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Mental Health > Anxiety and Anxiety Disorders: Exam 2 > Flashcards

Anxiety and Anxiety Disorders: Exam 2 Flashcards

1
Q

A state of apprehension, dread, uneasiness, or uncertainty generated by a real or perceived threat whose actual source is unidentifiable

It is different from fear which is feeling afraid or threatened by a clearly identifiable external stimulus that represents danger

Is an emotional subjective response
Is commonly experienced by all human beings
Can be a healthy adaptive reaction
Can be considered pathological

A

Anxiety

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2
Q

When it alerts the person to impending threats

When it motivates the person to take action to solve a problem or to resolve a crisis

A

A healthy adaptive reaction

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3
Q

When it is disproportionate to the risk

Continues after the threat no longer exist

Interferes with functioning

A

Pathological

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4
Q

Comprise a group of conditions that share a key feature of excessive anxiety with ensuing behavioral, emotional, cognitive, and physiological responses

A

Anxiety Disorders

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5
Q

Clients suffering from anxiety disorders demonstrate unusual behaviors such as:

A

Panic without reason
Unwarranted fear of objects or life conditions
Unexplainable or overwhelming worry

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6
Q

the wear and tear that life causes on the body

It occurs when a person has difficulty dealing with life situations, problems, and goals

Each person handles stress differently

A

Stress

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7
Q

An automatic physical reaction to stress mediated by the sympathetic nervous system

A

General Adaptation Syndrome

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8
Q

What are the 2 General adaptation syndrome stages that relate to an understanding of anxiety?

A

Adaptive
Maladaptive

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9
Q

________ is viewed as a nonspecific body response to any demand. Physical and __________ defenses are mobilized. The ______-___-_______ reaction occurs. Intense _______ is focused on the immediate threat or task. The body mobilizes to combat _____.

A

Stress
Psychological
Fight-or-Flight
Alertness
Stress

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10
Q

What are the 3 Stages of Reaction to stress?

A

Alarm reaction stage
Resistance stage
Exhaustion stage

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11
Q

Preparation for defense. What stage is this?

A

Alarm reaction stage

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12
Q

Blood shunted to areas needed for defense. What stage is this?

A

Resistance stage

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13
Q

Stores depleted; emotional components unresolved. What stage is this?

A

Exhaustion stage

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14
Q

Associated with the tension of everyday life
The person is alert, perceptual field is increased, learning is facilitated
Physiological responses are within normal limits
Affect is positive
What type of anxiety is this?

A

Mild Anxiety

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15
Q

Focus is on immediate concerns
The perceptual field is narrowed
Low-level sympathetic nervous system arousal occurs (increased pulse and respirations)
Tension and fear are experienced
What type of anxiety is this?

A

Moderate Anxiety

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16
Q

Focus is on specific details
Perceptual field is significantly reduced
Learning cannot occur
Sympathetic nervous system is aroused
Severe emotional distress is experienced
What type of anxiety is this?

A

Severe Anxiety

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17
Q

Dread and terror
Details are blown out of proportion
Personality is disorganized and unable to function
Physiological arousal interferes with motor activities
Overwhelming emotions cause regression to primitive or childlike behaviors
What type of anxiety is this?

A

Panic Anxiety (Panic attack)

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18
Q

Involves excessive worrying and high anxiety at least 50% of the time for 6 months or more
Quality of life is greatly diminished in older adults
Buspirone and serotonin-norepinephrine reuptake inhibitor (SSRI) are the most effective treatments
What is this disorder?

A

Generalized Anxiety Disorder

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19
Q

Generalized Anxiety Disorder (GAD) Symptoms:

A

Restlessness
Fatigue
Excessive anxiety and worry
Increased muscle aches or soreness
Impaired concentration
Irritability
Difficulty sleeping

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20
Q

Describe Panic Disorder:

A

-Discrete episodes of panic attacks; no stimulus for panic response
-Peaks in late adolescence and the mid 30s.
-Diagnosed when recurrent, unexpected attacks followed by at least 1 month of concern/worry about future attacks
-Half of people with panic disorder have agoraphobia (fear of being in a situation where you can’t escape danger)
-Increase risk of suicide
-Avoidance behavior
-Primary Gain: relief of anxiety achieved by specific anxiety-driven behaviors
-Secondary Gain: attention received as a result of anxiety-driven behaviors

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21
Q

Assessment for Panic Disorder:

