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Psych > 25. Anxiety > Flashcards

25. Anxiety Flashcards

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1
Q

uncomfortable feeling of apprehension or dread in response to internal or external stimuli (could have unknown source)

A

anxiety

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2
Q

physical sxs of anxiety

A
  • palpitations
  • increased BP
  • restlessness
  • SOB and hyperventilation
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3
Q

emotional sxs of anxiety

A
  • alarmed
  • fearful
  • tense
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4
Q

cognitive sxs of anxiety

A
  • difficulty thinking

- inability to perceive environment appropriately

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5
Q

factors that determine if anxiety is a sxs of mental disorder

A
  • intensity of anxiety relative to situation

- trigger for anxiety

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6
Q

types of anxiety

A
  • acute
  • chronic
  • mild
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7
Q

when is anxiety normal

A

when it is a motivating force that provides energy to carry out tasks

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8
Q

anxiety precipitated by imminent loss or change; threatens one’s security (crisis)

A

acute anxiety

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9
Q

anxiety that persists over time; due to worrying about everyday situations; leads to GAD

A

chronic anxiety

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10
Q

anxiety that occurs in normal everyday living; increases perception and improves problem solving

A

mild anxiety

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11
Q

how does mild anxiety manifest

A
  • restlessness
  • irritability
  • mild tension-relieving behaviors
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12
Q

how much is too much anxiety

A
  • when out of proportion to situation that is creating it

- interferes w/ social, occupational, or other important areas of functioning

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13
Q

Peplau’s 4 levels of anxiety

A
  • mild: seldom a problem; every day situations
  • moderate: perceptual field diminishes
  • severe: perceptual field is so diminished that concentration centers on one detail only or on many extraneous details; unable to make connections
  • panic: most intense state; unable to process environment
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14
Q

biological theories of anxiety

A
  • serotonin (emotional response) and NE (physical sxs)
  • GABA (inhibits neuroactivity -> calming effect)
  • HPA axis (anxiety linked to stress hormones)
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15
Q

psychological and social theories of anxiety

A
  • psychoanalytic (defense mechanisms) and psychodynamic theories
  • cognitive behavioral theories (attempting to unlearn behavior through experiences)
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16
Q

epidemiology of anxiety

A
  • most common psych illness
  • more common in women
  • associated w/ other mental or physical comorbidities (depression, CV disease, and respiratory disease)
  • most common condition in adolescents
  • FHx probably exists
  • high rates in caucasians
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17
Q

what can undiagnosed anxiety lead to in children and adolescents

A
  • separation anxiety disorder and/or mutism
  • suicidal ideation and suicide attempts
  • drug and alcohol dependence
  • educational underachievement later in life
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18
Q

coping mechanisms for anxiety

A
  • eating
  • drinking
  • sleeping
  • exercise
  • smoking
  • crying/laughing
  • talking to people they feel comfortable with
  • defense mechanisms
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19
Q

sudden onset of extreme apprehension or fear of impending doom; fear of losing one’s mind or having a heart attack

A

panic attack

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20
Q

fear of being in places or situations from which escape is difficult or help unavailable; most severe form of panic disorder

A

agoraphobia

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21
Q

diagnostic criteria for panic attacks

A

recurrent and unexpected panic attacks and 1 month or more after an attack of one of the following sxs

  • persistent concern about having another attack
  • worry about implication of attack or consequences
  • significant changes in behavior because of fear of attacks
22
Q

risk factors for anxiety

A
  • female, middle aged, low socioeconomic status and widows, separated or divorced
  • substance abuse
  • smoking tobacco
  • severe stressors
23
Q

several anxiety sxs + experience of separation anxiety during childhood leads to what

