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Exam 4 > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

At what point is a patient diagnosed with an anxiety disorder?

A

When normal feelings of anxiety get out of control and impair functioning

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2
Q

What are the five diagnoses that fall under the anxiety disorder umbrella?

A
  • Panic disorder
  • Generalized Anxiety disorder
  • Obsessive Compulsive Disorder (OCD)
  • Phobias
  • Post-traumatic Stress Disorder (PTSD)
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3
Q

How is anxiety described?

A
  • Stress response
  • Feelings of mental uneasiness (apprehension, dread, or helplessness)
  • Related to impending or actual threat to self or significant others
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4
Q

What are the 3 anxiety disorders that we need to know?

A
  • Generalize anxiety disorder
  • Separation Anxiety
  • Panic disorder
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5
Q

What is the primary symptom of an anxiety disorder?

A

Free-floating anxiety

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6
Q

What are the neurotransmitters involved with anxiety?

A
  • GABA
  • Norepinephrine
  • Serotonin
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7
Q

What is the role of the brain in anxiety disorders?

A

Each part of the limbic system will play a part

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8
Q

What does the amygdala do?

A

The emotional part of the brain

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9
Q

What does the hippocampus do?

A

Stores memory related to fear

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10
Q

What does the locus coeruleus do?`

A

Stimulates arousal

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11
Q

What does the hypothalamus do?

A

Activates the entire response

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12
Q

What does the thalamus do?

A

Integrates all sensory stimuli

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13
Q

What is the behavior theory of anxiety disorders?

A

Faulty thinking and behavior are learned dysfunctional responses to stress and so can be unlearned

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14
Q

What are the genetic theories associated with anxiety disorders?

A
  • Genetic predisposition

- Family history

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15
Q

What is the humanistic theory with anxiety disorders?

A

Various causes interact to produce complex of symptoms

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16
Q

What are the risk factors for anxiety disorders?

A
  • Childhood adversity
  • Family incidence
  • Social factors
  • Serious or chronic illness
  • Traumatic events
  • Personality factors
  • Multiple stressors
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17
Q

What are the risk factors associated with children?

A
  • Anxiety disorders reported more frequently in girls
  • Familial predisposition
  • Socioeconomic factors
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18
Q

What are the risk factors associated with older adults?

A
  • Cognitive or chronic physical impairment
  • Significant emotional loss
  • Lower economic
  • Being unmarried
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19
Q

How can you prevent an anxiety disorder?

A
  • 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
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20
Q

What unhealthy substance use should be avoided in patients with anxiety?

A
  • ETOH
  • illegal drugs
  • nicotine
  • caffeine
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21
Q

What are the mild clinical manifestations of anxiety disorders?

A
  • Increase in sensory perception, arousal
  • Increase in alertness, motivation
  • Restlessness, irritability, sleeplessness
22
Q

What are the moderate clinical manifestation of anxiety disorders?

A
  • Narrowing of perceptual field, attention span
  • Increased restlessness, respirations, sweating
  • Discomfort, irritability with others
23
Q

What are the severe clinical manifestations of anxiety disorders?

A
  • Perceptual field greatly reduced
  • Difficulty following directions
  • Feelings of dread, horror
  • Need to relieve anxiety
  • Headache, dizziness
  • Nausea, trembling, insomnia
  • Palpitations, tachycardia, hyperventilation
24
Q

What are the clinical manifestations of panic?

A
  • Inability to focus
  • Perception distorted
  • Terror, feelings of doom
  • Bizarre behavior
  • Dilated pupils, diaphoresis
  • Trembling, sleeplessness, palpitations, pallor
  • Immobility or hyperactivity
  • Incoherence, muscular incoordination
25
Q

What are the clinical manifestations of generalized anxiety disorder?

A
  • Pervasive apprehension, worry
  • Excessive anxiety for at least 6 months
  • Difficulty relaxing, fatigue, poor concentration
  • Irritability, muscle tension, GI issues
26
Q

What are the clinical manifestations of children with Generalized anxiety disordeR?

