behavior therapies can be very effective, only two-thirds of patients complete treatment.
Why is exposure therapy important?
This is important because avoiding things we are afraid of sends a very powerful message to our brains that there really is good reason to fear such things and that we do not have the skills to cope with them.
Why do patients have trouble sticking with exposure based treatments?
Often, this occurs because patients are unwilling to experience the intense distress that can accompany an exposure exercise. In addition, and perhaps more importantly, many patients do not fully understand the rationale behind exposure-based treatments, and thus have trouble sticking with it when things get tough.
What is exposure exercise in behavior therapy?
Essentially, patients are exposed to feared objects, such as a contaminated door handle or fearful thoughts, like a loved one dying in a car crash, over and over again until their anxiety has decreased.
What is the backbone of exposure therapy?
Habituation: The Backbone of Exposure Therapy. Exposure-based treatments take advantage of a natural process called habituation. Habituation occurs when a person stops responding or paying attention to a stimulus, such as a thought, object, place, person or action, with repeated exposure.
How do rituals prevent anxiety?
Patients are prevented from engaging in rituals or compulsions during the exposure. Rituals are a form of avoidance that prevent you from unlearning your fear and realizing that you can, in fact, cope with the anxiety caused by obsessions. As you are repeatedly exposed to the thing you are afraid of and no negative consequences occur, your fear will begin to disappear.
What is the priority diagnosis for a nurse?
The nurse should suspect that the client has exhibited signs/symptoms of a panic disorder. The priority nursing diagnosis should be panic anxiety. Panic disorder is characterized by recurrent, sudden-onset panic attacks in which the person feels intense fear, apprehension, or terror.
What is depersonalization in a nurse?
Depersonalization refers to being detached from oneself when experiencing extreme anxiety.
What is phobia in nursing?
Phobia is fear cued by a specific object or situation in which exposure to the stimulus produces an immediate anxiety response.
How long do panic attacks last in nursing?
Panic attacks usually last minutes but can, rarely, last hours. Symptoms of depression are also common with this disorder.
When is anxiety considered abnormal?
B. "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning."
Do clients recognize that their fear is excessive?
A. "These clients do not recognize that their fear is excessive, and they rarely seek treatment."
Is GAD a chronic disorder?
A. GAD is acute in nature, and panic disorder is chronic.
What is the role of a nurse in obsessive compulsive disorder?
The nurse is caring for a client receiving fluvoxamine and behavior therapy for obsessive compulsive disorder.
How does reducing rituals help with OCD?
Reducing the frequency of rituals for a person with OCD causes anxiety . Clients consequently benefit from learning techniques that can reduce their stress in a healthy way. Mood stabilizers are not typically used in the treatment of OCD, and nurses do not normally facilitate the performance of rituals. The client is likely aware of the negative consequences of obsessions and rituals, as evidenced by efforts to eliminate them.
When does the client stop the ritual?
The client stops the ritual only when prompted by external stimuli.
What is interrupted behavior?
Interrupt repeated behaviors to reduce the time used for activities.
How to help a client with OCD?
Verbalization of feelings will assist the client with reducing stress and anxiety. The client with OCD needs to learn new coping skills to manage the intrusive thoughts that lead to the performance of rituals. Allowing time in a client's daily schedule to perform the ritual will allow the client to complete the ritual and still manage daily activities. A loud environment is not recommended. Interrupting a client's ritual may lead to increased anxiety and is not recommended, unless it is harmful to the client.)
What does OCD do to a client?
Clients with OCD perform rituals to control intrusive thoughts, not to check the safety of the home, to control others, or to call attention to themselves.) A client with obsessive-compulsive disorder (OCD) tells the nurses that he checks the locks to his house 10 times before leaving in the morning for work.
How is obsessive compulsive disorder measured?
The severity of obsessive-compulsive disorder is measured by the amount of time the client spends in the compulsive behavior mode; it ranges from mild, which is less than 1 hour, to extreme, which is constant.
What does OCD mean in nursing?
A client diagnosed with obsessive-compulsive disorder (OCD) tells the nurse that he has had feelings of apprehension that are alleviated through frequent hand washing. The client's hands are red, swollen, and the nurse notes several areas of excoriation.
What are the symptoms of OCD?
Repetitive behaviors are a hallmark sign of OCD. Physical complaints can be seen in patients who perform repetitive activities such as hand washing. Signs of distress or increased anxiety can be seen in clients when they feel compelled to complete rituals. The ritual is the client's way of resolving the anxiety.
Why is OCD difficult to diagnose?
Diagnosis of OCD is difficult due to the variations in clinical presentation. Brain imaging in clients with OCD is abnormal.) The nurse educator is teaching a group of students about obsessive-compulsive disorder (OCD).
What are the repetitive acts associated with OCD?
Assessment findings that illustrate the repetitive acts associated with OCD include constant hand washing and the need to lock and unlock doors. The other findings would not support the repetitive acts associated with OCD.)