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47 Cards in this Set
- Front
- Back
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How many stages are involved in the Global Adaptive Syndrome, & What are they called?
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3 Stages Alarm Stage Resistance Stage Stage of Exhaustion |
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What stage lasts only a short time (minutes to hours) and includes S/S such as increased energy, increased metabolism, increased 02, increased BP, and Increased Mental Awareness? It is also termed: Fight-Flight-Freeze.
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The Alarm Stage of (G.A.S.)
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In this stage, the body attempts to adapt to stressors, the neuro-endocrine functions (ALARM) now approach normal, as well as VS & Hormonal levels, localize threat if possible, & compensatory mechanisms engage. What stage is described?
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The Resistance Stage (G.A.S. & L.A.S.)
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What is this stage? S/S include: vasodilation, hypotension, tachycardia, panic/crisis, all compensatory mechanisms are exhausted. If Resolution is meet = Recovery If Irresolution= death |
Stage of Exhaustion (G.A.S. & L.A.S)
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Explain Local Adaption Syndrome
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L.A.S. has three stages, but they do so locally. The Resistance and Exhaustion Stage are the same as G.A.S. but the Alarm Stage is different because it is occurs locally only. If it is uncompensated it turns into G.A.S.
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What are the three causes of Local Adaption Syndrom?
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-Chemical; Ex. Bee Sting -Thermal; Ex. Heat/ Sunburn -Mechanic; Ex. Surgery |
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Localized Symptoms. Some of which include: Increase in hormone levels, redness, edema, and pain |
Vascular Cellular Alarm (L.A.S.) |
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Mild Anxiety
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Sensation that something is different & warrants special attention. S/S: RESTLESSNESS, Fidgeting, GI Butterflies, Difficulty Sleeping, Noise (Stressor) Interventions: Teach- Quiet Environment, Activity, Sleep |
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Moderate Anxiety |
Disturbing feeling that something is definetly wrong & needs to focus on immediate concerns. S/S: Focus Breaks Down, Won't Retain Much, H/A, Fast Speech, High pitched voice, Pounding pulse Interventions: REDIRECT (Not Teach), Treat Physical Sx |
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Severe Anxiety |
S/S: perceptional field narrows, cannot think clearly, NOT REDIRECTABLE Interventions: REMAIN CALM & W/ CLIENT- Client safety is #1. Identify Support System |
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Panic Anxiety |
S/S: may bolt or run, panic attacks, FIGHT-FLIGHT-FREEZE, may not remember afterwords, dialated pupils, Hypertension, Tachycardia Interventions: safety is #1, no need to talk, reassure safery, stay w/ client. DO NOT APPROACH WITH MEDS DUE TO SAFETY |
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Defense Mechanisms What defense mechanism is this? Attempting to overcome a weakness by overachieving in another area. Example: A student with poor grades trying to excel in sports |
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Defense Mechanisms What defense mechanism is this? Refusing to acknowledge a disturbing condition Example: "I am NOT an Alcoholic I just get drunk everyday" |
Denial |
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Defense Mechanisms What defense mechanism is this? Transferring an emotional reaction from one object/ person to another Example: A guy who hates his job come home & yells at his wife. |
Displacement |
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Defense Mechanisms What defense mechanism is this? Person instills Values from another person into himself (important informing conscience in childhood) Ex: older sibiling tells younder sibiling not to talk to strangers expressing her parent's values to younger sibling |
Introjection |
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Defense Mechanisms What defense mechanism is this? A person's thoughts/impulses are attributed on someone else Ex: A person who denies any feels for a coworker accuses her of sexual harrassment. |
Projection |
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Defense Mechanisms What defense mechanism is this? Trying to justify questionable behavior as acceptable Ex: "I'm obese b/c I have to eat a lot to keep my sugar up"! |
Rationalization |
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Defense Mechanisms What defense mechanism is this? Developing attitudes/ behavior that are opposite of what they would really do. Ex: A woman is attracted to her husband's friend, but is rude to him |
Reaction Formation |
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Defense Mechanisms What defense mechanism is this? Returning to an earlier method of behaving. Ex: Child being sexually assualted is now wetting the bed. |
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Defense Mechanisms What defense mechanism is this? Voluntarily excluding anxiety producing event. Ex: Female doesn't remember being sexually assaulted |
Repression |
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Defense Mechanisms What defense mechanism is this? Substituting a social acceptable goal for one who's normal channel of expression is blocked. Ex: A person that's aggressive to other's becomes a football player. |
Sublimation |
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Defense Mechanisms What defense mechanism is this? Act/Communication used to negate previous act or communication Ex: A husband is abuse to his wife & brings her flowers the next day. |
Undoing
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This therapy is used with PTSD patients and is in the same line of therapy as cognitive behavioral therapy. It helps the patient face his/her fears and helps them to regain a measure of control.
