Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 202 Week 3 > Anxiety, Obsessive-Compulsive, & Related Disorders > Flashcards

Anxiety, Obsessive-Compulsive, & Related Disorders Flashcards

1
Q

Anxiety

  • Emotional process
  • Provides motivation
  • Response to a stressor
  • Normal vs abnormal
A

Levels

  • Mild
  • Moderate
  • Severe
  • Panic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Neurobiology of Anxiety Disorders: Neurotransmitters

?

↑ or ↓ serotonin

↑ or ↓ norepinephrine

↑ or ↓ gamma-aminobutyric acid (GABA)

A

↓

↑

↓

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Areas of the brain affected

?

Fear; particularly important in panic & phobia disorders

A

amygdala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

?

Arousal

A

Locus ceruleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

?

Associated with memory r/t fear responses

A

Hippocampus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

?

Respiratory activation; HR

A

Brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

?

Cognitive interpretations

A

Frontal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

?

Activation of stress response

A

Hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

?

Integration of sensory stimuli

A

Thalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

?

Tremor

A

Basal ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Epidemiological statistics

> most common of all psychiatric illnesses

> more common in women than in men by at least 2:1

> familial predisposition

A

> common comorbidities include another anxiety disorder, depression, & substance abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

?

  • persistent, unrealistic, & excessive anxiety
  • worry that have occurred more days than not for @ least 6 mos
  • cannot be attributed to specific organic factors
  • muscle tension, restlessness
  • procrastination, activity avoidance, seek reassurance
  • feeling keyed up or on edge

Clinically significant impairment in social, occupational, or other important areas of functioning

A

Generalized Anxiety Disorder (GAD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  • avoiding activities or events d/t a negative outcome or excessive preparation prior
  • affects decision-making; repeatedly seeking assurance from others
A
  • onset not common >20
  • tends to be chronic w/freq stress-related exacerbations & fluctuations in course of illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

?

  • recurrent panic attacks, onset unpredictable
  • intense apprehension, fear, terror, feelings of impending doom
  • intense physical discomfort
  • not triggered by situations in which the person is the focus of others’ attention
A

Panic Disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Panic Disorder

  • lasts min or rarely hrs; sx’s of depression common
    > avg age of onset of PD is late 20’s; remission & exacerbation periods
A

> risk factors: genetic vulnerability; tendency toward negative emotions; h/o childhood/sexual abuse; smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DSM V Criteria for Panic Disorders

At least 4 of the following sx’s must be present to identify the presence of a panic attack

A

Theories of Etiology Related to Panic & Generalized Anxiety Disorders

  • Psychodynamic Theory
  • Cognitive Theory
  • Biological aspects include
    1. Genetics
    2. Neuroanatomical
    3. Biochemical
    4. Neurochemical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Psychodynamic Theory

  • Conflict between id & superego that produces anxiety
A

Cognitive Theory

  • There’s distorted or counterproductive thinking patterns that accompany or precede maladaptive behaviors in emotional disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Neuroanatomical

  • Pathological involvement in temporal lobes
  • Dysfunction in limbic system (“emotional brain”) & frontocerebellar cortex have been noted in clients w/anxiety disorders
A

Biochemical

  • Abn elevations of blood lactate in those w/panic disorder
19
Q

?

A persistent, intensely felt, & irrational fear of a specific object, activity, or situation that results in a compelling desire to avoid the feared stimulus

  • Responses: intense anxiety or panic attacks
  • More often dx’d in women than men
A

Phobias

20
Q

Theories of Etiology Related to Phobias

  • Psychoanalytic Theory
  • Learning Theory
  • Cognitive Theory
  • Life experiences
  • Biological aspects include
    1. Neuroanatomical
    2. Temperament
A

Psychoanalytic Theory

> Freud’s theory of displacement

Learning Theory

> classical conditioning (Pavlov)

21
Q

Cognitive Theory

> A result of faulty thinking that may include negative self-statements & irrational beliefs

A

Neuroanatomical

  • Neurotransmitters
    > amygdala - “fight or flight” hormones

Temperament

  • May explain the idea of innate fears becoming phobias if reinforced from the past, e.g., childhood-dog-adulthood getting bit
22
Q

Specific phobias

?

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

  • more common in women than men
  • impairment interferes w/social or occupational functioning; causes marked distress

e.g., fear of speaking, eating in a public place, using a public restroom → sweating, tachycardia, dyspnea

A

Social Anxiety Disorder (Social Phobia)

23
Q

?

fear of being in places or situations from which escape might be difficult or in which help might not be available should panic sx’s occur

  • more common in women than men
  • can lead to isolation
A

Agoraphobia

24
Q

In both phobias, the fear, anxiety, or avoidance is persistent, typically lasting 6 mos or more for dx

A
25
Q

Anxiety Disorder due to Another Medical Condition & Substance/Medication-Induced Anxiety Disorder

direct physiological consequence of another medical condition, substance intoxication, or withdrawal, or exposure to a medication

A

Cardiac → MI, CHF, MVP

Endocrine → hypoglycemia, hypo or hyperthyroidism, pheochromocytoma

Respiratory → COPD, hyperventilation

Neurological → complex partial seizures, neoplasms, encephalitis

26
Q

?

  • obsessions, compulsions, or both
  • the severity of which is significant enough to cause distress or impairment in social, occupational, or other important areas of functioning
  • individual recognizes that the behavior is excessive or unreasonable
  • equally common among men & women
A

Obsessive-Compulsive Disorder

27
Q

?

