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332 > Anxiety Disorders/Personality Disorders/Aggression > Flashcards

Anxiety Disorders/Personality Disorders/Aggression Flashcards

1
Q

What is GAD? What are some manifestations (4)? What is GAD not due to? In order to diagnose how many manifestations need to be present?

A

Persistent and excessive anxiety. Feeling restless, keyed up, fatigue, irritability. Substances, medical conditions (heart/resp problems), developmental disorder (FASD, ASD). Three or more.

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2
Q

What are obsessions? What are compulsions?

A

Ideas, intrusive and persistent thoughts. Behaviors that are performed repeatedly.

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3
Q

In all anxiety disorders people have insight into their irrational fears/obsessions/compulsions? True or false?

A

True

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4
Q

What is the treatment for OCD?

A

CBT and ERT

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5
Q

What is the underlying cause of all anxiety disorders?

A

Serotonin imbalance

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6
Q

What is social phobia? These people are highly sensitive to what?

A

Marked or intense fear of social situations. Criticism or disapproval.

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7
Q

Generalized vs Specific social phobia?

A

Specific = only avoid certain anxiety provoking situations. Generalized = avoid basically every social situation.

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8
Q

What is the first line of treatment for all anxiety disorders? And another treatment?

A

SSRI. CBT.

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9
Q

What is the treatment for specific phobias?

A

ERT

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10
Q

What is a panic disorder? How does a panic attack make a person feel? What do these people do to prevent attacks?

A

Fear of/presence of unexpected panic attacks. Person feels like they might be dying/having MI. Change behaviours.

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11
Q

What is agoraphobia?

A

Fear of leaving house/crowds

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12
Q

What type of medication can be effective for managing symptoms of a panic attackbut doesn’t treat the root cause?

A

Benzodiazepine

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13
Q

What disorders have ERT as treatments (3)

A

Agoraphobia, specific phobias, and OCD.

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14
Q

What is a therapeutic nursing response for a patient experiencing a panic attack?

A

“Slow down, you’re safe, take deep breaths”.

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15
Q

What is the first thing we need to get back to normal in someone having a panic attack?

A

Breathing.

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16
Q

What should a nurse do as an initial intervention to reorient a patient following a PTSD nightmare?

A

Stay with patient and reassure safety.

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17
Q

What is an acute stress disorder (ASD)?

A

Acute/transient response that is evident IMMEDIATELY after exposure to a traumatic event.

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18
Q

What is a risk factor for PTSD?

A

ASD

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19
Q

How long must someone deal with ASD before it is considered PTSD? (length of time for each to diagnose)

A

ASD is < 1 month. PTSD is > 1 month.

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20
Q

What are the four main categories of diagnostic criteria for someone with PTSD. How long must these manifestations be in place before the person can be diagnosed?

A

Re-experiencing (flash backs, nightmares), avoidance (avoiding things associated with the event), negative cognition/mood (self-blame, blame others, estrange from others), and arousal (hyperarousal, irritability, exaggerated startle response).

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21
Q

What is a priority nursing assessment of a patient with PTSD?

A

Suicide risk assessment.

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22
Q

What are the cluster A personality disorders (3)? Cluster A PD are described as…

A

Paranoid, schizoid, schizotypal. Odd/eccentric.

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23
Q

What are the cluster B personality disorders (4)? Cluster B PD are described as…

A

Borderline, histrionic, antisocial, and narcissistic. Dramatic/emotional.

24
Q

What are the cluster C personality disorders (3)? Cluster C PD are described as…

A

Dependent, avoidant, and obsessive-compulsive. Anxious/fearful.

25
Q

What are the main characteristics of paranoid personalty disorder (3)?

A

Mistrust of others, suspicious, and hold grudges/are litigious.

26
Q

Three main characteristics of schizoid PD?

A

Introverted/aloof, lack desire for intimacy, and euthymic (inability to feel because they just do not care).

27
Q

Three main characteristics of schizotypal PD?

A

Fixed delusions/odd beliefs/magical thinking, eccentric, flat/incongruent emotional responses.

28
Q

Three main characteristics of borderline PD?

A

Pervasive pattern of unstable relationships, affective instability, impulsivity.

29
Q

What is the biggest fear of a person with borderline PD?

A

Rejection/abandonment.

30
Q

Individuals with BPD are more likely to take part in what kind of activities?

A

Self-injurious behaviour/self-mutilation/self-harm.

31
Q

People with BPD - self-injurious behaviours are what? Why does this make them feel good? Is this done for attention?

A

Maladaptive coping mechanism. Makes them “feel”, a way to reconnect with their body. Endorphins are released and they feel calm/pleasure. No.

32
Q

First line treatment for BPD?

A

Dialectical Behavior Therapy

33
Q

Three main characteristics of antisocial PD?

A

Lack remorse, pervasive pattern of disregard for and violation of others’ rights, easily irritated/aggressive.

34
Q

When can someone with antisocial PD be diagnosed? What must they have in order to be diagnosed?

A

18 years old. Must have a history of conduct disorder before age of 15.

35
Q

People with antisocial PD are more likely to engage in what?

A

Alcohol/drug abuse.

36
Q

Three main characteristics of histrionic PD?

A

Attention-seeking, persistent need for approval, and are outwardly charming, but have threatened self-esteem.

37
Q

People with histrionic PD have likely experienced what?

A

Abuse.

38
Q

Three main characteristics for narcissistic PD?

A

Inexhaustible need for admiration, grandiose sense of importance, strong sense of entitlement.

39
Q

Three main characteristics for avoidant PD?

A

Avoid social situations, extremely low self-esteem, timid/shy.

40
Q

Three main characteristics of dependent PD?

A

Adapt behavior to please others, let others assume responsibility for their decisions, extreme fear of separation.

41
Q

What is someone with dependent PD vulnerable to?

A

Abuse

42
Q

What has someone with dependent PD likely experienced?

A

Abuse

43
Q

Three main characteristics of obsessive-compulsive PD?

A

Preoccupied with orderliness, difficulty delegating tasks, perfectionist.

44
Q

What two ways can anger be expressed? Give examples of each

A

Verbal: yelling. Behavioural: clenching fists.

45
Q

What is the number 1 risk factor for aggression?

A

Perceived disrespect.

46
Q

How do we know behavior is escalating? STAMP…

A

Staring, Tone of voice, Anxiety, Mumbling, Pacing

47
Q

What is Trauma Informed Practice (TIP)?

A

Takes in account that trauma experiences overwhelm an individual’s capacity to cope.

48
Q

What types of trauma are there (5)? Example of each?

A

Single incident trauma - accident. Complex/repetitive trauma - ongoing abuse. Developmental trauma - child neglect. Intergenerational trauma - child of abused parent. Historical trauma - holocaust.

49
Q

What is toxic stress? Who does this affect? What can these people end up with in the long-run?

A

Continuous stress-response (fight or flight/ANS) even when no harm is apparent. The person is permanently on high-alert. Children. Children can get learning disabilities.

50
Q

What are good responses to aggressive behavior (8)?

A

Assess triggers, identify/treat underlying cause, detect early signs of agitation, stance, space, allow patient to express frustration, body language (open posture), and validate emotions.

51
Q

What are some things we can do to de-escalate aggressive behavior (6)?

A

Calm, respectful, awareness of verbal/non-verbal communication, decrease stimulus, offer choice, no touching patient.

52
Q

6 interventions for aggressive behaviour (least resistive to most resistive)?

A

Redirection, remove unsafe things from environment (things patient can throw), use PRN (opioid for withdrawal, nicotine patch), chemical restraint (PRN specifically ordered for sedation), seclusion, physical restraint.

53
Q

How long does an RN have to get a cover order for restraints after implementing them?

A

12 hr

54
Q

How often does a patient with restraints need to be monitored?

A

q 15-60 min, or 1:1 nursing.

55
Q

Why are behavioral care plans good? (4)

A

Maintain safety of pt/staff, reduce frequency/intensity of aggressive behavior, prevent secondary complications from aggressive behavior, and can integrate violence prevention strategies into CP.

56
Q

What are 5 predictors of violence?

A

Brain injury, substance abuse, missed doses of meds, and history of aggressive behavior.

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