Anxiety Disorders Flashcards
At what point is a patient diagnosed with an anxiety disorder?
When normal feelings of anxiety get out of control and impair functioning
What are the five diagnoses that fall under the anxiety disorder umbrella?
- Panic disorder
- Generalized Anxiety disorder
- Obsessive Compulsive Disorder (OCD)
- Phobias
- Post-traumatic Stress Disorder (PTSD)
How is anxiety described?
- Stress response
- Feelings of mental uneasiness (apprehension, dread, or helplessness)
- Related to impending or actual threat to self or significant others
What are the 3 anxiety disorders that we need to know?
- Generalize anxiety disorder
- Separation Anxiety
- Panic disorder
What is the primary symptom of an anxiety disorder?
Free-floating anxiety
What are the neurotransmitters involved with anxiety?
- GABA
- Norepinephrine
- Serotonin
What is the role of the brain in anxiety disorders?
Each part of the limbic system will play a part
What does the amygdala do?
The emotional part of the brain
What does the hippocampus do?
Stores memory related to fear
What does the locus coeruleus do?`
Stimulates arousal
What does the hypothalamus do?
Activates the entire response
What does the thalamus do?
Integrates all sensory stimuli
What is the behavior theory of anxiety disorders?
Faulty thinking and behavior are learned dysfunctional responses to stress and so can be unlearned
What are the genetic theories associated with anxiety disorders?
- Genetic predisposition
- Family history
What is the humanistic theory with anxiety disorders?
Various causes interact to produce complex of symptoms
What are the risk factors for anxiety disorders?
- Childhood adversity
- Family incidence
- Social factors
- Serious or chronic illness
- Traumatic events
- Personality factors
- Multiple stressors
What are the risk factors associated with children?
- Anxiety disorders reported more frequently in girls
- Familial predisposition
- Socioeconomic factors
What are the risk factors associated with older adults?
- Cognitive or chronic physical impairment
- Significant emotional loss
- Lower economic
- Being unmarried
How can you prevent an anxiety disorder?
- Advise that individuals keep journals to catalog stressors and sources of relief
- Advise avoiding unhealthy substance use
- Seek help early
- Keep track of anxiety patterns
What unhealthy substance use should be avoided in patients with anxiety?
- ETOH
- illegal drugs
- nicotine
- caffeine
What are the mild clinical manifestations of anxiety disorders?
- Increase in sensory perception, arousal
- Increase in alertness, motivation
- Restlessness, irritability, sleeplessness
What are the moderate clinical manifestation of anxiety disorders?
- Narrowing of perceptual field, attention span
- Increased restlessness, respirations, sweating
- Discomfort, irritability with others
What are the severe clinical manifestations of anxiety disorders?
- Perceptual field greatly reduced
- Difficulty following directions
- Feelings of dread, horror
- Need to relieve anxiety
- Headache, dizziness
- Nausea, trembling, insomnia
- Palpitations, tachycardia, hyperventilation
What are the clinical manifestations of panic?
- Inability to focus
- Perception distorted
- Terror, feelings of doom
- Bizarre behavior
- Dilated pupils, diaphoresis
- Trembling, sleeplessness, palpitations, pallor
- Immobility or hyperactivity
- Incoherence, muscular incoordination
What are the clinical manifestations of generalized anxiety disorder?
- Pervasive apprehension, worry
- Excessive anxiety for at least 6 months
- Difficulty relaxing, fatigue, poor concentration
- Irritability, muscle tension, GI issues
What are the clinical manifestations of children with Generalized anxiety disordeR?
- Intense worry over long period of time
- Significant distress
What are the clinical manifestations of separation anxiety disorder?
- Extreme state of uneasiness with being separated from familiar people
- Refusal to sleep alone, attend school
- Symtoms of fear last for at least 4 weeks
- More severe than normal separation anxiety
- Adult form (ASAD) newly recognized
Who most commonly has separation anxiety disorder?
Children
What are the clinical manifestations of panic disorder?
- Sudden attacks of terror
- Fear of one’s own unexplained symptoms
- Intense worry about next attack
- Can be debilitating if treatment is not sought
What are the symptoms of sudden attacks of terror?
- Pounding heart
- Sweating
- Fainting
- Flushed or chilled
- Chest pain
- Sense of impending doom
How long can a panic attack last?
A few moments to an hour
When is treatment for an anxiety disorder not likely to occur at home?
When a patient has panic disorder
What other treatments might need to be done in conjunction with treatment of anxiety disorder?
Treatment for substance abuse and/or depression
What diagnostic test are done for anxiety disorders?
- Based on observation, history, and physical
- No lab test available to diagnose anxiety disorders
- Test to rule out physical illness
- Referral to mental health professional
What is pharmacologic therapies used in conjunction with to control anxiety symptoms?
Psychotherapy
What types of medications are the medications of choice used for anxiety disorders?
Antidepressants
What types of medications are sparingly used to treat anxiety disorders?
anti anxiety meds
When are anxiolytics used?
When anxiety begins to significantly affect daily activities
What are the primary antidepressant medications used to reduce symptoms of panic and anxiety?
SSRIs
What is the antidepressant prototype drug used for anxiety?
Escitalopram oxalate
What is the mechanism of action for Escitalopram oxalate?
Increases availability of serotonin at specific postsynaptic receptor sites located within the CNS
What is the primary use for Escitalopram oxalate?
Generalized anxiety and depression
What are the adverse effects for Escitalopram oxalate?
- Dizziness
- Nausea
- Insomnia
- Somnolence
- Confusion
- Seizures
What class does lorazepam belong to?
Benzodiazepines
What is the mechanism of action for lorazepam?
binds to GABA receptor-chloride channel molecule, which intensifies GABA effects
What is the primary use for lorazepam?
For anxiety disorders and insomnia
What are the adverse effects for lorazepam?
- Drowsiness
- Dizziness
- Respiratory depression
What are the nonpharmacologic therapies for anxiety disorders?
- Cognitive-behavior therapy
- Herbal preparations
- Massage, therapeutic touch therapy
- Relaxation techniques
- Yoga, meditation, acupuncture
- Avoid caffeine
What is involved in cognitive-behavioral therapy?
- Teach client internal locus of control
- Develop goal-oriented contracts
- Help clients test reality
- Coping tool kit
What are the interventions to reduce the severity of symptoms of anxiety disorder?
- Establishing rapport
- Communicating therapeutically
- Enhancing coping skills; identifying maladaptive ones
- Promoting health
- Providing a safe environment
Which outcome is most realistic and appropriate when planning care for a client newly diagnosed with an anxiety disorder?
- Within 2 months, the client will discuss the reasons for episodes with significant others.
- Within 2 months, the client will be episode-free.
- Within 1 month, the client will experience decreased episodes.
- Within 2 months, the client will establish two new relationships.
- Within 1 month, the client will experience decreased episodes
A client arrives at the emergency department in a severe state of anxiety following a motor vehicle crash. The best intervention by the nurse is to:
- Remain with the client.
- Put the client in a room alone.
- Teach relaxation breathing exercises.
- Encourage the client to talk about the experience.
- Remain with the client
