Cap 2 Lesson 5

Front 1

vague, uneasy, emotional feeling experienced in response to perceived threat or danger.

Back 1

Anxiety

Front 2

Free floating anxiety

Back 2

person unable to connect anxiety to stimulus.

Front 3

Automatic relief behaviors

Back 3

Automatic relief behaviors: jaw-clenching, finger-tapping, pen-clicking. The things you do unconsciously to relieve anxiety.

Front 4

SXS anxiety

Back 4

excessive worry and anxiety plus (at least) 3 of the following: Restlessness, irritability, muscle tension, difficulty falling/staying asleep, fatigue.

Front 5

Possible Somatic Symptoms:

Back 5

Possible Somatic Symptoms: chest pain, hyperventilation, headaches, tremors, increased urinary frequency, GI disturbances

Front 6

Signs and Symptoms of Generalized Anxiety Disorder:

Back 6

chronic excessive worry and anxiety (no reason). Negative self-talk. Fatigue. Sleeping problems. Increased startle reflex. Inability to relax, feeling on edge. Muscle tension, headaches, irritability, anticipating the worst, inability to concentrate, tremors, breathing difficulties, GI issues, urinary frequency, bruxism.

Front 7

recurrent, unexpected panic attacks. Twice as common in females.

Back 7

Panic disorder

Front 8

intense feeling of fear/terror occurring suddenly and intermittently without warning.....

Back 8

Panic attack

Front 9

SXS panic attack

Back 9

heart pounding, palpitations, shortness of breath, dizziness, sweating, weakness, numbness, shakiness, chilled with nausea, chest pain, tingling/numbness of hands/feet, feelings of suffocation, feeling out of control, fear of dying or heart attack, agoraphobia, depression...

Front 10

avoidance of specific places, situations tending to trigger panic attacks…significant impairment of everyday activities; often become homebound; unemployment/school drop-out common.

Back 10

Agoraphobia

Front 11

excessive, persistent irrational fear of specific objects or situations that pose little danger. Signs & Symptoms: physical symptoms of anxiety

Back 11

Specific phobia

Front 12

excessive fear of any social situations in which embarrassment is possible. Discomfort being watched or at risk of being judged by others.

Back 12

Social anxiety disorder

Front 13

Propranolol, a beta blocker, is used to reduce

Back 13

Social anxiety

Front 14

response to situation involving actual death or threat of severe injury. Intense feeling of fear/dread with each recurring mental rerun of event. Signs & Symptoms: duration is greater than 1 month. Intense feeling of fear. Mental reruns. Emotional numbness following the event. Flashbacks: relieving the event as if actually there.

Back 14

PTSD

Front 15

More on PTSD

Back 15

Increased anxiety not previously present; feeling extreme guilt. Avoidance due to emotional numbing; insomnia. Inability to concentrate; impaired social or work functioning. Dissociation, depersonalization possible. More common with family hx.

Emotional numbing: people will avoid places or people that are connected to an experience because they do not want to feel feelings related to the PTSD.

Front 16

recurrent, persistent, unwanted thoughts or images causing intense anxiety

Back 16

Obsession

Front 17

repetitive behavior engaged in to reduce high level of anxiety

Back 17

Compulsion

Front 18

Diagnosis of OCD

Back 18

significant decline in functioning level with actions consuming greater than 1 hour/day

Front 19

Invasive, inappropriate thoughts commonly related to

Back 19

sexuality, violence, illness, death, contamination

Front 20

Questioning thoughts as to whether they did or did not do something (curling iron)

Back 20

Repeated doubts

Front 21

Antianxiety meds

Back 21

Vistaril (hydroxyzine) for anxiety. Benzo’s are pams and lams. Drowsiness and dizziness, big thing is that they should not be long term because of tolerance and dependance. Long term meds should be SSRI’s. Buspar (buspirone) for anxiety. Smoking decreases sedative and antianxiety effects of benzo’s. Most success when combining with psychotherapy

Front 22

Nursing Interventions and Assessments for anxiety

Back 22

Assess mood, orientation daily; monitor BP daily (while standing, sitting). Offer strategies to relieve dry mouth. Ingest medication with food, milk.

Front 23

Know : an emotion that is prolonged to the point it colors one’s entire psychological thinking

Back 23

Mood

Front 24

Know: facial expression displayed in association with one’s mood

Back 24

Affect

Front 25

Know: excessive feeling of happiness;

Back 25

Euphoria

Front 26

Euphoria may escalate to : frenzied, unstable mood; may be out of touch with reality (unipolar: means they do not experience mania with depression).

