Anxiety

Question 1

anxiety

Answer 1

a universal human experience and is among the most basic of emotions.

is a feeling of apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat

whereas anxiety is a vague sense of dread realted to unspecific or unknon danger

Question 2

fear

Answer 2

a reaction to specific danger

Question 3

Hildegard Peplau

Answer 3

identified anxiety as a key element in her theory of interpersonal relationships

developed a useful anxiety model consisting of four levels: mild, moderate, severe, and panic

Question 4

mild anxeity

Answer 4

occurs in the normal experience of everyday living and allows an individual to perceive reality in sharp focus.

sees, hears, grasp more information, and problem solving becomes more effective

physical symptoms may include slight discomfort, restlessness, irritability, or mild tension-relieving behaviors (nail biting, foot or finger tapping, fidgeting)

Question 5

moderate anxiety

Answer 5

anxiety increases, th epercetual field narrow, and some details are excluded from oberservation.

sees, hears, and grasp less informtaion and may demostrate selective inattention, where only certain things in the environmnet are seen or heard unless they are pointed out.

ability to think clearly is hampered, but learning and problem solving can still take place; though not ta an optimal level

SNS begins to kick in

Question 6

symptoms of moderate anxiety

Answer 6

experience tension
pounding heart
increase pulse
increased respiratory rates
perspiration
mild somatic symptoms (gastric discomfort, headache, urinary urgency)

voice tremors and shaking may be noticed

Question 7

severe anxiety

Answer 7

perceptual fild of a person experiencing severe anxiety is greatly reduced

may focus on one particular detail or on many scattered details and have difficulty noticing wha tis going on in the environment, even when another person points it out

learning and problem solving are not possible at this level and the person may be dazed and confused.

behavior is automatic and aimed at reducing or relieving anxiety

Question 8

symptoms of severe variety

Answer 8

headache
nausea
dizziness, insomnia

somatic symptoms often increase

trembling and pounding heart are common, and the person may experience hyperventilation and a sense of impending doom or dread

Question 9

Panic

Answer 9

most extreme level of anxiety and results in marked dysregulated behavior

unable to process waht is going on in the environment and may lose touch with reality

Question 10

behavior of panic attack

Answer 10

manifested with pacing
running
shouting
screaming
withdrawal

hallucinations, which are false sensory perception, such as seeing something that is not really there or hearing voices, may be experienced

physical behavior may become erratic, uncoordinated, and impulsive

acute pain may lead to exhaustion

Question 11

defense mechanisms

Answer 11

automatic coping styles that protect people from anxiety and enable them to maintain their self-image by blocking feelings, conflicts, and memories

Question 12

adaptive use of defense mechanism

Answer 12

lower their levels of anxiety and to achieve their goals in acceptable ways

Question 13

maladaptive use of of defense mechanism

Answer 13

occurs when one or several are used to excess, particulary immature defense.

Question 14

anxiety disorders

Answer 14

use ragid, repetitive, and ineffective behaviors to try to control their anxiety

intereferes with personal, occupational, or social functioning

most common health problems

Question 15

types of anxiety disorder

Answer 15

separation anxiety disorder
specific phobia
social anxiety disorder (social phobia)
panic disorder
agoraphobia
generaized anxiety disorder

Question 16

separation anxiety disorder

Answer 16

normal infant development that begins around 8 months of age and peak at 18 months, and begin to decline after that

exhibit developmentally inappropriate levels of concerns over being away from a significant ogher.

fear that omething horrible will happen to other person and that it will result in permanent separation.

so intenese that it distracts suffers from their normal acitivities and causes sleep disruptions, and nightmares

manifested in physical symptoms, such as gastrointestinal disturbances and headaches

Question 17

adult form of anxiety separation anxiety disorder

Answer 17

can begin in childhood or adulthood

a person who is the subject of the attachment—a parent, a spouse, a child, or a friend–may be more alienated due to the constant neediness and clinginess of the other

often have extreme difficulties in romantic relationships and are more likely to be unmarried.