Are defined by repetitive behaviors

Include hand washing, ordering, checking, or mental acts like praying, counting, and repeating words silently

Behaviors or mental acts are aimed at preventing or reducing anxiety & distress or preventing some dreaded event or situation

Not better explained by sx’s of another medical condition

Can impair social, occupational, & other areas of function

A

compulsions

28
Q

?

Recurrent & persistent thoughts, urges, or images that are experienced some time during the disturbance as intrusive & unwanted in that most individuals causes marked anxiety or distress

Can also be the individuals’ attempt to ignore or suppress such thoughts, urges, & images or to neutralize them w/some thought or action (e.g., by performing a compulsion)

A

obsessions

29
Q

Obsessions & compulsions are time consuming, usually >1 hr/day

A
30
Q

Other related disorders

  • Body Dysmorphic Disorder (client is not delusional)
  • Trichotillomania
    > not assoc w/alopecia
    > “hair-pulling” disorder (scalp, eyebrows, eyelashes)
  • Hoarding disorder
A

Assessment Scales

  • Hamilton Anxiety Rating Scale
    > clinician-administered
    > psychic & somatic sx’s
  • Beck Anxiety Inventory [self-administered]
  • Zung Self-Rated Anxiety Scale [self-administered]
31
Q

Nursing Diagnoses

A

Interventions & Outcomes

32
Q

Anxiety/Panic

  • Remain w/client
  • Calm approach
  • Simple, brief messages
  • Teach strategies for addressing hyperventilation
  • Provide low stimuli
  • Administer tranquilizing medication
  • Patient education (coping skills)
A

Fear

  • Explore the client’s perception of the threat
  • Discuss the reality of the situation
  • Encourage the client to explore underlying feelings
  • Specific techniques
33
Q

Ineffective Coping

  • Help client recognize factors that precipitate onset
  • Provide support & praise independent behaviors
  • Help client identify relationship between emotional problems & compulsive behaviors
  • Provide a structured schedule of activities
  • Gradually limit the amount of time allotted for ritualistic behavior
  • Educate on thought-stopping & relaxation
A

Disturbed Body Image

  • Assess the client’s perception of body image
  • Help w/recognition of misperception
  • Encourage verbalization of fears & anxieties
  • Involve the client in activities that reinforce a positive sense of self
34
Q

Ineffective Impulse Control

Defined as a pattern of performing rapid, unplanned reactions to internal or external stimuli w/o regard for the negative consequences of these reactions to the impulsive individual or to others

A
  • Support the client in his or her effort to stop behavior (e.g., hair pulling)
  • Provide a nonjudgmental attitude
  • Assist the client w/habit reversal training
  • Educate on stress management techniques
35
Q

Treatment Modalities

  • Individual Psychotherapy
  • Cognitive Therapy
  • Behavior Therapy
  • Psychopharmacology
A
36
Q

Anti-anxiety Agents (anxiolytics)

  • Limbic system & reticular formation, GABA
  • Benzodiazepines: short-term use
  • Buspirone: doesn’t depress CNS; for those w/anxiety disorder & addiction problem

! Interactions, contraindications

A
  • Caution w/ h/o drug abuse or addiction
  • Tolerance/dependence
  • Avoid abrupt withdrawal (e.g., sweating, agitation, tremors, N/V, delirium, seizures)
37
Q

Sedatives - Hypnotics

  • Anticonvulsants
  • Preoperative sedatives
  • Generalized CNS depression
A
  • Barbiturates
  • Eszopiclone (Lunesta), Zaleplon (Sonata), Zolpidem (Ambien) [nonbenzodiazepines]
38
Q

Medications for Panic and Generalized Anxiety Disorders (GAD)

  • Anxiolytics
  • Tricyclics - for Panic disorder; cause severe s/e @ high doses compared to SSRIs
    > clomipramine (Anafranil), imipramine (Tofranil)
  • SSRIs & SNRIs for GAD
A
  • SSRIs for Panic disorder
    > paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft)
  • SNRI - Venlafaxine (Effexor) for Panic disorder
39
Q

Anti-hypertensive agents
- beta blockers, alpha-2 receptor agonists to decrease anxiety; less effective on psychic sx’s, more somatic

A

Anticonvulsants
- pregabalin (Lyrica) [schedule V substance!]

40
Q

Clomipramine

1st rx approved by the FDA to treat OCD

! most selective for serotonin reuptake than any of the other tricyclics

A

! Benzodiazepines are not considered 1st line of treatment d/t abuse potential; have helped in social anxiety disorder

41
Q

Medications for Obsessive-Compulsive Disorder

Antidepressants/SSRI’s
- fluoxetine, paroxetine, sertraline, fluvoxamine (Luvox) (in increased doses to treat OCD)

A

Medications for Phobic Disorders

  • Anxiolytics
  • Antidepressants
  • Anti-hypertensive agents
42
Q

For anticipatory performance anxiety or stage fright:

> atenolol, propranolol [beta blockers]

A

For agoraphobia & social anxiety disorder:

imipramine [tricyclic]
phenelzine (Nardil) [MAOI]

43
Q

Medications for Body Dysmorphic Disorder

  • Antidepressants
  • clomipramine (tricyclic)
  • fluoxetine (SSRI)
A

Medications for Trichotillomania

  • SSRI (have shown moderate results)
44
Q

SSRI’s in OCD

  • SSRIs are more efficacious in OCD when used at high doses, in excess of the typical dose range
  • Also take longer to respond to SSRI monotherapy than do those of MDD; an adequate trial is 8-12 wks
A

Doses of up to:

40 mg of escitalopram (Lexapro)

80 mg of fluoxetine (Prozac)

100 mg of paroxetine (Paxil)

300 mg of fluvoxamine (Luvox)

NUR 202 Week 3 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions