Anxiety disorders

Question 1

Disturbances in serotonin , norepinephrine, and gamma-aminobutyric acid (GABA) have been implicated in the pathophysiology of …

Answer 1

anxiety disorders

Question 2

Fear, particularly important in panic and phobic disorders

Answer 2

Amygdala

Question 3

Associated with memory related to fear responses

Answer 3

Hippocampus

Question 4

Arousal

Answer 4

Locus ceruleus

Question 5

Respiratory activation, heart rate

Answer 5

Brain stem

Question 6

Activation of stress response

Answer 6

Hypothalamus

Question 7

Cognitive interpretations

Answer 7

Frontal cortex

Question 8

Integration of sensory stimuli

Answer 8

Thalamus

Question 9

Tremor

Answer 9

Basal ganglia

Question 10

Recurrent attacks, unpredictable, intense fear, feeling of impending doom; intense physical discomfort

Answer 10

Panic disorder

Question 11

Chronic , unrealistic , excessive anxiety and worry; symptoms existed 6 months or longer .

Answer 11

Generalized anxiety disorder

Question 12

Fear of being in places or situations from which escape might be difficult ; help might not be available

Answer 12

Agoraphobia without history of panic disorder

Question 13

Fear of situations in which a person might do something embarrassing or be evaluated negatively by others

Answer 13

Social phobia

Question 14

Unreasonable fear when in the presence of, or when anticipating an encounter with , a specific object or situation

Answer 14

Specific phobia

Question 15

Unwanted repetitive behavior pattern or mental acts ( praying, counting) that are intended to reduce anxiety , not to provide pleasure . They may be performed to an obsession or in stereotyped fashion

Answer 15

Compulsions

Question 16

Recurrent obsessions or compulsions that are severe enough to be time consuming or to cause marked distress or significant impairment

Answer 16

Obsessive-Compulsive Disorder

Question 17

The development of characteristic symptoms following exposure to an extreme traumatic stressor involving a personal threat to physical integrity or to the physical integrity of others

Answer 17

Posttraumatic Stress Disorder

Question 18

1. Panic anxiety - Panic disoreder ; Generalized anxiety diorder
2. Powerlessness -
3. Fear - Phobic diosrder
4. Social isolation - Phobic disorder
5. Ineffective coping - OCD
6. Ineffective role performance - OCD
7. Posttrauma syndrome - PTSD
8. Complicated grieving - PTCD

Answer 18

nursing diagnoses commonly associated with anxiety disorders

Question 19

Characterized by physical symptoms suggesting medical disease , but without demonstrable organic pathology or known pathophysiological mechanism to account for them .

Answer 19

Somatoform disorders : pain disorder; hypochondriasis; conversion disorder; body dysmorphic disorder

Question 20

Disruption in the usually integrated functions of consciousness , memory, identity or perception

Answer 20

Dissociative disorders - dissociative amnesia; dissociative identity disorder; depersonalization disorder

Question 21

Supportive therapy
• Group therapy
• Cognitive-behavioral strategies
• Stress reduction
• Relaxation training
• Psychopharmacology

Answer 21

four psychological interventions the nurse might use in the treatment of
the patient with a maladaptive psychophysiological response to stress.

Question 22

particularly effective

treatment for panic disorder

Answer 22

Cognitive-behavioral therapy (CBT) - a patient can gain mastery over panic episodes by identifying and replacing negative beliefs that cause anxiety with positive,
empowering self-talk.

Question 23

GABA acts by

Answer 23

nhibiting neurotransmitter release at the synapses, thus
preventing neurons from “overfiring.” This decrease in neuronal activity keeps anxiety messages from reaching the brain and produces a calming effect. The opposite effect will occur if the
action of GABA is inhibited; anxiety can increase to cause a panic response.

Question 24

Alprazolam ( Xanax )

Answer 24

benzodiazepine - antianxiety agent

Question 25

Chlordiazepoxide (Librium )

Answer 25

benzodiazepine - antianxiety agent

Question 26

Diazepam ( Valium )

Answer 26

benzodiazepine - antianxiety agent

Question 27

Clonazepam ( Klonopin )

Answer 27

benzodiazepine - antianxiety agent

Question 28

Buspirone ( BuSpar )

Answer 28

azaspirodecanediones - antianxiety agent

Question 29

Depress subcortical levels of the CNS, particularly the limbic system and reticular formation ; may potentiate powerful inhibitory action of GABA.

Answer 29

benzodiazepines action

Question 30

not known; does not depress the CNS; desired effect through interactions with serotonin , dopamine, and other neurotransmitter receptors

Answer 30

Buspirone action

Question 31

Used in the treatment of anxiety disorders , anxiety symptoms, acute alcohol withdrawal, skeletal muscle spasms, convulsive disorders, status epilepticus, preoperative sedation

Answer 31

antianxiety agents - indications

Question 32

1. Drowsiness, confusion, lethargy
2. Tolerance; physical and psychological dependence
3. Potentiate the effects of other CNS depressants
4. Aggravation of depression
5. Orthostatic hypotension
6. Paradoxical excitement (opposite effect)
7. Nausea and vomiting
8. Dry mouth
9. Blood dyscrasias ( unusual bleeding)

Answer 32

benzodiazepines - side effects

Question 33

same as for benzodiazepines except

1. No tolerance
2. Delayed onset - 10 days - 2 weeks

Answer 33

Buspirone - side effects

Question 34

For patients on long-term therapy - Don’t quit taking the drug abruptly - can be life threatening - depression, insomnia, increased anxiety, abdominal and muscle cramps , tremors, vomiting, sweating, convulsions, and delirium

Answer 34

benzodiazepines - Tolerance - interventions

Question 35

1. Antianxiety - antiolytic agents : benzodiazepines + Buspirone
2. Antidepressants

Answer 35

Psychopharmacological therapy - anxiety disorders

Question 36

Used to desensitize individuals to phobic stimuli ; individual is “flooded” with continuous presentation (through mental imagery) of the phobic stimulus until it no longer elicits anxiety

Answer 36

Implosive therapy - flooding

Question 37

technique for assisting individuals to overcome their fear of a phobic stimulus; there is hierarchy of anxiety producing events through which the individual progresses during therapy

Answer 37

Systematic desensitization