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Psych Nursing > Ch 18 > Flashcards

Ch 18 Flashcards

1
Q

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

A

anxiety

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2
Q

is anxiety a necessary force for survival?

A

yes

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3
Q

an external pressure that is brought to bear on the individual

A

stressor

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4
Q

is the subjective emotional response to that stressor

A

anxiety

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5
Q

Anxiety may be distinguished from fear in that anxiety is…

A

an emotional process, whereas fear is a cognitive one

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6
Q

who was the first to associate anxiety with neurotic behaviors?

A

Freud

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7
Q

the most common of all psychiatric illnesses

A

anxiety disorders

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8
Q

what are panic disorders characterized by

A

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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9
Q

anxiety may or may not be accompanied by

A

agoraphobia

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10
Q

symptoms of panic attack

A 
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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11
Q

what are generalized anxiety disorder symptoms

A

WATCHERS

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

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12
Q

what is GAD characterized by

A

chronic, unrealistic, and excessive anxiety and worry

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13
Q

Ego unable to intervene betweenid and superego

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

A

psychodynamic theory

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14
Q

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

A

cognitive theory

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15
Q

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

A

agoraphobia

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16
Q

examples of agoraphobia

A 
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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17
Q

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

A

social anxiety disorder

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18
Q

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

A

specific phobia

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19
Q

exposure to phobic objects produces what symptoms

A

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

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20
Q

Unconscious fears may be expressed in a symbolic manner as phobia

A

psychoanalytic theory

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21
Q

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

A

learning theory

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22
Q

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

A

cognitive theory

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23
Q

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

A

temperament

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24
Q

what may set the stage for phobic reactions later in life

A

early experiences

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25
Q

Medical conditions that may produce anxiety symptoms

A

Cardiac
Endocrine
Respiratory
Neurological

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26
Q

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

A

substance induced anxiety disorder

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27
Q

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

A

obsessive compulsive disoder

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28
Q

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

A

obsessions

29
Q

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

A

compulsions

30
Q

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

A

body dysmorphic disorder

31
Q

common symptoms of body dysmorphic disorder

A

depression and obsessive-compulsive personality are common

32
Q

what is hair pulling disorder also called

A

Trichotillomania

33
Q

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

A

trichotillomania

34
Q

The persistent difficulty discarding possessions regardless of their value.

A

hoarding disorder

35
Q

gender ratio for hoarding disorder

A

more men than women

36
Q

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.

A

psychoanalytic theory

37
Q

Conditioned response to a traumatic event
Passive avoidance
Active avoidance

A

learning theory

38
Q

Psychosocial influences related to trichotillomania

A

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

39
Q

Possible decrease in serotonin with what disorders

A

OCD and body dysmorphic disorder

40
Q

Nursing diagnoses commonly associated with anxiety

A 
Panic anxiety (panic disorder and GAD)
Powerlessness (panic disorder and GAD)
41
Q

nursing diagnoses commonly associated with OCD

A 
Ineffective coping (OCD)
Ineffective role performance (OCD)
42
Q

nursing diagnoses commonly associated with body dysmorphic disorder

A

disturbed body image

43
Q

nursing diagnosis commonly associated with hair pulling disorder

A

ineffective impulse control

44
Q

nursing diagnoses commonly associated with phobias

A 
Fear (phobias)
Social isolation (agoraphobia)
45
Q

client outcomes for GAD

A

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

46
Q

client outcomes for phobias

A

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

47
Q

client outcomes for OCD

A

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

48
Q

implementation for anxiety

A

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

49
Q

implementation for fear

A

Include the client in making decisions.

Encourage the client to explore underlying feelings.

50
Q

implementation for ineffective coping

A

Initially meet the client’s dependency needs.

Provide a structured schedule of activities.

51
Q

implementation for disturbed body image

A

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.

52
Q

implementation for ineffective impulse control

A

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

53
Q

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

A

communicate with simple words and brief messages

54
Q

what are the two types of behavior therapy

A

Systematic desensitization

Implosion therapy

55
Q

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

A

systematic desensitization

56
Q

what meds are the first line given for anxiety

A

SSRIs (Zoloft and Lexapro)

57
Q

this is an antihistamine used for anti anxiety

A

Hydroxyzine (Vistaril)

58
Q

this is the only FDA approved med for anxiety

takes 4-6 weeks for full effects

A

Buspirone (Buspar)

59
Q

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

A

Benzodiazepines

60
Q

what are examples of Benzodiazepines

A

Xanax, Klonopin (Clonazepam)

61
Q

describe Benzodiazepines

A

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

62
Q

what is very important of all anti anxiety drugs

A

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

63
Q

what are the common side effects of antianxiety drugs

A

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

64
Q

specific medications for panic and GAD

A

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

65
Q

specific medications for phobic disorders

A

Anxiolytics
Antidepressants
Antihypertensive agents

66
Q

medication for OCD and body dysmorphic disorder

A

Antidepressants

67
Q

medications for hair pulling disorder

A 
Chlorpromazine
Amitriptyline
Lithium carbonate
Selective serotonin reuptake inhibitors and pimozide
Olanzapine
68
Q

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

A

That there is a potential for dependence and tolerance

Xanax is a benzodiazepine and has addictive properties

Psych Nursing (21 decks)

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