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36 Cards in this Set
- Front
- Back
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what is the most common of all psychiatric disorders
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anxiety
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when is anxiety considered a problem
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when the anxiety is out of proportion to the situation creating it or interferes with functioning
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recurrent anxiety attacks with an unpredictable onset
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panic disorder
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s/s panic disorder
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think they are having a heart attack
palpitations trembling choking feeling sweating fear of losing control dizziness fear of dying paresthesias nausea chest pain SOB chills hot flashes |
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how long do panic disorders typically last
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few minutes to hours (rarely)
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chronic, unrealistic, excessive anxiety & worry
"Worry warts" |
generalized anxiety disorder (GAD)
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how long must someone be showing symptoms of GAD for it to be diagnosed
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> 6 mo
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causes significant distress or impairment in functioning
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GAD
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s/s GAD
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restless
keyed-up fatigued irritable difficulty concentrating difficulty sleeping |
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persistent irrational fear of a specific object, activity or situation that results in compelling desire to avoid what is dreaded
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phobia
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recurrent obsessions or compulsions that are severe enough to be time consuming or caused marked distress or significant impairment
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Obsessive-Compulsive Disorder (OCD)
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defense mechanism in OCD
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undoing
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what happens if they attempt to resist compulsive behavior
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sends anxiety through the roof
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meds given for OCD
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SSRI's - Luvox, also Celexa, Lexapro, Prozac
Tricyclic - Anafranil |
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nursing diagnosis for OCD
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ineffective role performance r/t need to perform rituals
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interventions for OCD as inpatient
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allow to perform ritual at first
then begin setting limits teach relaxation techniques, how to recognize & manage anxiety |
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development of symptoms following an exposure to an extreme traumatic stressor that threatens persons physical integrity or the integrity of others
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PTSD
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symptoms of PTSD
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intrusive recollection of thing that happened
re-experience trauma sustained high level of anxiety or can be numb nightmares can't remember some aspects sometimes may turn to substance abuse initially to help w/sleep |
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when is PTSD diagnosed
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symptoms for >1 mo that interfere w/functioning - can have a delayed onset
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nursing diagnoses PTSD
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Panic/anxiety
Fear Ineffective coping Powerlessness Social isolation Post trauma syndrome |
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treatment modalities for all anxiety disorders
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best tx is therapy & meds
Individual therapy Cognitive Behavior Systematic desensitization for phobias Implosion therapy (flooding) – bombard person with that which they fear Group, esp homogenous groups Psychopharmacology – short term benzo’s, long term become addictive, instead use BuSpar or antidepressants, esp SSRI’s |
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Yalom's Curative Factors - what makes a group helpful
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Instillation of hope – see others get better
Universality – others share my problem Education/information – about disease, management, where to get help Altruism - get a boost to self-esteem by trying to help others in same boat Re-experience and attempt to resolve earlier life conflicts – somebody in group might remind you of someone (mother) Development/correction of socialization skills Role modeling – emulate another in group, how to confront somebody Interpersonal learning – learn about self Group cohesion – be part of a group Catharsis – emotional cleansing |
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numerous recurrent long lasting physical complaints with no cause found
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somatization disorder
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unrealistic belief that something minor (blemish, mole) reflects a serious disease
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hypochondriasis
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pain for which a physical cause is not found. Even if pain is found, it is worse under certain psychological factors
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pain disorder
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sudden onset usually of a loss of functioning or change in functioning that results from psychological conflict. physical symptoms cannot be medically explained. rapid onset & quick resolution
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conversion disorder
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preoccupation w/some imagined or minor defect in one's appearance
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body dysmorphic disorder
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aka sociopath
doesn't conform to societal rules feel no guilt (no superego) disregard for authority & law |
antisocial personality
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defense mechanism for antisocial personality
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projection - see themselves as victims
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interventions for antisocial personality
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Accept individual, not behavior
Develop trust relationship Matter-of-fact honesty Watch promises but keep word Low stimulus environment Watch closely (Q15) to be sure they aren’t bothering other people Help identify object of anger or hostility Work w/them to appropriately deal with anger/hostility Explore other ways to manage No special privileges, uphold unit rules Calm attitude, sufficient staff if necessary |
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frantic effort avoid real/imagined abandonment, very intense affect, feel chronically depressed in response to feelings of abandonment, inability to be alone, poor sense of judgment, character,
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Borderline Personality
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Other s/s of borderlines
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self-damaging (cutters)
recurrent suicidal behaviors unstable mood dissociate & hear voices |
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mother becomes threatened as child tries to become more independent. withdraws emotional support when showing independence and love & support when showing clinginess
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object relations theory - reason for abandonment issues in borderline
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defense mechanism of borderlines
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splitting -- pit one staff member on another (I like you better than other nurses)
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interventions for borderlines
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Close observation, attitude of acceptance
Verbal contracting against cutting behavior If injury occurs, care matter-of-fact, no attention or sympathy Encourage them to talk about feelings they were having before SIB occurs (self-injurous behavior) Talk about feelings, anger Teach appropriate expression of anger Journaling is very helpful Explore abandonment fears Redirect violent behavior w/physical outlets Sufficient staff Meds prn 1:1 observation of suicidal Set limits, explain consequences Rotate staff to avoid dependence on one person Do not allow them to talk about other people |
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treatment for borderlines
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Treatment of choice: Dialectical Behavioral Therapy – focuses on developing life skills that decrease emotional dysregulation and unhealthy attempts to cope w/emotions
Medications – antipsychotics, mood stabilizers, antidepressants (SSRI’s usually) and maybe MAOI but danger of OD |