Question 18

characteristics of adult separation anxiety disorder

Answer 18

harm avoidance
worry
shyness
uncertainty
fatigability
lack of self direction

accompanied by a significant level of discomfort and disability that impairs social and occupational functioning

Question 19

when is separation anxiety diagnosed

Answer 19

before the age of 18, after a month of symptoms

Question 20

what cause anxiety separation disorder

Answer 20

significant loss through death of a relative or pet
separation from significant others
change in environment by moving or immigration
sexual or physical assault may also precede symptoms
inherited traits such as neuroticism may play a role in separation anxiety disorder

Question 21

types of anxiety separation disorder

Answer 21

depressive disorder
bipolar disorder
anxiety disorder
postraumatic estress disorder
obsessiv compulsive disorder (OCD)
personality disorders

Question 22

specific phobia

Answer 22

persistant fear of a specific obhect, activity, or situation that lead to a desire for avoidance or actual avoidance of the object, activity, or situation

characterized byt the experience of high levels of anxiety or fear in response to certain objects or situations
e.g. dogs, spiders, heights, storms, water, blood, closed spaces, tunnels, and bridges.

Question 23

how do people with phobia cope

Answer 23

decrease anxiety through self medication with alcohol or drugs

animals, the environment and situation-specific phobias are more common in females

both blood injury and injections is experience equally in both genders

Question 24

Blood injury and injection (BII)

Answer 24

associated with a diphasic cardiovascular response that begins with tachycardia adn thn goes on to bradycardia, hypotension, diaphoresis, and fainting

Question 25

what condition seek out treatment

Answer 25

comorbid conditions major depressive disorder anxiety substance use somatic symptom disorder dependent personality disorder

Question 26

social anxiety disorder

Answer 26

aka social phobia characterized by severe anxiety or fear provoked by exposure to a social or a performance situation that could be evaluated negatively by others.

Question 27

risk factors for social anxiety disorder

Answer 27

childhood mistreatment and adverse childhood experience trait of shyness is also strongly heritable

Question 28

most common manifestation of socail anxiety disorder

Answer 28

fear of public speaking chronic social isolation may increase the risk for major depressive disorder substance use disorder are common and may be related to the social isolation and inhibitation bipolar disorder and body dysmorphic disorder are also comorbid such as with children comorbidies include high-funcitoning autism and selective mutism

Question 29

panic disorder

Answer 29

the sudden onset of extreme apprehension or fear, susually associated with feelings of impending doom the feelings of terror present during a panic attack are so severe that normal functioning is suspended, the perceptual field is severely limited, and misinterpretation of reality may occur people experiencing panic attack may behlieve that they are losing their minds or having a heart attack. typically they come out of the blue (suddenly and not necesarily in response to stress) and are extremely intense; they last a matter of minutes (10 minutes) and then subside?

Question 30

what occurs before the onset of panic disorder

Answer 30

major depressove disorder

Question 31

what accompany panic disorder

Answer 31

substance use disorder in an attempt to self-medicate

Question 32

nonpsychiatric disorder

Answer 32

hyperthyroidism dizziness cardiac arrhythia asthma chronic obstructive pulmonary disease (COPD) irritable bowel syndrome

Question 33

DSM-5 criteria for panic disorder

Answer 33

recurrent upexpected panic attacl an abrupt surge of intense fear or discomfort that reaches a peak within minutes; during the attack, four (or more) of the following symptoms occur: palpitation, poundingh eart, or accelerated HR sweating trembling or shaking sensation of SOB or smothering feeling of choking chest pain or discomfort nausea or abd distress feeling dizzy, unsteady, lightheaded, or faint chills or heat sensation parethesias (numbness or tingling sensations) derealization (feelings of unreality) or depersonalization (being detached from onself) fear of losing control or "going crazy" fear of dying

Question 34

agoraphobia

Answer 34

intense excessive anxiety or fear about being in places or situations from which escape might be difficult or embarrassing or where help might not be available feared places or avoid in an effort to control anxiety

Question 35

commonly avoided for agoraphobia

Answer 35

being alone outside being alone at home traveling in a car, bus, or airplane being on a bridge riding in an elevator