A
  • Intense worry over long period of time

- Significant distress

27
Q

What are the clinical manifestations of separation anxiety disorder?

A
  • 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
28
Q

Who most commonly has separation anxiety disorder?

A

Children

29
Q

What are the clinical manifestations of panic disorder?

A
  • Sudden attacks of terror
  • Fear of one’s own unexplained symptoms
  • Intense worry about next attack
  • Can be debilitating if treatment is not sought
30
Q

What are the symptoms of sudden attacks of terror?

A
  • Pounding heart
  • Sweating
  • Fainting
  • Flushed or chilled
  • Chest pain
  • Sense of impending doom
31
Q

How long can a panic attack last?

A

A few moments to an hour

32
Q

When is treatment for an anxiety disorder not likely to occur at home?

A

When a patient has panic disorder

33
Q

What other treatments might need to be done in conjunction with treatment of anxiety disorder?

A

Treatment for substance abuse and/or depression

34
Q

What diagnostic test are done for anxiety disorders?

A
  • 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
35
Q

What is pharmacologic therapies used in conjunction with to control anxiety symptoms?

A

Psychotherapy

36
Q

What types of medications are the medications of choice used for anxiety disorders?

A

Antidepressants

37
Q

What types of medications are sparingly used to treat anxiety disorders?

A

anti anxiety meds

38
Q

When are anxiolytics used?

A

When anxiety begins to significantly affect daily activities

39
Q

What are the primary antidepressant medications used to reduce symptoms of panic and anxiety?

A

SSRIs

40
Q

What is the antidepressant prototype drug used for anxiety?

A

Escitalopram oxalate

41
Q

What is the mechanism of action for Escitalopram oxalate?

A

Increases availability of serotonin at specific postsynaptic receptor sites located within the CNS

42
Q

What is the primary use for Escitalopram oxalate?

A

Generalized anxiety and depression

43
Q

What are the adverse effects for Escitalopram oxalate?

A
  • Dizziness
  • Nausea
  • Insomnia
  • Somnolence
  • Confusion
  • Seizures
44
Q

What class does lorazepam belong to?

A

Benzodiazepines

45
Q

What is the mechanism of action for lorazepam?

A

binds to GABA receptor-chloride channel molecule, which intensifies GABA effects

46
Q

What is the primary use for lorazepam?

A

For anxiety disorders and insomnia

47
Q

What are the adverse effects for lorazepam?

A
  • Drowsiness
  • Dizziness
  • Respiratory depression
48
Q

What are the nonpharmacologic therapies for anxiety disorders?

A
  • Cognitive-behavior therapy
  • Herbal preparations
  • Massage, therapeutic touch therapy
  • Relaxation techniques
  • Yoga, meditation, acupuncture
  • Avoid caffeine
49
Q

What is involved in cognitive-behavioral therapy?

A
  • Teach client internal locus of control
  • Develop goal-oriented contracts
  • Help clients test reality
  • Coping tool kit
50
Q

What are the interventions to reduce the severity of symptoms of anxiety disorder?

A
  • Establishing rapport
  • Communicating therapeutically
  • Enhancing coping skills; identifying maladaptive ones
  • Promoting health
  • Providing a safe environment
51
Q

Which outcome is most realistic and appropriate when planning care for a client newly diagnosed with an anxiety disorder?

  1. Within 2 months, the client will discuss the reasons for episodes with significant others.
  2. Within 2 months, the client will be episode-free.
  3. Within 1 month, the client will experience decreased episodes.
  4. Within 2 months, the client will establish two new relationships.
A
  1. Within 1 month, the client will experience decreased episodes
52
Q

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:

  1. Remain with the client.
  2. Put the client in a room alone.
  3. Teach relaxation breathing exercises.
  4. Encourage the client to talk about the experience.
A
  1. Remain with the client

Exam 4 (13 decks)

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