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Exposure Therapy |
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This specialized CBT was developed by the military for ACTIVE DUTY personal with PTSD in which they use the empty chair technique to say what he/she feels needs to be said to person DEAD OR ALIVE. Therapy is very intense.
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Adaptive Disclosure |
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Used successfully with rape victims and Combat Vets that suffer from PTSD. Involves structured sessions focusing on examining beliefs that are erroneous or interfere with ADLs.
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Cognitive Processing Therapy |
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PTSD vs TBI (BIG DIFFERENCES)
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TBI-Affects 5 senses, Somatic symptoms (H/A, N/V, Difficulty making desicions, Forgetfullness PTSD- Re-experiencing traumatic events, Detachment from people/ places/ activities, Associated co-morbidities like substance abuse Both- Insomnia, Memory Problems, Irritability, Fatigue, Labil Mood, Irritability |
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How long does the CRISIS last & what are the three possible outcomes?
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4-6 weeks *Patient returns to Normal (Positive Outcome) *Patient is better than Normal (Positive Outcome) *Patient is worse that normal (Negative Outcome) |
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In Crisis their are two types of Interventions, Distinguish between the two A) Designed to assess pt's health status & promote problem-solving (Provides feedback by offering suggestions or forming a course of action. B)Deals with pt's need for empathy |
B) Supportive Interventions |
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1)Verbalize causes/effects of stress/anxiety 2)Identify/Use Sources of Support 3)Use Problem Solving to find solutions to stressors 4)Practice Healthy Lifestyle & Habits & Anxiety reducing techniques 5)Verbalize decrease in anxiety and increase in comfort |
Evaluating outcomes for anxiety |
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MAJOR DEPRESSIVE DISORDERS |
I eat so much & gained some weight. I can't sleep at night or concentrate. I'm always tired and worthless as can be. I'm no good at anything & no one likes me, I should just die! What disorder do I have?
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Bipolar--Manic Phase
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I talk real fast and I am very loud. It's all about me even if there's a crowd. I get distracted easily, and I change the subject often. I don't need sleep, and I come without cause. I start suddenly and escalate quickly. I even see things that others don't see. What disorder do I have?
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Selective Serotonin Reuptake Inhibitors |
*ANTIDEPRESSANTS* EXAMPLES: *Escitalopram & Sertaline |
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SSRI MOA
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Action: Blocks the reuptake of Serotonin
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Side Effects (SSRI's) (4AWINSS) |
4A- Anorexia, Anxiety, Agitation, Akathisia W- Weight Gain I-Insomnia N-Nausea S-Sedation S-Suicidal Ideation |
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Serotonin Toxicity (S/S)
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A-ataxia M-muscle rigidity N-nausea/vomiting |
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Food/ Drug Interactions (SSRI)
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*Don't take with MAOI (increases chance of Serotonin Toxicity *Avoid ETOH, Grapefruit juice & Caffeine |
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Teaching/ Precautions (SSRI)
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*Avoid serotonin boosting medications and remedies (can increase risk of serotonin syndrome) *Use sugarless candy/gum for dry mouth. *Change position slowly (prevent orthostatic HTN) |
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Tricyclic Antidepressants
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*ANTIDEPRESSANTS* *EXAMPLES: amitriptyline, despiramine (NOTRIPTYLINE) |
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TCA MOA
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Blocks reuptake of norepi, and to some degree serotonin |
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Indications TCA
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Moderate to Severe Depression |
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How long until effective for TCA?
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Weeks to see improvement and months for FULL effect
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Side Effects for TCA's
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S-sexual dyfunction H-HTN (orthostatic) A-agranulocytosis F-fat (weight gain) T-tachycardia |
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Sx to report to MD (TCA'S)
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*Suicidal Ideation *Sx of Serotonin Toxicity *Anticholinergic SE if bothersome *Sexual Dysfunction *S/Sx of Infection |
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Food/Drug Interactions (TCA'S) |
*Don't given with MAOI's or within 2 weeks of an MAOI *Barbiturates may increase CNS depression *Avoid ETOH, Grapefruit Juice & Caffeine |
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Labs/ Diagnostics/Follow ups req. (Why) (TCA'S) |
Baseline/periodic WBC count (agranulocytosis) Baseline/periodic EKG (fatal dysrhythmia) CAUTION::: glaucoma, BPH, urinary retention/ obstruction and/or renal/resp. disorders |
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Teaching/Precautions (TCA'S)
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*Take full dose at night if sedating *Use sugarless candy/gum *Orthostatic HTN, don't take with alcohol, don't stop abruptly (due to W/D sx) |
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