Anxiety, Obsessive compulsive, trauma and stressors related disorder Flashcards
Causes of panic disorder
Genetics
Biochemical: > norepinephrine & heightened sensitivity to somatic symptoms
Cognitive behavioral theory
Life events
Psychoanalytic theory
Pharmacologic therapy of panic disorders
Fast acting: Benzodiazepines
Longer term: SSRIs, SNRIs
Beta-blockers: < stress hormone
Causes of GAD
Genetics: imbalance in serotonin, norepinephrine, GABA, and glutamate
Biochemical abnormalities: > in blood lactate
Psychosocial & environmental factors: children of more anxious parents
Stress = trigger not cause
Symptoms of GAD
SOB, tachycardia, palpitations, sweating, irritability, fatigue, trembling, headache, poor concentration, excessive anxiety/worry over minor matters
Treatment of GAD
Cognitive therapy
Cognitive behavioral therapy
Biofeedback training
Pharmacologic therapy for GAD
Benzodiazepines
SSRIs
SNRIs
Treatment of social anxiety disorder
Negative thought stopping: rubber band
Desensitization therapy
Relaxation techniques
cognitive behavioral therapy
Pharmacologic therapy
Social anxiety disorder
SSRIs
beta adrenergic blockers
Nursing interventions
Social anxiety disorder
encourage interaction
Progressive muscle relaxation
Gradual desensitization
How they normally cope with fear
Symptoms of specific phobias
Severe anxiety, low self-esteem, depression, feelings of weakness
Pharmacologic therapy of specific phobias
Benzodiazepines
SSRI
Risk factors for PTSD
limited social supports
Parental neglect
High anxiety
Low self-esteem
Hx of psychiatric disorders
Symptoms of Acute stress disorder
Generalized anxiety, hyperarousal, avoidance of reminders of traumatic event, physical restlessness, sleep disturbances, poor concentration
Mixed disturbance of emotions and conduct adjustment disorders
depression, anxiety, and symptoms of conduct disorder
Causes of adjustment disorders
Dev. diabilities, intellectual disorders, genetics
Early childhood trauma, children in foster families
Transactional model of stress/adaptation: continuous stress/sudden stressor. Different type of trauma
Causes of anxiety disorder
Genetics
Biochemical factors: biological makeup
Neuroanatomic factors: brain atrophy & underdeveloped frontal and temporal lobes
Traumatic life events
Medical conditions: hyperthyroid, respiratory/cardiovascular
Nursing interventions for agoraphobia
Assertiveness skills: self-confidence, motivated
Discuss feared object or situation
Systematic desensitization program
Administering medications
Nursing interventions for specific phobias
discuss
Assertiveness skill
Relaxation & though stopping techniques
Medication
Causes of PTSD
Traumatic event
Imbalance of serotonin
What is acute stress disorder
Syndrome of anxiety and behavioral disturbances that occur within 4 weeks of an extreme trauma
Depressed mood adjustment disorders
Have depression every time dealing with change
Anxiety adjustment disorders
Symptoms of anxiety related to change
Related to bereavement adjustment disorders
Significant losses in family
What is panic disorder
Recurrent, unexpected panic attacks that occur without warning and cause intense apprehension and feelings of impending doom
Symptoms of panic disorder
Going crazy/feeling like dying
Last 1-30 min
Extreme anxiety & fear
Feelings of impending doom
Palpitations
Breathing difficulty
Chest pain
Nausea
Dizziness
Chills/hot flashes
Treatment of panic disorders
Patient teaching
Cognitive therapy
Deep breathing
Progressive relaxation techniques
Biofeedback
Guided imagery
Nursing interventions for panic disorders
Stay with pt until attack subsides
Reduce stimuli
Breathing techniques = < hyperventilation
Short, simple sentences
Encourage express feelings
Teach coping mechanisms
Definition of agoraphobia
Intense, excessive anxiety or fear about being places or situations from which escape might not be available
Causes of agoraphobia
Biochemical imbalances
Crowded place, open or closed place
Personality traits: introverted, dependent personalities
Symptoms of agoraphobia
Fear/avoidance of open/closed spaces
Fear of standing in line or being in a crowd
Fear of being outside the home
Fear of panic attack in public=embarrassment
Treatment for agoraphobia
SSRIs, SNRI, benzodiazepine, desensitization, implosive therapy-pictures and talk about their feelings about it
Generalized anxiety disorder
What do you need to do in order to be diagnosed?
