Ch 18 Flashcards by Christina Stafstrom

an emotional response to anticipation of danger, the source of which is largely unknown or unrecognized

anxiety

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is anxiety a necessary force for survival?

yes

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an external pressure that is brought to bear on the individual

stressor

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is the subjective emotional response to that stressor

anxiety

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Anxiety may be distinguished from fear in that anxiety is…

an emotional process, whereas fear is a cognitive one

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who was the first to associate anxiety with neurotic behaviors?

Freud

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the most common of all psychiatric illnesses

anxiety disorders

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what are panic disorders characterized by

recurrent panic attacks, the onset of which are unpredictable and manifested by intense apprehension, fear, or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort

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anxiety may or may not be accompanied by

agoraphobia

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symptoms of panic attack

sweating, trembling, shaking
SOB, chest pain, discomfort
nausea, dizziness, chills, hot flashes
numbness, tingling sensations
fear of losing control and dying

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what are generalized anxiety disorder symptoms

WATCHERS

worry, anxiety, tension, concentration (lack of), hypervigilence, energy, restlessness, sleep (decrease)

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what is GAD characterized by

chronic, unrealistic, and excessive anxiety and worry

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Ego unable to intervene betweenid and superego

Overuse or ineffective use of ego defense mechanisms results in maladaptive responses to anxiety

psychodynamic theory

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Faulty, distorted, or counterproductive thinking patterns result in anxiety that is maintained by mistaken or dysfunctional appraisal of a situation

cognitive theory

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Fear of being in places or situations from which escape might be difficult or in which help might not be available in the event of panic-like symptoms or other incapacitating symptoms

agoraphobia

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examples of agoraphobia

Traveling in public transportation
Being in open spaces
Being in shops, theaters, or cinemas
Standing in line or being in a crowd
Being outside of the home alone in other situations

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Excessive fear of situations in which the affected person might do something embarrassing or be evaluated negatively by others

social anxiety disorder

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Fear of specific objects or situations that could conceivably cause harm, but the person’s reaction to them is excessive, unreasonable, and inappropriate

specific phobia

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exposure to phobic objects produces what symptoms

panic, including palpitations, sweating, dizziness, and difficulty breathing

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Unconscious fears may be expressed in a symbolic manner as phobia

psychoanalytic theory

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Fears are conditioned responses and thus are learned by imposing reinforcements for certain behaviors

learning theory

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Anxiety is the product of faulty cognitions or anxiety-inducing self-instructions

cognitive theory

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Characteristics with which one is born that influence how he or she responds throughout life to specific situations (e.g., innate fears)

temperament

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what may set the stage for phobic reactions later in life

early experiences

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Medical conditions that may produce anxiety symptoms

Cardiac Endocrine Respiratory Neurological

May be associated with intoxication or withdrawal from any of the following substances. Alcohol, sedatives, hypnotics, or anxiolytics Amphetamines or cocaine Hallucinogens Caffeine Cannabis

substance induced anxiety disorder

Recurrent obsessions or compulsions that are severe enough to be time-consuming or to cause marked distress or significant impairment

obsessive compulsive disoder

Recurrent thoughts, impulses, or images experienced as intrusive and stressful, and unable to be expunged by logic or reasoning

obsessions

Repetitive ritualistic behavior or thoughts, the purpose of which is to prevent or reduce distress or to prevent some dreaded event or situation

compulsions

Characterized by the exaggerated belief that the body is deformed or defective in some specific way

body dysmorphic disorder

common symptoms of body dysmorphic disorder

depression and obsessive-compulsive personality are common

what is hair pulling disorder also called

Trichotillomania

The recurrent pulling out of one’s own hair that results in noticeable hair loss Preceded by increasing tension and results in sense of release or gratification

trichotillomania

The persistent difficulty discarding possessions regardless of their value.

hoarding disorder

gender ratio for hoarding disorder

more men than women

Clients with OCD have weak, underdeveloped egos. Aggressive impulses are channeled into thoughts and behaviors that prevent the feelings of aggression from surfacing and producing intense anxiety fraught with guilt.