Back 26

Mania

Front 27

Major depressive disorder

Back 27

experience depressed mood/loss of interest in activities most of each day for 2 weeks; single or recurrent episodes. Significant: persistence, severity. Signs & Symptoms: hopelessness, guilt, melancholy, Self-blame, fatigue, appetite loss, weight changes, Decreased libido, crying episodes, irritability, anxiety, Excessive worry, increased somatic symptoms, Lack of concentration, difficulty making decisions.

Front 28

Know: (lack of pleasure in things they previously enjoyed).

Back 28

Anhedonia

Front 29

Know: (marked decrease in energy level).

Back 29

Anergia

Front 30

recurrent state of depression greater than 2 years. Common Signs and Symptoms: lifetime struggle with depression symptoms. Negativism: learned sense of helplessness. Escapes: substance use; spending sprees. Sexual promiscuity; acting-out behaviors. Sleep Difficulties; change in eating habits. Fatigue; decreased concentration and decision-making ability

Back 30

Persistent Depressive Disorder (Dysthymia):

Front 31

brain dysfunction causing abnormal, erratic shifts in mood, energy, and functional ability; possible genetic factor

Back 31

BPD

Front 32

alternating from euphoria to dysphoria and irritability

Back 32

Labile

Front 33

Know difference: bipolar 1: bipolar 2 :

Back 33

Know difference: bipolar 1: manic and depressive, bipolar 2 : hypomania and depressive

Front 34

Type of mania less than 4 days. Decreased need for sleep; grandiosity; incessant talking. Irresponsible, impulsive behavior. Increased moodiness; irritability.

Back 34

Hypomania

Front 35

greater than 1 week. Disrupts ability to function; lack of insight. Excessive level of activity; psychotic states. Thoughts of persecution. Clang Associations: rhyming phrases with no meaning.

Back 35

Fulll blown manic episode

Front 36

chronic mood disturbance with fluctuating periods of hypomanic symptoms + periods of depression. Alternating periods recurrent with short periods of normalcy (usually < 2 months).

Back 36

Cyclothymic disorders

Front 37

MAOIs may have a hypertensive crisis with what

Back 37

foods and drugs to avoid: aged cheese, alcohol, avocados, bananas, caffeine, smoked and processed meats, caviar, corned beef, chicken livers, chocolate, fava, figs, meat tenderizers, pickled herring, raisins, sour cream, soy sauce, yogurt.

Front 38

Lithium

Back 38

effective on mania; not on depression. Peak blood level 1-3 hours. Entirely excreted by the kidneys unchanged so adequate renal functioning is necessary for use. Any increase or decrease in dietary sodium affects levels. Loss of sodium from perspiration, vomiting, or diarrhea can increase risk of lithium toxicity.

Front 39

For lithium, drink

Back 39

8-10/day

Front 40

Know: what is any drug, medication, or toxin which shares potential for abuse

Back 40

Substance

Front 41

physiological and psychological dependence on alcohol or other drugs. Withdrawal symptoms present when substance is discontinued.

Back 41

Addiction

Front 42

brain adapts to repeated dosing, causing decreased effects, requiring greater amounts of drug to achieve same effect

Back 42

Tolerance

Front 43

Drug most often abused by Americans

Back 43

Alcohol

Front 44

Phases of Substance Dependency

Back 44

Phase one: first use. User experiences “high”; regulates amount of substance and opportunities for use.

· Phase two: user experiences hangover effects. Begins to feel guilty for behaviors during use.

· Phase three: dependent lifestyle begins. Use can no longer predict outcome; engages in compromising behaviors; loses insight.

· Phase four: user demonstration of dependency/addiction. Periods of blackout, paranoia, helplessness.

Front 45

encephalopathy, psychosis related to Nutritional disease (deficiency of thiamine and niacin) of CNS, found in alcoholics. Progressive memory loss; disorientation with emotional lability and apathy; weakness; fatigue.

Back 45

Wernicke-korsakoff syndrome:

Front 46

first phase of dependency treatment. Immediate withdrawal from drug: 3-5 days. Physical, psychological effects. Can be life-threatening. Unsupervised withdrawal from drug dependence can result in death

Back 46

Detoxification

Front 47

Know

Back 47

Vitamins for deficiencies: iron, folate, thiamine, vitamin C Know:: Understand Wernicke-Korsakoff Syndrome & the nutritional issues with this

Front 48

Know: Medications to maintain sobriety: acamprosate and disulfiram (Antabuse) for alcohol; naltrexone (opioid antagonist)

Back 48

Know: Medications to maintain sobriety: acamprosate and disulfiram (Antabuse) for alcohol; naltrexone (opioid antagonist)