Ch 19

Question 1

PTSD is more common in who

Answer 1

women than men

Question 2

Individuals who have difficulties with stress reactions to more “normal” events may be diagnosed with

Answer 2

adjustment disorder

Question 3

adjustment disorders…

Answer 3

quite common and can occur at any age.

Question 4

A reaction to an extreme trauma, which is likely to cause pervasive distress to almost anyone, such as natural or man-made disasters, combat, serious accidents, witnessing the violent death of others, being the victim of torture, terrorism, rape, or other crimes

Answer 4

PTSD

Question 5

symptoms of PTSD

Answer 5

depression, survivor’s guilt, nightmares, hypervigilence, anger, aggression, substance abuse, increased anxiety, relationship problems, amnesia to certain aspects of trauma, numbing of responsiveness, re-experiencing traumatic event

Question 6

when do symptoms of PTSD begin

Answer 6

can begin within first 3 ms to yrs after trauma

Question 7

Similar to PTSD in terms of precipitating traumatic events and symptomatology

Answer 7

acute stress disorder

Question 8

what is the time line for acute stress disorder

Answer 8

Symptoms are time limited: up to 1 month following the trauma.
If the symptoms last longer than 1 month, the diagnosis is PTSD.

Question 9

Seeks to explain why some individuals exposed to massive trauma develop PTSD while others do not

Answer 9

psychosocial theory

Question 10

Negative reinforcement leads to the reduction in an aversive experience, thereby reinforcing and resulting in repetition of the behavior.
Avoidance behaviors
Psychic numbing

Answer 10

learning theory

Question 11

A person is vulnerable to PTSD when fundamental beliefs are invalidated by experiencing trauma that cannot be comprehended and when a sense of helplessness and hopelessness prevail.

Answer 11

cognitive theory

Question 12

symptoms related to the trauma are maintained by the production of endogenous opioid peptides that are produced in the face of arousal, and which result in increased feelings of comfort and control.
When the stressor terminates, the individual may experience opioid withdrawal, the symptoms of which bear strong resemblance to those of PTSD.

Answer 12

biological aspects

Question 13

what are the biological factors of PTSD

Answer 13

Disregulation of the opioid, glutamatergic, noradrenergic, serotonergic, and neuroendocrine pathways may also be involved in the pathophysiology of PTSD.

Question 14

generally describes a philosophical approach that values awareness and understanding of trauma when assessing, planning, and implementing care.

Answer 14

trauma informed care

Question 15

nursing diagnoses for trauma related disorders

Answer 15

Post trauma syndrome

Complicated grieving

Question 16

client outcomes for trauma related disorders

Answer 16

Can acknowledge the trauma and the impact on his life
Can demonstrate adaptive coping strategies
Has made realistic goals for the future
Has worked through feelings of survivor’s guilt
Attends support group of individuals recovering from similar traumatic experiences
Verbalizes desire to put trauma in the past and progress with his or her life

Question 17

implementation for trauma related disorder

Answer 17

Reassurance of safety
Decrease in maladaptive symptoms
Demonstration of more adaptive coping strategies
Adaptive progression through the grieving process

Question 18

Characterized by a maladaptive reaction to an identifiable stressor or stressors that results in the development of clinically significant emotional or behavioral symptoms

Answer 18

adjustment disorder

Question 19

time line for adjustment disorders

Answer 19

Symptoms occur within 3 months of the stressor and last no longer than 6 months.
Exception: The “related to bereavement” subtype

Question 20

types of adjustment disorders

Answer 20

With depressed mood
With anxiety
With mixed anxiety and depressed mood
With disturbance of conduct
With mixed disturbance of emotions and conduct
Related to bereavement

Question 21

adjustment disorder nursing diagnoses

Answer 21

Complicated grieving
Risk-prone health behavior
Anxiety

Question 22

implementation for adjustment disorder

Answer 22

Adaptive progression through the grief process
Helping the client achieve acceptance of a change in health status
Assisting with strategies to maintain anxiety at a manageable level

Question 23

trauma related disorders treatments

Answer 23

Cognitive therapy
Prolonged exposure therapy
Group/family therapy
Eye movement desensitization and reprocessing
Psychopharmacology

Question 24

psychotherapy developed in 1989
this causes distraction which helps client to discuss trauma
biological mechanisms is unknown
very effective

Answer 24

EMDR (eye movement desensitization and reprocessing)

Question 25

what are the medications used for PTSD

Answer 25

SSRIs (antidepressants)- Paxil and Zoloft

these are the only FDA approved drugs for PTSD

Question 26

what is another med frequently prescribed for those struggling with PTSD

Answer 26

prazosin (Minipress)
effective for nightmares(helps with sleeping)
BP med that is not addictive

Question 27

what is NOT recommended for PTSD

Answer 27

benzos

Question 28

Which of the following medications is considered to be a first-line medication of choice in the treatment of PTSD?

Answer 28

paroxetine