Cause a disturbance in relationships, school, and work
What is cognitive therapy
Change ways of thinking so they are positive
What is cognitive behavior therapy?
Changing thinking and behaviors
Nursing interventions of GAD
Stay with pt if anxious
Encourage pt to discuss feelings
Reduce stimuli
Teach progressive muscle relaxation, guided imagery, deep breathing
Appropriate referrels
What is social anxiety disorder
Marked persistent fear/anxiety in social or performance situations
Thinking of how others are perceiving them
Causes of social anxiety disorder
Shyness & social inhibition
Parental and peer influences
Serotonin, dopamine, glutamate imbalance
Early traumatic event
Genetics
Brain structure
Societal expectations
Isolated upbringing
Symptoms of social anxiety disorder
Fear/avoidance of eating, writing, or speaking in public
Low self-esteem
Profuse sweating
Trembling
Difficulty talking
Worried about looking worried
Specific phobias
Trauma
Repeated warnings of danger about feared object/situation
Panic attacks when exposed
Learned behavior
Causes of specific phobias
Trauma
Repeated warnings of danger about feared object/situation
Panic attacks when exposed
Learned beahvior
Treatment for specific phobias
Cognitive behavioral therapy
Desensitization/exposure therapy
What is posttraumatic stress disorder
Considered a trauma and stressor related disorder, occurs after someone has witnessed or experienced a serious traumatic event
Symptoms of PTSD
Anger, poor impulse control, avoidance of people, places, and things, emotional detachment, depersonalization, difficulty concentrating, insomnia, hyper vigilance, social withdrawal, hopelessness, flashbacks, nightmare
Treatment of PTSD
Desensitization, relaxation techniques, CBT, psychotherapy, group therapy
Pharmacologic treatment of PTSD
SSRIs, SNRIs, TCA, MAOI
Nursing interventions for someone with PTSD
Establish a trusting relationship
Stay with pt during flashbacks and nightmares
Disturbance of conduct adjustment disorder
Have no regard for others, violent physical and emotional towards others. Break the law
Unspecific adjustment disorders
Doesn’t fit any other categories. General physical or somatic complaints
Ex. pain, stomachaches, headache related to change
What is obsessive compulsive disorder
Unwanted, recurrent, and intrusive thoughts or images which the person tries to alleviate through repetitive behaviors and mental acts
Behaviors have to take up more than 1 hour a day
Causes of obsessive compulsive disorder
Enlarged basal ganglia
Thought that fuels the compulsion to relieve anxiety
Genetics
Symptoms of obsessive compulsive disorder
Cleaning: rituals & fear of contamination
Symmetry: repeating, ordering, counting
Repetitive thoughts that cause stress
Repetitive behaviors
Perceived need to achieve perfection
Treatment of OCD
Behavior therapy
Allow behavior if not harmful in order to relieve anxiety. Later limit how much compulsion. Help them talk through anxiety and see they don’t need compulsion
Nursing interventions of OCD
Diversions
Accepting attitude
Give pt time to perform ritualistic behavior
Set reasonable limits
Effective coping skills
Identify progress & set realistic expectations
Substance induced anxiety disorder
Symptoms of anxiety related to their substance use disorder beyond side effects of taking substance
Body dysmorphic disorder
Preoccupied on a perceived defect on the body part
Trichotillomania
Anxiety causes hair pulling
Hoarding disorder
Difficulty with discarding any possessions
Seen with pt who had an extreme loss or lower socioeconomic status
