Anxiety and Anxiety Disorders: Exam 2 Flashcards by Taylor Biggs

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

Anxiety

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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 healthy adaptive reaction

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When it is disproportionate to the risk

Continues after the threat no longer exist

Interferes with functioning

Pathological

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

Anxiety Disorders

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Clients suffering from anxiety disorders demonstrate unusual behaviors such as:

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

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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

Stress

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

General Adaptation Syndrome

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

Adaptive
Maladaptive

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________ 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 _____.

Stress
Psychological
Fight-or-Flight
Alertness
Stress

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What are the 3 Stages of Reaction to stress?

Alarm reaction stage
Resistance stage
Exhaustion stage

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Preparation for defense. What stage is this?

Alarm reaction stage

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

Resistance stage

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

Exhaustion stage

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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?

Mild Anxiety

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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?

Moderate Anxiety

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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?

Severe Anxiety

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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?

Panic Anxiety (Panic attack)

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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?

Generalized Anxiety Disorder

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Generalized Anxiety Disorder (GAD) Symptoms:

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

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Describe Panic Disorder:

-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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Assessment for Panic Disorder:

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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Nursing Diagnoses for Panic Disorder:

Risk for injury
Ineffective coping
Disturbed sleep patterns

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Outcomes for Panic Disorder:

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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Interventions for Panic Disorder:

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

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Evaluation for Panic Disorder:

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

Intense illogical persistent fear of specific object or situation Response is out of proportion to the situation or circumstance

Phobia

Categories of Phobias:

Agoraphobia Specific phobia Social anxiety or phobia

Categories of specific Phobias:

Natural environment Blood – injection Situational Animal Other types

Types of Behavioral Therapy:

Positive reframing Assertiveness training Systemic desensitization Flooding Exposure Response prevention

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?

Stress Related Illnesses

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

Ignored Physical

_______ can exacerbate symptoms of many _______ illnesses.

Stress Medical

What are the etiologies of anxiety?

Biological factors Psycho-dynamic factors Interpersonal factors Behavioral factors

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?

Biological Factors

What are the neurotransmitters associated in biological factors?

Gamma-aminobutyric acid (GABA) Norepinephrine Serotonin Cholecystokinin

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

Psycho-dynamic Factors

What are the 3 types of anxiety?

Reality anxiety Moral anxiety Neurotic anxiety

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?

Interpersonal Factors

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?

Behavioral Factors

For the assessment of anxiety what to you include?

Data to determine level and stage of anxiety

What are the stages of signs/symptoms of anxiety?

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

Physical signs of Anxiety:

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

Physiological Symptoms of Anxiety:

Mimic symptoms of physical illness

Abnormal Lab Findings with Anxiety:

elevated adrenocorticotropic hormones cortisol catecholamine levels hyperglycemia

Effective Symptoms of Anxiety:

depression irritability apathy crying anger worthlessness apprehension helplessness

Cognitive Symptoms of Anxiety:

inability to concentrate indecisiveness inability to learn/reason forgetfulness

Social Symptoms of Anxiety:

changes in communication social withdrawal

Spiritual Symptoms of Anxiety:

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

Nursing Diagnoses for Anxiety:

Anxiety Fear Ineffective individual coping Powerlessness Social isolation Spiritual distress

Implementation for Anxiety:

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

Psychopharmacology Associated with Implementation for Anxiety:

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

turning negative messages into positive ones

Positive Reframing

making more realistic appraisal of situation

Decatastrophizing

learning to negotiate interpersonal situations

Assertiveness Training

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?

Professional Practice Issues

What is you evaluation/outcomes from professional practice issues?

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.

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

Anxiety Positive

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.

Defense Human Cognitive Unconsciously

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.

Discomfort Unconscious

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

Harmful Overused Resolve

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

GOOD Increase Think Protect

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 ___________.

Disrupting Wrong Nervous Concentrating

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

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

What is the goal of decatagtrophizing cognitive therapy?

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

What does severe anxiety psychological responses include?

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

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.

Panic Attack Depersonalization De-realization Reassure Deep

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

safe intervention

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?

Example: "you seem upset/agitated." Therapeutic Communication is used This is designed to get the client to communicate what they are feeling.

What medication is used for acute anxiety?

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

What medication is used for the maintenance of anxiety?

Buspirone: Buspar

What are the most commonly seen medications for anxiety?

Benzodiazapine: Atavan and Buspirone: Buspar

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

Flooding Cognitive Behavioral Therapy

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

Exposure Cognitive Behavioral Therapy

Refraining from compulsion, avoidance, or escape behavior

Response Prevention Cognitive Behavioral Therapy