Question 36

when does agoeraphobia begins

Answer 36

begins in adolescence or early adulthood ratio of female to males with agoraphobia is 2:1

Question 37

before onset of agoraphobia

Answer 37

experience anxiety disorder phobia panic socia anxiety after depressive disorder alcohol use disorder

Question 38

Generalized anxiety disorder

Answer 38

excessive worry putting things off and avoidance are key symptoms and many results in lateness or absence from school or employment and overall social isolation sleep disturbance is common fatigue side effect of sleep deprivation genetic account for one-third of the risk of developing GAD

Question 39

Selective mustism

Answer 39

a condition where children do not speak owing to fear or negative response or evaluation. they tend to speak at home around immediate family members when engage in activities that do not require speech, these children seem comfortable

Question 40

substance-induced anxiety disorder

Answer 40

symptoms of anxiety, panic attacks, obsessions, and compulsions that develope with the use of substance (alcohol, cocaine, heroin, hallucinogens)

Question 41

anxiety due to medical condition

Answer 41

direct physiological result of a medical condition, such as hyperthyroidism, pulmonary embolism, or cardiac dysrhythmias. to determine if symptoms are related to medical condition, a careful and comprehensive assessment of multiple factors is necessary

Question 42

what is anxiety expressed through

Answer 42

somatic symptoms others through cognitive symptoms predominate

Question 43

Panic attack in Latin America and northern Europeans

Answer 43

sensation of choking, smothering, or tingling as well as fear of dying in other cultural groups, involves fear of magic or witchcraft

Question 44

social anxiety in Japanese and Korean cultures

Answer 44

relate to belief that the individual's blushing, eye contact, or body odor is offensive to others

Question 45

ataque de nervios "attack of the nerves"

Answer 45

disorder found primarily among hispanic population in response to stressful events such as death, acute family discord, or witnessing an accident symptoms are dramatic: sudden trembling, faintness, papitation, out of control shouting, heat that moves from the chest to the head, and seizure like activity

Question 46

how are phobia measured

Answer 46

fear questionaire

Question 47

how are panic symptoms measured

Answer 47

panic disorder severity scale high scores may indicate GAD or Panic disorder

Question 48

a patient with anxiety disorder can be helped to focus and solve problems how? (mild to moderate anxiety)

Answer 48

asking open-ended questions giving broad openings exploring and seeking clarification closing off topics of communication and bringing up irrelevent topics can increase a person's anxiety, making the nurse, not the patient, feel better provide calm presence, recognizing the anxious person's distress, and being willing to listen

Question 49

severe to panic level of anxiety coping

Answer 49

unproductive relief behaviors may take over, and the person may not be in control nursing interventions aimed at providing SAFETY for teh patient and others to meet physical needs, such as requirement for fluids and for rest to prevent exhaustion guiding the patient to calm environment the use of medication and restraints/seclusions may have to be considered (only used after less restrictive interventions have failed to decrease patient's anxiety to a safe level patient is out of control, so they need to known that they are safe from their own impulses firm, short, and simple statememts are useful

Question 50

antidepressant for anxiety disorders

Answer 50

SSRI are first line of defense in most anxiety related disorders include paroxetine (paxil), fluoxetine (prozac), escitalopram (Lexapro) ,a sertaline (zoloft) some are more activating effect and may increase anxiety (fluoxetine and sertraline) serotonin norepinepherine reuptake inhibitor (SNRI) is another first line defense used in treatment of several anxiety disorder venlafaxine (effexor), duloxetine (cymbalta) is effective in treating GAD

Question 51

Antianxiety drugs

Answer 51

used to treat somatic and psychological symptoms of anxiety disorder benzodiazepines are most commonly used becuase they have a quick onset of actions should be used for short period of time due to dependency, or until other medication or treatment reduce symptoms side effect is sedation ataxia decreased cognitive functions paradoxical reactions-- reactions that are the exact opposite of the intended response---somtimes occur anxiety, agitation, talkativeness, and loss of impulse control may occur not recommended for patient with substance use disorder and also older adults owing to risk of delirium, falls,a nd fractures