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56 Cards in this Set
- Front
- Back
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What is anxiety?
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uncomfortable feeling of apprehension or dread
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What is normal anxiety?
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Appropriate to situation and dissipates when situation resolves
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What is abnormal anxiety?
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determined by the intensity of anxiety relative to situation, trigger for anxiety, symptoms
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What are the physical symptoms of anxiety?
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1. palpitations
2. Bp and pulse changes 3. dyspnea/ SOB 4. startle reaction, tremors 5. weakness, twitching 6. GI distress, abd pain 7. choking, gasping 8. pale, flushed, sweating |
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What are the affective symptoms of anxiety?
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1. edgy, uneasy, fearful
2. nervous, tense, scared 3. Jittery, jumpy, terrified |
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List the cognitive symptoms of anxiety.
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1. mind is hazy, dazed
2. feelings of unreality 3. cant't concentrate or recall 4. loss of objectivity 5. fear of losing control 6. difficulty reasoning 7. self-consciousness |
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What are some behavioral symptoms of anxiety?
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1. Flight, avoidance
2. restlessness 3. immobility 4. impaired coordination |
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Describe what is sensed with mild anxiety.
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-sensation that something is different
-increased sensory stimulation |
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What is sensed with moderate anxiety?
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-Disturbing feeling that something is wrong
-feeling nervous or agitated |
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What is sensed with severe anxiety?
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-primiteive survival skills take over
-difficulty thinking and reasoning, physiologic changes -packing or resltess |
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Which stage of anxiety is predominated by emotional-psychmotor realm and has an adrenaline surge?
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Panic
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What is the most common psychiatric disorder in the US?
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Anxiety
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What % of people experience anxiety disorder in their life-time? who does it affect more?
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14.6%
women get it more than men |
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What risk factors increase the likelihood of anxiety disorder?
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Smokers
< age 45 separated/divorced survivors of abuse |
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What is agoraphobia?
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Fear of open places, but more like a fear of being in a place that you cannot escape
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What is the most extreme form of anxiety?
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Panic
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what is the primary concern for the nurse for a pt having a panic attack?
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safety
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What is the time frame of panic attacks?
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Build to peak in 10-15 mins
they rarely last > 30 mins |
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what is derealization?
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sensation that one's surroundings are altered. That things aren't real
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What are the symptoms of panic attack that must be experienced by a pt for Dx by the DSM?
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Must have at least 4 of the following:
1. palpitations (CV changes) 2. sweating 3. Trembling 4. SOB, smothering 5. chest pain 6. N, GI pain 7. dizzy, unsteady, faint 8. Derealization or depersonalization 9. Fear of losing control 10. feeling of choking 11. fear of dying 12. Paresthesia 13. chills or hot flashes |
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What is a phobia?
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Illogical intense fear of an object or social situation that causes extreme stress and anxiety
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What are the nursing interventions for a panic attack?
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1. Stay with the pt and remain calm
2. Give clear, simple direction 3. non-stimulating environment 4. reassurance 5. administer PRN anxiolytic medications |
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What are the 2 criteria for a DSM Dx of panic disorder?
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1. Recurrent unexpected panic attacks
2. at least one of the attack has been followed by 1 month or more of on or more of the following: -persistent concern --worry about the implications of the attack --sig change in behavior related to the attacks |
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What should the nurse assess for with a pt with panic disorder?
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-Pattern of attacks, symptoms, responses
-mental status -suicide? -family -avoidance? -cognitive thought pattern |
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Describe cognitive restructuring in the tx of panic disorder.
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-replace negative thoughts w/more realistic views
-ID, evaluate and restructure thoughts -Panic attack is separate and independent of trigger. |
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Describe the interoceptive exposure technique for panic disorder?
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-exposure to sensations experienced during panic attack
-evoke feared sensations -Sensations do not have to progress to panic attacks |
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What is desensitization? What type of therapy uses it?
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Step by Step progression to help minimize the fear
Used by behavioral therapy |
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What are the techniques of relaxation therapy?
