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N363: Practice of Nursing IV > Exam 2: Anxiety > Flashcards

Exam 2: Anxiety Flashcards

1
Q

Anxiety (definition)

A

A sense of psychological distress

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2
Q

Is transient anxiety normal?

A

Yes, a normal response to job interviews, tests, walking into unfamiliar places, and other scenarios

Feeling anxious, frightened, uneasy, or worried are all normal responses to life experiences that are perceived as disruptive, threatening or dangerous

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3
Q

Anxiety provides what?

A

The motivation for achievement, a necessary force for survival

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4
Q

Are anxiety and stress the same thing?

A

No, they are commonly interchangeably used but they are not the same

Stress is not a disorder - it is a normal part of life with no good or bad connotations.

Often what causes anxiety is stress

Stress is more transient but anxiety will persistently persist even without a stressor

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5
Q

What does it mean when stress is described as individualized?

A

It is unique to each person and what one may perceive as stressful may not be perceived that way by others

Anxiety can present differently among people as well

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6
Q

Frequently stressors are cited as causes of anxiety, when the mind interprets events as threatening, the body…

A

Responds with the signs and symptoms of anxiety

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7
Q

Physiologic Response: Fight or Flight Changes

A

HR and BP Increase

Blood flow to muscles increase

RR increases

Perspiration and Blood Clotting Increases

Saliva Production, digestion, immune responses all decrease

energy producing stored glycogen is released

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8
Q

Anxiety as a ____

A

Continuum

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9
Q

What does it mean that anxiety acts as a continuum

A

It affect cognition, psychological, and physical functioning all while being rated as MILD, MODERATE, or SEVERE

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10
Q

Mild anxiety results in…

A

Improved functioning with heightened awareness

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11
Q

As anxiety increases beyond mild…

A

It interferes with all aspects of functioning

Cognitive functioning becomes distorted and the body must endure extended periods of high physical alertness

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12
Q

Anxiety Disorder

A

Group of conditions in which the affected person experiences persistent anxiety that cannot be dismissed

Coping mechanisms are ineffective

Anxiety interferes with ADLs

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13
Q

Persons with Anxiety feel…

A

The core of their personalities are threatened when there is no actual danger

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14
Q

How are anxiety and fear different?

A

Anxiety is an emotional process and fear is a cognitive one

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15
Q

Anxiety effects what 3 main things

A

Sensation

Cognition

Verbal Ability

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16
Q

Effects of Mild Anxiety

A

Heightens sensation, sight, hearing, able to learn and verbalize rationally

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17
Q

Effects of Moderate Anxiety

A

Begins to dull perceptions

Can attend to greater sensory input if directed

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18
Q

Effects of Severe Anxiety

A

Perceptions become increasingly distorted, become scattered, and disorganized

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19
Q

Effects of Panic (What comes after severe anxiety)

A

Perception grossly distorted

Cannot differentiate real from imaginary stimuli

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20
Q

When does anxiety require intervention?

A

When it is of greater than expected intensity based on context

When it prevents fulfillment of professional, personal, or social roles

When it is accompanied by flashbacks, obsessions, or compulsions

When you are unable to attend to daily and social activities

When it lasts longer than expected given the precipitating stress/events

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21
Q

What is the most common of all psychiatric illnesses?

A

Anxiety Disorders

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22
Q

Anxiety Disorders are more common in what groups?

A
  1. Women > Men
  2. Minority children and children from low SES environments at risk
  3. Those with familial predispositions
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23
Q

