Panic disorder is a real illness that can be successfully treated. It is characterized by sudden attacks, usually accompanied by a pounding heart, sweating, weakness, fainting, or dizziness. During these attacks, people with panic disorder may feel tightness or cold; their hands may cramp or feel numb, and they may experience nausea, chest pain, or sensations in the hand over. Panic attacks usually produce a sense of unreality, fear of impending doom, or a fear of losing control.

All of the symptoms described above are symptoms of panic disorder. People who have panic attacks sometimes believe they are having a heart attack, losing their minds, or on the verge of death. They can not predict when or where an attack will occur, and among the many episodes of worry and fear the attack will happen again.

Panic attacks can occur at any time, even during sleep. Attacks usually occur within 10 minutes, but some symptoms may last much longer.

But not all people who experience panic attacks will develop panic disorder. Many people only have one attack and never again. The tendency to develop panic attacks seems innate.

People who keep repeating panic attacks can be severely disabled by their condition and should seek treatment before they start to avoid places or situations where panic attacks have occurred. For example, if a panic attack happened in the elevator, someone with panic disorder may develop a fear of elevators that can influence the choice of a job or an apartment, and restrict where that person can seek medical attention or enjoy entertainment.

The lives of some people become so limited that they avoid normal activities, such as shopping or driving. Approximately one-third to stay at home or be able to face the feared situation only if accompanied by a spouse or other trusted person. When the condition progresses this far, it is called agoraphobia, or fear of open spaces.

Early treatment can often prevent agoraphobia, but people with panic disorder sometimes go from doctor to doctor for years and visit the emergency room repeatedly before someone correct diagnosis of their condition. This is unfortunate, because panic disorder is one of the most treatable of all the anxiety disorders, responding in many cases for some types of drugs or some kind of cognitive psychotherapy, which help change the mindset that leads to fear and anxiety.

Panic disorder is often accompanied by other serious problems, such as depression, drug abuse or alcoholism. This condition must be treated separately. Symptoms of depression include feelings of sadness or hopelessness, changes in appetite or sleep patterns, low energy, and difficulty concentrating. Most people with depression can be treated with antidepressants, some types of psychotherapy, or a combination of both.

Nursing Management for Panic Disorder

1. Try to keep the client's mind stay calm, and do not be too prejudiced against everything.
2. Look for places that are favored by clients to calm the panic.
3. Invite clients to share their feelings with others who are considered able to be able to assist clients in eliminating panic experienced.
4. Do not be influenced by the situation heats up and make the client always thought about the feelings of panic.
5. Prioritize the most important thing before the client to do something.
6. Immediately rose and spirit of panic, through the clarity and sensitivity in analyzing everything that happened. Whether that will happen or has already happened, and do not easily take the decision of the client's own self.
7. Spend a little time the client, to fill a positive thing and can soothe panic experienced.
8. Pray and ask the Lord's guidance.
9. Use alternative treatments that can help the client, such as meditation, therapy, or others.

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Syncope (Fainting)

Fainting or syncope is also called a momentary loss of consciousness due to blood flow to the brain is temporarily reduced. In contrast to the shock, the pulse becomes slower, although it will soon rise again. Usually patients can recover.

Nursing management for patients with syncope, we should be able to ascertain precipitating factors or causes that appropriate treatment can be done. The cause of fainting that deserves our attention among which are; disorders vascular tone or blood volume, cardiovascular disorders, cerebrovascular disease, and other disorders such as metabolic disorders, psychogenic and seizures. Syncope caused by a heart defect risk of causing death.

As a form of prevention, patients with recurrent syncope or have a history of fainting without prior symptoms should avoid activities that could cause further injury, when it came to losing consciousness at the time of the event, such as; swim alone, operating heavy machinery or driving. Elderly patients with dizziness or syncope are at risk of traumatic injury. Morbidity and mortality of elderly patients are very significant as they fall when they lose consciousness.

Before someone fainted, there is usually a sign that perceived. Therefore, it can be deep breathing, and relaxation techniques to avoid fainting. Such techniques can help control fainting associated with the regulation of blood pressure.

Lying at least 10-15 minutes in a cool and quiet. By the time symptoms appear to be unconscious as lightheadedness, nausea or cold and moist skin, can be counter-pressure maneuvers such as clenched fingers, tense hands, and crossed legs or thighs pressed. If fainting occurs frequently without triggering events, usually a sign of underlying heart disease.

If the patient has lost consciousness, the patient should be placed in a position that supports blood flow to the brain, protected from trauma and get a secure airway. Actions that can be performed on first aid is laid unconscious patient with legs elevated and sustained. The patient should certainly be able to get some fresh air. Therefore, the window should be opened, or if the patient is outside the room or in the crowd, lest the patient surrounded. If not immediately recovered consciousness, breathing and pulse should be checked and prepared to anticipate resuscitation if necessary.

If possible, the patient should lie supine and head facing to the side to prevent aspiration and airway obstruction by the tongue. Furthermore, pulse and cardiac auscultation assessment can help determine whether the fainting associated with bradyarrhythmias or tachyarrhythmias. The clothing should be loosened stick tight, especially on the neck and waist. Stimulation of peripheral such as dripping water on the face can help resuscitate the patient. Any gift to a patient's mouth, including water, should be avoided if the patient is still in the physical weakness.

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