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Case Study: Obsessive-Compulsive Disorder
Lana, age 28, has been admitted to the psychiatric unit with a diagnosis of OCD. She has been under the care of a psychiatrist since she was 14 years old. At that time, she was diagnosed with Anorexia Nervosa. She was treated for that disease and stabilized, and her family underwent counseling for about a year. She had a mild recurrence of the disease during her college years but was treated on an outpatient basis. Lana reported to the admitting nurse that during the past few years she has become increasingly obsessed with neatness and cleanliness. She washes her hands many times a day, and, when possible, changes her clothing several times a day. She spends an enormous amount of time doing laundry and cleaning her apartment. Her hands crack and bleed from the excessive hand washing. She takes hours to get ready to go somewhere. If the routine is interrupted in any way, she starts over from the beginning. Recently she got up at 1:30 a.m. to start getting ready for work. She has also started to lose weight again. She has a poor body image, and although her weight is appropriate for her height, she sees herself as overweight. She tells the nurse that she knows her behavior is inappropriate, but she can’t seem to stop herself.
What are Lana’s signs and symptoms?
What is risk factors to OCD?
Name two medications to treat Lana’s OCD? What are the actions of the medications? What are the side effects?
Name a nonpharmacologic treatment for Lana’s OCD? Describe this nonpharmacological treatment?
Behaviors Associated with Anxiety, OCD, and Related Disorders
Identify the anxiety disorder associated with the behaviors listed below. Number 1 has been completed as an
example.
a.
Panic disorder
e. Generalized anxiety disorder
b.
Agoraphobia
f. Social anxiety disorder
c.
Specific phobia
g. OCD
d.
Hair-pulling disorder
h. Body dysmorphic disorder
_ 1. Janet becomes panicky when she gets near a dog.
2. Patricia weighs and measures her food. Long after everyone else has finished eating, she is still calculating the caloric value of her food and remeasuring her portion.
3. Frances will not leave her home unless a friend or relative goes with her.
4. The nurse asks Heather about the bald spots on her scalp. Heather replies that when she gets nervous, she feels better if she pulls on her hair.
5. Sonja refuses to eat in a restaurant. She is afraid others will laugh at the way she eats.
6. About once a week, without warning, Stanley’s heart begins to pound, he becomes short of breath, and sometimes he experiences chest pain. The doctor has ruled out physical problems.
7. Janie wants desperately to visit a foreign country with her friends, but because of her fear of needles, she has not been able to get the required immunizations.
8. Helen is a very restless person. She is always nervous and keyed up. She worries about many things over which she has no control.
9. Virginia has some freckles across her nose and cheeks. She visits dermatologists regularly trying to find one who will “get rid of these huge, ugly spots on my skin.”
10. George never volunteers to speak in class. He is afraid his classmates will laugh at what he says.
11. Carl will go to church, but only if he can sit right near the door.
12. When Sally sees a spider on the floor, she screams and runs out of the room.
13. Every day when Wanda gets home from work, she cleans her house. She has told her friends not to call her during this time, and if anything interferes with her cleaning, she becomes very upset and starts over from the beginning.
14. Don has always been an excellent student and was valedictorian of his high school graduating class. Since starting college, he has been unusually worried about his academic performance. Lately, he has been unable tosleep, is irritable, has difficulty concentrating, and has begun experiencing nausea and vomiting due to worry that he will not do well academically.
15. Helen’s boss has told her that if she is late for work one more time she will lose her job. Helen gets up early enough to be at work on time, but she must follow a specific routine of putting her apartment in order before sheleaves the house. If one activity in her routine is interrupted, she must start over from the beginning. These delays and repetitions in her routine are causing her to be late for work.
1. What are the symptoms of a person with agoraphobia?
2. What neurotransmitter has been implicated in the development of obsessive-compulsive disorder?
3. What are some predisposing factors that have been associated with hair-pulling disorder?
4. What is the primary nursing intervention for a person in panic anxiety?
SCIENCE
HEALTH SCIENCE
NURSING