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-deep breathing
-progressive relaxation -positive visualization or guided imagery -listening to music |
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What are the drugs used for panic disorder
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-SSRIs
-SNRIs -TCAs -MAOIs -Benzo: short term |
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What are the common benzos?
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The pams
Xanax Ativan Valium Klonopin |
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Why are benzos not as favorable?
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-Dependence and rebound depression
-withdrawal symptoms -sedation, confusion, dizziness, headache and visual disturbances. |
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What is obsessive/compulsive disorder?
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Severe obsessions/compulsions that take up more than 1 hour per day and interfere with functioning
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What are obsessions?
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-Unwanted, recurrent, intrusive thoughts
-fear of contamination is common |
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What are compulsions?
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-Ritualistic, repetitive behaviors that relieve anxiety
-Hand washing, checking, praying, counting |
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What do people with OCD often strive to obtain?
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Perfection
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For a person with OCD, what feeling happens between a trigger and the compulsion?
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The anxious moment
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What is the most effective form of Tx for pts with OCD?
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Combination of behavioral therapy and meds
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What is Deep Brain Stimulation?
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Like a brain pacemaker. Sends an electrical stimulus throughout the brain to minimize the compulsions
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What are the adjunctive treatments for OCD?
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1. Relaxation
2. Support groups 3. ECT 4. DBS 5. Psychosurgery |
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What are the nursing intervention for OCD?
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1. Provide for basic needs
2. maintain accepting attitude 3. allow time to carry out ritualistic behavior 4. monitor suicide thoughts 5. set realistic expectations 6. monitor meds 7. ask specific question about thoughts and behaviors |
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What are the characteristics of generalized anxiety disorder?
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1. Excessive worry
2. common disorder 3. onset can be gradual or acute 4. onset in early 20's 5. immunosuppression |
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What % of people with GAD have panic disorder?
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25%
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What is the DSM criteria for GAD
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1. Excessive anxiety and worry occurring more days than not for 6 months.
2. difficult to control the worry 3. experience restlessness or edgy, easily fatigued, difficulty concnetrating, muscle tension, sleep disturbances. 4. the symptoms cause distress in social, relationships, work and other aspects of life |
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What are the SxS related to excessive physiological arousal in GAD?
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SOB, tachy, dry mouth, sweating and nausea
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Poor concentration and unrealistic assessment of the problem are examples of what category of the SxS of GAD?
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Distorted cognitive processing category
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What are exs of poor coping skills of GAD?
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avoidance
drinking smoking |
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what are the treatments (non-drug) for GAD?
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-Relaxation
-Laugh -Psychotherapy -Cognitive -Biofeedback Training |
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What are the pharmacologic Tx for GAD?
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1. BuSpar (Buspirone)
2. Benzos 3. SSRIs 4. TCAs |
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What are characteristics of PTSD?
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persistent and recurrent flashbacks, reliving event, nightmares and avoidance
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How many americans are thought to have PTSD?
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8%
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Are men or women more prone to PTSD?
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Women
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What is PTSD?
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Disorder that occurs after experiencing or witnessing serious traumatic event.
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How do you Dx PTSD by the DSM?
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a. The patient must have a history of exposure to a traumatic event that involved actual or threatened death or serious injury to self or others and the person’s response involved fear, helplessness or horror
b. The traumatic event is persistently relived in one or more ways including, but not limited to, dreams, acting or feeling the event is recurring, psychological distress etc. c. The person has persistent avoidance of stimuli related to the trauma and numbing of general responsiveness. |
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What are the SxS of PTSD?
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-Anger
-Poor impulse control -Chronic anxiety -Avoidance -emotional detachment -depersonalization -difficulty concentrating -insomnia |
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What are the Tx options for PTSD?
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-Psychotherapy
-Exposure -Stress Management -Relaxation technique -Group Therapy -Pham treatment |
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What are the nursing interventions for PTSD>
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1. Encourage to express grief
2. deal with displays of anger 3. encourage pt to assess angry outbursts 4. Help patient regain control over angry impulses 5. encourage verbal vs physical expression 6. medication issues |
