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Mental Health > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Anxiety

A

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

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2
Q

T/F Normal anxiety is health rxn necessary for survival

A

T

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3
Q

What are the levels of anxiety?

A
  1. Mild
  2. Mod
  3. Severe
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4
Q

Describe mild anxiety

A
  • occurs in the normal experience of everyday living allowing an individual to perceive reality in sharp focus
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5
Q

What are some physical Sx of mild anxiety?

A
  1. Slight discomfort
  2. Restlessness
  3. Irritability
  4. Tension-relieving behaviors (ex. nail biting)
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6
Q

Describe moderate anxiety

A

sees, hears, and grasps less info
- ability to think clearly is hampered, but learning and problem solving can still take place although not at an optimal level

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7
Q

What are some Sx of mod anxiety?

A
  1. tachypnea
  2. tachycardia
  3. diaphoresis
  4. gastic discomfort
  5. headache
  6. urinary urgency
  7. voice tremors and shaking
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8
Q

Describe severe anxiety

A

focusing on 1 particular detail or many scattered details and have difficulty noticing what is going on in the env even when someone else pts it out

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9
Q

What are some Sx of severe anxiety?

A
  1. headache
  2. Nausea
  3. Dizziness
  4. Insomnia
  5. hyperventilation
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10
Q

What is the most extreme level of anxiety and results in dysregulated behavior?

A

panic

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11
Q

What are some Si/Sx of panic?

A

behavior becomes

  • erratic
  • uncoordinated
  • impulsive
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12
Q

Which of the 2 defense mechanisms are always healthy methods of coping?

A

sublimation and altruism

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13
Q

What are some physical Sx of Separation anxiety disorder?

A

GI disturbances and headaches

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14
Q

What is a persistent irrational fear of a specific obj, act, or situation that leads to a desire for avoidance or actual avoidance?

A

specific phobia

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15
Q

Describe social anxiety disorder (SAD)

A

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

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16
Q

What are some RFs for SAD?

A

Childhood mistreatment and adverse childhood events

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17
Q

Describe agoraphobia

A

intense anxiety or fear about being places or situation from which escape might be difficult or embarrassing or in which help might not be available

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18
Q

What are the key Sx of GAD?

A

Putting things off and avoidance

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19
Q

Define obsessions

A

thoughts, impulses or images that persist and recut so that they cannot be dismissed from the mind even thought the individual attempts to do do

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20
Q

Define Complusions

A

ritualistic behaviors an individuals feels drive to perform in an attempt to reduce anxiety or prevent an imagined calamity

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21
Q

What is separation anxiety disorder?

A

people exhibit developmentally inapprop. levels of concern over being away from significant other

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22
Q

What is common finding in adults with separation anxiety disorder?

A

difficulties with romantic relationships and are often unmarried

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23
Q

List all the defense mechanisms

A
  1. Regression
  2. Suppression
  3. Dissociation
  4. Projection
  5. introjection
  6. Sublimation
  7. Displacement
  8. Denial
  9. Rejection
  10. Compensation
  11. Conversion
  12. Identification
  13. Intellectulization
  14. Rationalization
  15. Rxn
  16. Splitting
  17. Undoing
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24
Q

T/F We all know when we are using a defense mechanism

A

false, they are not always apparent

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25
Q

What is the diff. with adaptive and maladaptive use of defense mechanisms?

A

Adaptive use helps people lower anxiety to achieve goals in acceptable ways and maladaptive use occurs when one or several are used in xs, particularly in the overuse of immature defenses

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26
Q

Sara has an unconscious hostility toward her daughter is overprotective and hovers over her from harm, interfering w/ her normal growth and development

A

Rxn formation

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27
Q

Steven loses a promotion starts complaining to others, hands in sloppy work, misses appts, and comes in late for meetings

A

Regression

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28
Q

Ken forgot his wife’s birthday after a marital fight

A

Repression

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29
Q

An individual drinks ETHOL when self-esteem is low to temporarily diffuse discomfort

A

Compensation

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30
Q

What is the diff between repression and suppression?

A

repression is unconscious while suppression is conscious

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31
Q

” I didn’t get the job b/c the boss doesn’t like me.”

A

Rationalization

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32
Q

Claire’s husband died 3 yrs earlier still keeps his clothes in the closest and talks about him in the present tense

A

Denial

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33
Q

Susan experienced abuse during childhood and needs to separate from reality, so she is perpetually disconnected from reality

A

Dissociation

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34
Q

Laura feels a lump in her breast shortly before leaving for a 3-wk vacation puts the info in the back of her mind until after returning from her vacation

A

Suppression

35
Q

Dani is a 26-yr old woman who initially values her acquaintances yet invariably becomes disillusioned when they turn out to have flaws

A

Splitting

36
Q

Darla has repressed an attraction toward other women, so she refuses to socialize b/c she fears another woman will make homosexual advances toward her

A

Projection

37
Q

Lily is unable to acknowledge fear os her father becomes fearful of animals

A

Displacement

38
Q

Mike becomes blind after seeing his wife flirt w/ other women

A

Conversion

39
Q

This is the transference of emotions associated w/ a particular person, obj, or situation to another nonthreatening person, obj, or situation

A

Displacement

40
Q

This refers to the unconscious rejection of emotionally unacceptable feat. and attributing them to others

A

Projection

41
Q

This is the inability to integrate the (+) and (-) qualities of oneself or other into a cohesive image

A

Splitting

42
Q

What is the key ft. of panic disorder?

A

panic attacks

43
Q

What is the outcome for priority Dx of Severe Anxiety aeb sudden onset of fear impending doom or dying, increase RR and HR, SOB, and dizziness?

A

panic attacks will become less intense and time between episodes will lengthen so that pt can fxn at the usual level

44
Q

What is the key pathological feat. of GAD?

A

excessive worry

45
Q

What is the outcome for a priority Dx of ineffective coping rt to persistent anxiety, fatigue, and difficulty concentrating?

A

pt will maintain role performance

46
Q

Do obsessions and compulsions exist together and occur w/ each other?

A

they can exist independently, but they most occur together

47
Q

Tiffany has had 5 nose surgeries, 3 breast augmentations and is in the office to get liposuction and botox. She still claims she is not perfect and sees her dermatologist 5x/mo. What are her actions associated w/?

A

body dysmorphic disorder

48
Q

Which neurotransmitters regulate anxiety? Which of the following is the common focus of antianxiety meds?

A
  1. NE
  2. SE
  3. Dopamine
  4. GABA- common focus of meds
  5. EP
49
Q

When a potential anxious pt is brought into in by their fam member what is your first priority in your assessment?

A

whether the anxiety is primary or secondary to another medical condition

50
Q

What is important to consider about the pt and their Si/Sx?

A

they are the expert, so the assessment should be pt-centered

51
Q

What is an assessment tool you can use to determine if the pt is experiencing anxiety?

A

Severity Measure for GAD

52
Q

What are some nursing DX for anxiety?

A
  1. anxiety
  2. ineffective coping
  3. chronic low self-esteem
  4. Self-mutilation
53
Q

Rhonda comes into the clinic ashamed of her appearance, believes that she is looks absolutely disgusting, and embarrassed by her psoriasis, what is your nursing Dx?

A

chronic low-esteem

54
Q

Liam comes into the clinic with skin excoriation due to washing his hands every 20 mins, what is your nursing Dx?

A

self-mutilation

55
Q

Jenny haf a panic attack out of the blue for 10 minutes which then subsided, scared everyday because her attacks are unexpected, what is your nursing Dx?

A

anxiety

56
Q

Shannon cannot go to social gatherings and complains that her anxiety interferes with her work, what is your nursing Dx?

A

ineffective coping

57
Q

After my Dx, what is important in my implementation step?

A

determine what level of anxiety the pt is experiencing

58
Q

Jared can still solve problems but has in the inability to concentrate, what are some nursing interventions?