Adaptive and Maladaptive Coping Mechanisms for Anxiety

A

Withdrawal or retreating from the anxiety provoking situations

Acting out - discharging anxiety through aggression

Psychsomatization

Avoidance - evasive behaviors

Problem solving systematic method for addressing difficult situations

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24
Q

Psychosomatization

A

Physiologic expression of anxiety

25
Anxiety disorder barriers to treatment
Lack of knowledge r/t nature and prevalence Lack of knowledge of the positive response to treatments Social stigma Cost - 42 billion each year Misdiagnosis and untreated
26
2 Important Theories about Anxiety Disorders
Neurobiological Theories Psychological Theories
27
Neurobiological Theories about Anxiety Disorders
50% of all affected people have a similarly affected relative Genetic mutation with the development of COD Bodys ability to regulate serotonin and GABA are likely to lead to anxiety disorders Hippocampus - processing threatening stimuli and encoding information into memories Locus coeruleus - initiates responses to danger could be overactive potential for PTSD Striatum - area of the brain involved in motor control and thought to be involved with OCD
28
Psychological Theories about Anxiety disorders
Low self esteem Shyness Timid as a child Critical or angry parents Long term abuse Violence Poverty Anxiety resulting from conditioning - developed by linking dangerous or fear inducing events with a neutral event
29
Panic
Intense apprehension Terror without any real threat accompanied with somatic or cognitive symptoms The next level above anxiety
30
Characteristics of Panic
Over response to stressors Incorrectly perceives circumstances Can feel depersonalized, derealization Very debilitating and may feel out of body
31
Characteristics of Panic
Over response to stressors Incorrectly perceives circumstances Cognitive symptoms = can feel depersonalized, derealization Somatic symptoms = choking, dizziness, chest pain, sweating, vertigo, fainting, hot and cold flashes, fear of dying, going crazy
32
How long do panic attack last?
10-30 minutes all the way to continuing up to 1 Hour
33
Panic Disorder
Characterized by recurrent panic attacks, 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 Onset unpredictable
34
Agoraphobia
Characterized by the same symptoms of panic disorder In addition, the individual experiences FEAR of being in places or situations from which escape may be difficult or embarrassing or in which help might not be available in the event that a panic attack should occur
35
The limitations of panic disorder and agoraphobia become so severe...
It diminishes QOL and leads to depression
36
Generalized Anxiety Disorders (GAD)
Characterized by chronic, unrealistic, and excessive worry and anxiety for at least 6 MONTHS!!! So much discomfort causes interference with ADLs and relationships Persistent and chronic s/sx of muscle tension, autonomic hyperactivity, apprehension, feeling "on edge," inability to concentrate, chronic fatigue, impaired sleep patterns, and depression
37
Phobia
A persistent irrational fear attached to an object or situation that objectively DOES NOT POSE A DANGER May be simple and specific to certain situations, events, and objects Ex: acro (heights), calustro (closed spaces), etc
38
What is an important difference between panic attacks and phobias?
Panic attacks can be unpredictable; Phobias are ALWAYS anticipated and never unexpected
39
When phobias are accompanied with panic attacks that is a ....
Panic Disorder
40
Social Phobia
Compelling fear and desire to avoid situations that involve strangers or scrutiny from others Fear of speaking in front of others, eating, and using public bathrooms
41
Nursing Diagnoses for Panic Disorders
Panic and anxiety r/t real or perceived threat to biological integrity or self concept evidenced by inability to perform ADL's s/t ... Powerlessness r/t impaired cognition evidenced by inability to complete tasks of bathing s/t...
42
Goals for Treating Anxiety Disorders
The patient: - is able to recognize signs of escalating anxiety - is able to intervene so that anxiety does not reach levels of panic - is able to discuss long term plan to prevent panic or anxiety when stressful situations occur - practices techniques of relaxation daily - engages in physical exercise 3x a week
43
Obsessive Compulsive Disorder
Cluster C Personality Disorder - Anxious or Fearful Significant impairment and distress linked to an obsession and a compulsion to act on in order to reduce anxiety Not exactly an anxiety disorder as there is no real connection Can be mild or severe and if not treated can become so uncomfortable it can lead to depression or suicide
44
What sets OCD apart from an anxiety disorder?
OCD has compulsion linked to an obsession, and compulsions decrease anxiety related to the obsessions
45
OCD is time consuming, it takes up how much of a persons day?
More than 1 hour/day!
46
Obsessions
Recurrent, intrusive, persistent ideas, thoughts and impulses - cognitively invasive Usually clients see them as repugnant and meaningless but remain preoccupied with them
47
Compulsions
Ritualistic behaviors that clients are compelled to perform in order to prevent or reduce anxiety
48
Acute Stress Disorder
Occurs within the 1st month of exposure to extreme trauma like combat, rape, or physical assault Symptoms will begin shortly after the incidence with dissociation occurring with detachment, dream state, poor memory and dissociative amnesia of what was encountered Usually resolves within 2-28 days
49
Post Traumatic Stress Disorder
Acute Stress Symptoms continuing greater than 1 month with additional symptoms of generalized anxiety, intrusive thoughts, flashbacks, nightmares, sleep disturbances, and a need to avoid triggers Can cause low self asteem, loss of positive and trusting attitudes, and sense of being damaged
50
After ___ months, PTSD is considered chronic
3 months
51
Acute Stress Disorder usually resolves...
in 2-28 days
52
General Clinical S/Sx of all Anxiety Disorders
Substance abuse and use Barbiturate and benzodiazepine dependence Chronic relationship difficulties Frequent healthcare services for somatic complaints Negative outlook Obsessive or compulsive behaviors Eating disorders Sometimes can become healthcare dependent for their somatic complaints and issues
53
Diagnostic Testing for Anxiety Disorders
Testing should be done to rule out any underlying illnesses and stressors that could be leading to s/s related to anxiety Identification should be done as well to differentiate medical illness from anxiety - and once an anxiety disorder is identified the goal is to improve s/s and decrease recurrence
54
Treatments for Anxiety Disorders
CBT - recognize thoughts that cause anxiety - gain insight and learn new responses Relaxation - desensitization, replacing anxiety with relaxation responses Psychopharmacology - SSRIs, Buspirone, beta Blockers, TCAs Benzodiazepines
55
What is the issue in using Benzodiazepines for anxiety disorders?
They should only be used in the short term and at the lowest dose without discontinuing abruptly as it can cause dependence/withdrawal
56
Nursing Diagnoses for Stress and Anxiety Disorders
Anxiety r/t perceived threat or stress (state) Ineffective coping r/t inadequate individual resources (states) Ineffective breathing r/t hyperventilation r/t severe anxiety (state)
57
Desired outcomes for treatment of anxiety disorders
Patient will report a decrease in aggressive behaviors and a decrease in the intensity of anxiety Patient will report the effective use of coping strategies to deal with symptoms of anxiety Patient will demonstrate breathing techniques to control anxiety and hyperventilation
58
Successful management of an anxiety disorder involves...
Helping the client ID thoughts and behaviors that lead to anxiety, ID stressors, then finding effective coping strategies that are developed with the client and the nurse through a therapeutic and holistic approach

N363: Practice of Nursing IV (16 decks)

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