Anxiety Disorders Flashcards

1
Q

What is fear?

A
  • A cognitive response to a specific source or object that the person can identify or describe
  • Involves intellectual or cognitive appraisal of threatening stimuli
  • Fear provokes anxiety
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2
Q

What is anxiety?

A
  • Integral part of human experience
  • A vague, subjective feeling of uneasiness, tension, apprehension or dread
  • Results from an external threat to one’s integrity
  • Function of anxiety is to warn individual of impending threat, conflict or danger
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3
Q

What are the four levels of anxiety?

A

Mild, moderate, severe and panic

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4
Q

Describe mild anxiety:

A
  • Feels comfortable/safe, carries through with habitual behaviours
  • Aware of surroundings, thoughts controlled, able to learn and problem solve
  • Vitals normal, mild muscle tension
  • Generally we live in a state of mild anxiety
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5
Q

Describe moderate anxiety:

A
  • Vitals slightly elevated, tension present
  • Feels ready and challenged, and able to engage in competition and learn new skills
  • Able to learn and problem solve
  • Can be a good place to be when trying to accomplish goals
  • Perceptual field narrows, can be confused
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6
Q

Describe severe anxiety:

A
  • Fight or flight, ANS stimulated
  • Feels threatened/startled
  • Shaky, stuttering, disorganized
  • PF narrows, selective attention, time distortion, problem-solving is difficult
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7
Q

Describe panic anxiety:

A
  • Can occur in someone exposed to high levels of stress and living with chronic stress
  • Body reaches exhaustion state from prolonged ANS stimulation
  • Intervention required
  • PF scattered/closed, no problem solving
  • Feels helpless/angry/fearful
  • Combative or withdrawn
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8
Q

What is signal anxiety?

A
  • Identifiable cause, environmental cue

- Ex. phobias (becoming frightened easily when seeing a spider)

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9
Q

What is trait anxiety?

A

Function of personality structure, learned anxious behavior from upbringing

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10
Q

What is state anxiety?

A
  • Conflicting or stressful situations
  • A state where you are in conflict
  • Ex. upcoming exam, competing demands for time, trouble at work, etc.
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11
Q

What is free-floating anxiety?

A
  • Unattached to any idea or event
  • Comes on randomly
  • Gives a sense of impending doom, as if about to die; a sense of severe dread or fear
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12
Q

Describe the epidemiology of anxiety:

A
  • The most common psychiatric disorders tx by HCP’s
  • Approx 19 million Canadian’s are affected
  • More common in women than men
  • Affects all ages, however the typical age of onset for panic disorders is in late adolescence and early adulthood
  • High co-morbid rates of anxiety and depression
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13
Q

What is generalized anxiety disorder?

A
  • People who tend to feel anxious more often than not, resulting in excessive anxiety and worry
  • Present for at least 6 months, with the presence of 3 of the following: restlessness, edginess, fatigue, poor concentration, irritability, muscle tension and sleep disturbance
  • Anxiety and worry that interferes with normal social and occupational functioning
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14
Q

What are panic attacks?

A
  • A physical symptom of anxiety; it is NOT a psychiatric illness!
  • Discrete period of intense fear, discomfort, dread or doom
  • Develops abruptly, and peaks within 10 minutes
  • Exhibits are least four symptoms: shortness of breath, chest tightness, increased HR, palpitations, feelings of doom, sweating/trembling, dissociation
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15
Q

What are the criteria for panic disorder?

A
  • Must meet these two criteria:
  • Presence of recurrent or unexpected panic attacks
  • At least one of the attacks is followed by: persistent concern about having additional attacks; worry about the implications of the attack; or a significant change in behaviors as a result
  • Must be present for at least one month
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16
Q

What are phobias?

A

Fear of something that can lead to feelings of panic or intense anxiety in response to a specific situation

17
Q

What is agoraphobia?

A
  • Anxiety about being where escape is difficult
  • Situations are avoided or endured with anxiety
  • Leaving a comfort zone causes huge anxiety (ex. leaving your home, fear of open spaces, etc.)
  • Not due to the effects of a medical condition, substance or other mental disorder
18
Q

What is specific phobia?

A
  • Marked, persistent, excessive fear
  • Cued by presence/anticipation of specific objects or situations
  • Exposure to the phobic stimulus provokes an anxiety response/panic attack
  • Avoided or endured with anxiety
  • Persons with a simple phobia recognize that their fear is excessive or unreasonable
19
Q

What is social phobia?

A
  • Marked, persistent fear of one or more social or performance situations, exposing individual to scrutiny while behaving in an embarrassing way
  • Only able to have social relationships with familiar people
  • Recently on the rise; technology replaces our natural social skills and makes it difficult to endure real-life encounters
  • Only able to have social relationships with familiar people
  • Avoids social or performance situations or endure them with intense anxiety or distress
  • Treated with psychotherapy or SSRI’s; self-treatment with substances on the rise (alcohol and cannabis to take the ‘edge off’)
20
Q

What is PTSD?

A
  • Reaction to traumatic events
  • Symptoms are present for more than one month and will impair functioning
  • Recurrence, avoidance and heightened arousal
21
Q

What is acute stress disorder?

A
  • Similar to PTSD, but short-lived (~2-30 days)
  • Experience three symptoms indicating dissociation (detached, numbness)
  • The symptoms of dissociation prevent the individual from adaptively coping with the trauma
  • Not able to pursue a necessary task
22
Q

What is OCD?

A
  • Obsessions: recurrent or persistent unwanted thoughts, impulses or images that cause anxiety
  • Compulsions: repetitive behaviors that the person feels driven to perform in response to the obsession
  • Obsession cannot be suppressed/ignored and therefore interferes with normal functioning
  • Treated with behavioral therapy or medications (SSRI’s, TCA’s)
23
Q

Describe the nursing assessment that goes along with treating anxiety disorders:

A
  • Safety risk
  • Physical symptoms
  • Discussion re: response to stress and coping mechanisms
24
Q

What are nursing diagnoses for individuals with anxiety?

A
  • Ineffective coping
  • Self-care deficit
  • Ineffective role performance
  • Loneliness
  • Spiritual distress
  • Powerlessness
  • Isolation
25
Q

How do we plan is nursing care for these individuals?

A
  • Goal is to improve coping
  • Involve people in therapy
  • Ideal to have treated by outpatient therapy
26
Q

What are some nursing interventions for anxiety?

A
  • Deep breathing exercises
  • Mindfulness
  • Behavioral cognitive therapy
  • Healthy sleep and wake patterns
  • Nutrition
  • Decrease intake of stimulants (ex. coffee)
  • Meditation
  • Positive self-talk
  • Teaching assertiveness, social skills and communication techniques
  • Acceptance therapy
  • Social supports
  • Do NOT try to have patients distract selves or avoid anxiety, has potential to make worse in the long run
  • Medications (benzos, SSRI’s, TCA’s, beta-blockers, etc.)