A
  • help him to focus and solve problems by asking open-ended questions, giving broad openings
  • evaluate his past coping styles
  • offer activities that may temporarily relieve feelings of inner tension
59
Q

Jill is unable to solve problems and has no idea what is going on in her env, what are some nursing interventions?

A
  • provide safety
  • prevent exhaustion
  • guide her to a quiet env
  • meds
  • restraints/ seculsion
60
Q

How should I communicate with Jill who is unable to solve problems and cannot grasp the env around her?

A

firm, short, and simple statements

61
Q

Which class of meds are the first line of defense for anxiety?

A

Antidepressants

62
Q

List all the antidepressants (SSRIs)

A
  1. Celexa
  2. Lexapro
  3. Luvox
  4. Prozac
  5. Paxil
  6. Zoloft
63
Q

Which 2 SNRIs are effective for anxiety?

A

Cymbalta and Effexor

64
Q

When giving antidepressant for anxiety, what is a common finding?

A

some may initially increase anxiety

65
Q

Can you give an Nardil for anxiety? Rationale

A

Nardil is an MAOI and is contraindicated for pts w/ anxiety b/c they cannot consume tyramine and the pt may or may not abide by this dietary restriction which can lead to hypertensive crisis

66
Q

What do anxiolytics treat in those w/ anxiety disorders?

A

somatic and psychological Sx

67
Q

Why are benzodiazepines given most commonly?

A

because they have a quick onset of action

68
Q

Since benzodiazepines are addictive, how are these meds given?

A

they are given for only a short period, only until other medications or treatments reduce Sxs

69
Q

What is my nursing intervention when a pt is taking Ativan or Klonopin?

A

monitor for

  • sedation
  • ataxia
  • decreased cognitive fxn
70
Q

What type of pts are benzodiazepines contraindicated for? Rationale

A
  • Substance use disorder- CNS depression

- Elderly- risk of delirium, falls, and fractures

71
Q

What about pregnant woman can they take benzodiazepines?

A

this has to be weighted by the risk of fetal exposure vs the risk of untreated anxiety

72
Q

What are some risk does a mom put her baby in if she takes benzodiazepines?

A

increases risks for cleft lip and palate

73
Q

Which non-benzodiazepine is an alt med?

A

Buspirone (BuSpar)

74
Q

Why would a dr. prescribe BuSpar vs Ativan for a pt?

A

BuSpar is not addictive unlike Ativan, so therefore it can be given long-term

75
Q

What are some side effects BuSpar?

A
  1. Nausea
  2. Dizziness
  3. Headache
  4. Nervousness
  5. Excitement
  6. Syncope
76
Q

What type of pts is BuSpar contraindicated?

A
  1. renal impaired

2. hepatic impaired

77
Q

How long does it take to see the full therapeutic effects of BuSpar?

A

2-4 wks

78
Q

What other meds are given for anxiety disorders?

A
  1. Beta blockers
  2. Antihistamines
  3. Anticonvulsants
  4. Antipsychotics
79
Q

What is the reason a pt with anxiety may receive a beta blocker?

A

beta blockers block receptors that cause the heart to beat faster, so therefore they reduce physical manifestations of anxiety by decreasing HR and reducing blushing

80
Q

What is the reason a pt with anxiety may receive Gabapentin or Lyrica?

A

helps manage GAD and SAD

81
Q

What is the use of antihistamines w/ anxiety disorders?

A

they lower anxiety levels and helpful in treating pts with substance use problems

82
Q

If Samantha has severe anxiety and is self-medicating with ETHOL and has long-term use of Kava. What test should you order? Why?

A

Liver enzymes b/c kava inhibits P450 which metabolizes potential toxic compounds in the liver

83
Q

List the Benzodiazepines

A
  1. Ativan (lorazepam)
  2. Klonopin (clonazepam)
  3. Librium ( chlorodizepoxide)
  4. Serax (oxazepam)
  5. Tranxene (diazepam)
  6. Xanax (Alprazolam)

Mental Health (16 decks)

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