A

Hamilton Rating Scale for Anxiety
History
General appearance and motor behavior
Mood and affect
Thought process
Sensorium and intellectual processes
Judgment and insight
Self-concept
Roles and relationships
Physiological and self-care concerns

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22
Q

Nursing Diagnoses for Panic Disorder:

A

Risk for injury
Ineffective coping
Disturbed sleep patterns

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23
Q

Outcomes for Panic Disorder:

A

The client will be free from injury
The client will utilize effective coping mechanisms
The client will sleep at least 6 hours per night

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24
Q

Interventions for Panic Disorder:

A

Promote safety and comfort
Use therapeutic communication
Manage anxiety
Provide client and family education

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25
Q

Evaluation for Panic Disorder:

A

Individualized and based on the diagnoses and associated outcomes
Requires ongoing assessment to determine if outcomes were achieved

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26
Q

Intense illogical persistent fear of specific object or situation

Response is out of proportion to the situation or circumstance

A

Phobia

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27
Q

Categories of Phobias:

A

Agoraphobia
Specific phobia
Social anxiety or phobia

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28
Q

Categories of specific Phobias:

A

Natural environment
Blood – injection
Situational
Animal
Other types

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29
Q

Types of Behavioral Therapy:

A

Positive reframing
Assertiveness training
Systemic desensitization
Flooding
Exposure
Response prevention

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30
Q

A broad term covering a spectrum of illnesses that result from or worsen because of stress

Chronic stress can cause eating disorders such as anorexia and bulimia
What is this defining?

A

Stress Related Illnesses

31
Q

Stress that is _______ or suppressed can cause ________ symptoms with no actual organic disease (somatic symptom disorders)

A

Ignored
Physical

32
Q

_______ can exacerbate symptoms of many _______ illnesses.

A

Stress
Medical

33
Q

What are the etiologies of anxiety?

A

Biological factors
Psycho-dynamic factors
Interpersonal factors
Behavioral factors

34
Q

Anxiety results from improper functioning of body systems involved in the normal stress response
Genetics
Hyperactivity of the autonomic nervous system
What anxiety etiology is this?

A

Biological Factors

35
Q

What are the neurotransmitters associated in biological factors?

A

Gamma-aminobutyric acid (GABA)
Norepinephrine
Serotonin
Cholecystokinin

36
Q

Anxiety is a warning of danger
Anxiety and the personality are closely related
What anxiety etiology is this?

A

Psycho-dynamic Factors

37
Q

What are the 3 types of anxiety?

A

Reality anxiety
Moral anxiety
Neurotic anxiety

38
Q

Attainment of satisfaction and security
Anxiety is a response to external factors arising out of contact with other human beings
What anxiety etiology is this?

A

Interpersonal Factors

39
Q

Responses to stressors are often the result of learned behaviors
Anxiety may result from the inability to achieve desired goals
What anxiety etiology is this?

A

Behavioral Factors

40
Q

For the assessment of anxiety what to you include?

A

Data to determine level and stage of anxiety

41
Q

What are the stages of signs/symptoms of anxiety?

A

Physical signs
Physiologic symptoms
Abnormal lab findings
Effective symptoms
Cognitive symptoms
Social symptoms
Spiritual symptoms

42
Q

Physical signs of Anxiety:

A

increased BP
elevated respiration’s
increased HR
sweaty palms
diaphoresis
dilated pupils
dyspnea
nausea
vomiting

43
Q

Physiological Symptoms of Anxiety:

A

Mimic symptoms of physical illness

44
Q

Abnormal Lab Findings with Anxiety:

A

elevated adrenocorticotropic hormones
cortisol
catecholamine levels
hyperglycemia

45
Q

Effective Symptoms of Anxiety:

A

depression
irritability
apathy
crying
anger
worthlessness
apprehension
helplessness

46
Q

Cognitive Symptoms of Anxiety:

A

inability to concentrate
indecisiveness
inability to learn/reason
forgetfulness

47
Q

Social Symptoms of Anxiety:

A

changes in communication
social withdrawal

48
Q

Spiritual Symptoms of Anxiety:

A

feeling hopeless and despair
fear of death
inability to find life meaning

49
Q

Nursing Diagnoses for Anxiety:

A

Anxiety
Fear
Ineffective individual coping
Powerlessness
Social isolation
Spiritual distress

50
Q

Implementation for Anxiety:

A

Coping strategies
-Breathing exercises
-Guided imagery
-Meditation
-Listening to music
-Recreational activity
Psychopharmacology
Individual and group therapy