psychoanalytic theory

Conditioned response to a traumatic event Passive avoidance Active avoidance

learning theory

Psychosocial influences related to trichotillomania

Stressful situations Disturbances in mother-child relationship Fear of abandonment Recent object loss Possible childhood abuse or emotional neglect

Possible decrease in serotonin with what disorders

OCD and body dysmorphic disorder

Nursing diagnoses commonly associated with anxiety

``` Panic anxiety (panic disorder and GAD) Powerlessness (panic disorder and GAD) ```

nursing diagnoses commonly associated with OCD

``` Ineffective coping (OCD) Ineffective role performance (OCD) ```

nursing diagnoses commonly associated with body dysmorphic disorder

disturbed body image

nursing diagnosis commonly associated with hair pulling disorder

ineffective impulse control

nursing diagnoses commonly associated with phobias

``` Fear (phobias) Social isolation (agoraphobia) ```

client outcomes for GAD

Is able to recognize signs of escalating anxiety and intervene before reaching panic level Is able to maintain anxiety at manageable level and make independent decisions about life situation

client outcomes for phobias

Functions adaptively in the presence of the phobic object or situation without experiencing panic anxiety Verbalizes a future plan of action for responding in the presence of the phobic object or situation without developing panic anxiety

client outcomes for OCD

Is able to maintain anxiety at a manageable level without resorting to the use of ritualistic behavior Demonstrates more adaptive coping strategies for dealing with anxiety than ritualistic behaviors

implementation for anxiety

Maintain calm, nonthreatening approach. Keep the immediate surroundings low in stimuli. Teach the client signs of escalating anxiety.

implementation for fear

Include the client in making decisions. | Encourage the client to explore underlying feelings.

implementation for ineffective coping

Initially meet the client’s dependency needs. | Provide a structured schedule of activities.

implementation for disturbed body image

Help client see his or her body image is distorted. Involve client in activities that reinforce positive sense of self. Make referrals to support groups.

implementation for ineffective impulse control

Convey a nonjudgmental attitude. Practice stress management techniques. Offer support and encouragement.

When caring for a client who is experiencing a panic attack, which of the following nursing actions should be implemented?

communicate with simple words and brief messages

what are the two types of behavior therapy

Systematic desensitization | Implosion therapy

a treatment for phobias in which the patient is exposed to progressively more anxiety-provoking stimuli and taught relaxation techniques.

systematic desensitization

what meds are the first line given for anxiety

SSRIs (Zoloft and Lexapro)

this is an antihistamine used for anti anxiety

Hydroxyzine (Vistaril)

this is the only FDA approved med for anxiety | takes 4-6 weeks for full effects

Buspirone (Buspar)

these have many side effects and are very addictive (must sign waiver for responsibility)

Benzodiazepines

what are examples of Benzodiazepines

Xanax, Klonopin (Clonazepam)

describe Benzodiazepines

may cause dimentia, depression, hypotension alcohol + booze = you lose (DIE) LAST RESORT (short term basis, NOT long term) required by law to look at record of drug history

what is very important of all anti anxiety drugs

do not end abruptly (will cause seizures) be careful with BP (rise SLOWLY from lying/sitting position) can aggravate depression

what are the common side effects of antianxiety drugs

drowsiness, confusion, dependence, depression, orthostatic hypotension, paradoxical excitement, dry mouth, NV, blood dyscrasias

specific medications for panic and GAD

Anxiolytics Antidepressants Antihypertensive agents (Propanolol- for nerve wracking experiences like stage fright)

specific medications for phobic disorders

Anxiolytics Antidepressants Antihypertensive agents

medication for OCD and body dysmorphic disorder

Antidepressants

medications for hair pulling disorder

``` Chlorpromazine Amitriptyline Lithium carbonate Selective serotonin reuptake inhibitors and pimozide Olanzapine ```

What should the nurse plan to teach a client who is taking alprazolam (Xanax) three times a day?

That there is a potential for dependence and tolerance | Xanax is a benzodiazepine and has addictive properties

Ch 18 Flashcards

(68 cards)