A

panic disorder later in life

24
Q

emergency care during panic attack

A
  • safe and therapeutic environment
  • medication and monitoring of effects
  • individual psychotherapy
  • psychological testing (MSE)
  • administer PRN meds
25
Q

priority care issues during panic attack

A

safety because of high risk for suicide

26
Q

nursing assessment for panic attacks

A
  • rule out life threatening medical causes (sx eval)
  • assess for substance use
  • self-report scales
  • MSE
27
Q

prevention of panic attacks

A
  • identify physiological arousal
  • identify healthy coping thoughts
  • reduce stress
28
Q

interventions for panic attacks

A
  • CBT (deep breathing, meditation, positive self-talk, relaxation techniques)
  • grounding techniques (focusing on present moment)
29
Q

explain the 5 4 3 2 1 method of grounding

A
  • 5 things they can see
  • 4 things they can feel
  • 3 things they can hear
  • 2 things they can smell
  • 1 thing they can taste
30
Q

excessive anxiety or worry about numerous things for at least 6 months; commonly seen w/ depression

A

generalized anxiety disorder (GAD)

31
Q

common sxs of GAD

A
  • restlessness
  • fatigue
  • poor concentration
  • irritability
  • tension
  • sleep disorders
32
Q

epidemiology for GAD

A
  • may have comorbid dx
  • twice in common in women
  • insidious onset
  • affects all ages
  • typical onset in childhood or adolescence; also common after 20 y/o
33
Q

assessment for GAD

A
  • assess sxs
  • diet and nutrition
  • sleep patterns
  • drug use
34
Q

prevention of GAD

A
  • psychoeduation on healthy eating, sleep, exercise and impact of substance use
  • medications
35
Q

interventions for GAD

A

CBT (cognitive restructuring)

36
Q

common meds used for GAD

A
  • benzodiazepines (most common)
  • SNRIs
  • buspirone
  • beta-blockers
37
Q

common benzodiazepines (anxiolytics)

A
  • diazepam (Valium)
  • lorazepam (Ativan)
  • alprazolam (Xanax)
  • clonazepam (Klonopin)
  • chlordiazepoxidem (Librium)
  • oxazepam (Serax)
38
Q

non-anxiolytic used for anxiety

A

buspirone (Buspar)

39
Q

problems w/ benzos

A
  • dependence

- rebound anxiety

40
Q

pros of buspirone (Buspar)

A
  • non-sedating
  • non habit forming
  • not a PRN
  • good for the elderly
41
Q

cons of buspirone (Buspar)

A

takes a longer time to work compared to benzos

42
Q

non-benzodiazepine hypnotics (also given as sleep aids)

A
  • zolpidem (Ambien)
  • zalepon (Sonata)
  • eszopiclone (Lunestra)
  • ramelteon (Rozerem)
43
Q

persistent irrational fear of specific objects, activities, or situations

A

phobia

44
Q

types of phobias

A
  • specific: response to specific object
  • social: result of exposure to social situations or required performance
  • agoraphobia
45
Q

persistent fear of specific objects or situation leading to avoidance behavior

A

specific phobia

46
Q

interventions for specific phobias

A
  • anxiolytics for short term relief of anxiety
  • exposure therapy (tx of choice)
  • systematic desensitization (gradual introduction to phobia)
47
Q

persistent fear of social or performance situation in which embarrassment may occur

A

social anxiety disorder (social phobia)

48
Q

interventions for social anxiety disorder

A

SSRIs to reduce social anxiety and phobic avoidance

49
Q

goals for phobias

A

function adaptively in presence of phobia without reaching panic

50
Q

responses to extreme external or internal events or stressors; failure to integrate identity, memory, and consciousness

A

dissociative disorders

51
Q

types of dissociative disorders

A
  • dissociative amnesia: inability to recall specific event or period of time
  • dissociative fugue: unexpected travel away for home; lost identity or formed a new one
  • depersonalization disorder: being detached from one’s body; disconnected from reality
  • dissociative identity disorder (multiple personality disorder)
  • dissociative disorder not otherwise specified

Psych (17 decks)

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