51
Q

Psychopharmacology Associated with Implementation for Anxiety:

A

Selective serotonin reuptake inhibitors (SSRIs): Celexa, Lexapro, Prozac, Paxil, Zoloft

Tricyclic antidepressants: Elavil, Anafranil, Tofranil

Antihistamine: Benadryl, Atarax

Anti-epileptics: Tegretol, Neurontin, Depakote

Buspirone: Buspar

Benzodiazepines: Ativan, Klonopin, Xanax, Valium

52
Q

turning negative messages into positive ones

A

Positive Reframing

53
Q

making more realistic appraisal of situation

A

Decatastrophizing

54
Q

learning to negotiate interpersonal situations

A

Assertiveness Training

55
Q

Be aware of own level of anxiety
Remain calm
Establish a trusting relationship
Avoid trying to “fix” client’s problem
What are these associated with?

A

Professional Practice Issues

56
Q

What is you evaluation/outcomes from professional practice issues?

A

Progress should be evaluated during each nurse-client interaction
Should focus on changes in lifestyle, behavior, feelings, level of anxiety, client’s understanding of the disorder, and view of the future.

57
Q

_________ is unavoidable. It can serve many _______ functions. (Ex: what alerts us of danger.)

A

Anxiety
Positive

58
Q

Clients may use ________ mechanisms, Fraud describes these as _________ attempts to control awareness of and to reduce _________. They are _______ distortions that a human uses __________ to maintain a sense of being and to maintain control of a situation.

A

Defense
Human
Cognitive
Unconsciously

59
Q

Defense mechanisms are used to lessen _________ and to deal with stress. They arise from the _________ and the person isn’t aware that they are using them.

A

Discomfort
Unconscious

60
Q

Defense mechanisms are _________ when they are _________ because it stops the person from leaning a variety of methods to _________ anxiety producing situations.

A

Harmful
Overused
Resolve

61
Q

Mild anxiety = ________! Sensor stimulation that ______ and helps the person focus to learn, solve problems, _______, act, feel, and _______.

A

GOOD
Increase
Think
Protect

62
Q

Moderate anxiety involves that __________ feeling that involves and notes that something is _________. Person becomes ________/agitated. Can still process information, solve problems, and learn new things. However, have difficulty ___________.

A

Disrupting
Wrong
Nervous
Concentrating

63
Q

What should you ask during decatagtrophizing cognitive therapy? What kind of communication does these questions involve?

A

What is the worst that can happen?
Could you survive that?
Was it as bad as you imagined it being?

Involves therapeutic communication

64
Q

What is the goal of decatagtrophizing cognitive therapy?

A

to promote a decrease in anxiety, not dismissing the patients feelings, but asking the patient to asses these feelings.

65
Q

What does severe anxiety psychological responses include?

A

Headache
NVD
Trembling
Rigid stance
Vertigo (dizziness and feeling of passing out)
Pale skin
Increased HR
Chest pain

66
Q

Panic anxiety (_____ ______) = feeling like they are disconnected from themselves (________________) and they believe that things aren’t real (________________). The nurse should reassure the client that they are safe and _______ the client by instructing them to take ______ breaths.

A

Panic Attack
Depersonalization
De-realization
Reassure
Deep

67
Q

When the nurse is staying with the client, while allowing them personal space, what kind of intervention is this pertaining?

A

safe intervention

68
Q

When talking with a patient who is suffering from anxiety, see clarification of what you observe. What is an example of this? What type of communication does this produce? Why is this good to do with the client?

A

Example: “you seem upset/agitated.”

Therapeutic Communication is used

This is designed to get the client to communicate what they are feeling.

69
Q

What medication is used for acute anxiety?

A

Benzodiazapine: Atavan (MOST COMMON), Klonopin, Xanax, and Valium.

70
Q

What medication is used for the maintenance of anxiety?

A

Buspirone: Buspar

71
Q

What are the most commonly seen medications for anxiety?

A

Benzodiazapine: Atavan and Buspirone: Buspar

72
Q

A form of behavior therapy and desensitization—or exposure therapy—based on the principles of respondent conditioning.

A

Flooding Cognitive Behavioral Therapy

73
Q

Exposing the target patient to anxiety source without intention to cause danger

A

Exposure Cognitive Behavioral Therapy

74
Q

Refraining from compulsion, avoidance, or escape behavior

A

Response Prevention Cognitive Behavioral Therapy

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