Exam 6 Anxiety

Question 0

Moderate anxiety

Answer 0

Tension, pounding heart, increased pulse rate and respiratory rate, perspiration, mild somatic symptoms, (gastric discomfort, headache, urinary urgency) voice tremors and shaking.

Question 1

Mild anxiety

Answer 1

Slight discomfort, restlessness, irritability, mild tension - relieving behaviors.

Question 2

Severe anxiety

Answer 2

Learning and problem solving not possible, dazed, confused. Behavior is automatic and aimed at reducing or relieving anxiety.

Question 3

Severe anxiety s/s

Answer 3

Headache, nausea, dizziness, insomnia, increased trembling, pounding heart, hyperventilation, sense of impending doom or dread.

Question 4

Panic

Answer 4

Pacing, running, shouting, screaming or withdrawal, hallucinations, or false sensory perception. Behavior erratic, uncoordinated and impulsive.

Question 5

Fear

Answer 5

Reaction to a specific danger.

Question 6

Anxiety

Answer 6

Is a human experience, basic emotion, vague sense of dread related to an unspecific or unknown danger.

Question 7

Normal anxiety

Answer 7

Is a healthy reaction necessary for survival.

Provides energy needed to carry out task involved in living and caring out goal

Question 8

Mild anxiety

Answer 8

Everyday living, allows an individual to perceive reality in sharp focus.

Question 9

Moderate anxiety

Answer 9

Perceptual field narrows, details are excluded. Ability to think clearly is hampered, but learning and problem solving can still take place just not at optimal levels.

Question 10

Severe anxiety

Answer 10

May focus on one particular detail or many scattered details. Have difficulty noticing what is going on around them even when it is pointed out to them.

Question 11

Panic

Answer 11

Most extreme level of anxiety. Results in markedly disturbed behavior. They can’t process what is going on around them.

Question 12

Phobia

Answer 12

A persistent irrational fear of a specific object, activity or situation that lead to a desire for avoidance or actual avoidance of the object, activity or situation

Question 13

Social phobia or social anxiety disorder. SAD

Answer 13

Severe anxiety or fear to social or performance situations.

Question 14

Obsession

Answer 14

Thoughts, impulses or images that persist and recur so that they cannot be dismissed.

Question 15

Compulsions

Answer 15

Ritualistic behaviors an individuals feels driven to preform in an attempt to reduce anxiety.

Question 16

GAD generalize anxiety disorder

Answer 16

Excessive anxiety or worry about numerous things, last for 6 months or longer.

Question 17

Post Traumatic Stress Disorder PTSD

Answer 17

Persistent re-experiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others. To which the individual responded with intense fear, helplessness or horror.

Question 18

Acute stress disorder. ASD

Answer 18

Resolves within 4 weeks. Occurs within one month after exposure to a highly traumatic event.

Question 19

Three symptoms of ASD

Answer 19

Subjective numbing, detachment, absence of emotional responsiveness

Question 20

Substance-Induced anxiety disorder

Answer 20

Symptoms of anxiety that develop with the use of a substance.

Question 21

Medical condition anxiety

Answer 21

Due to a direct medical condition such as hyperthyroidism

Question 22

Panic attack

Answer 22

Sudden onset of extreme apprehension or fear, usually associated with feeling of impending doom.

Question 23

Nursing intervention mild anxiety

Answer 23

+1.
Identify and discuss the source of the anxiety.
Promote problem solving
Tolerate and benefit from it.

Question 24

+2

Nursing intervention moderate anxiety

Answer 24

Encourage ventilation
Exercise
Help client focus
May need oral medication

Question 25

+3

Nursing interventions severe anxiety

Answer 25

Short simple commands
Decrease the anxiety provoking stimuli
Redirect the client
Seclude (time out)
May need IM injection

Question 26

+4

Nursing interventions panic

Answer 26

Guide firmly
Take physical control
IM medications 
Short, simply commands
Restrain as needed for safety of client and others.  Remember have to get doctors order for restraints.
Secure environment.

Question 27

Anti-anxiety medications

Answer 27

Anxiolytics 
CNS depressants.
Respiratory depression
Don't mix with other CNS depressants or alcohol.
Don't drive or use machinery
Avoid in pregnant of lactating women

Question 28

Ativan

Generic lorazepam

Answer 28

Given IV, PO IM
IV onset 3-5 minutes.
Caution in renal and hepatic impairment, myasthenia gravis, organic brain syndrome or Parkinson’s disease.
Contraindicated with narrow angle glaucoma.

Question 29

Xanax

Generic alprazolam

Answer 29

PO
Use withdrawal precautions - seizures or other strong withdrawal symptoms may occur with abrupt discontinuation.
Contraindicated with narrow angle glaucoma and per-existing hypotension.

Question 30

Valium

Generic diazepam

Answer 30

PO,IV,IM
Contraindicated in narrow angle glaucoma
Caution with other CNS depressants, low albumin levels, or hepatic disease.

Question 31

Buspar

Generic buspirone

Answer 31

PO
increases toxicity of digoxin and haldol
Adverse effects: dizziness, light headed ness
Avoid use in hepatic or renal impairment

Question 32

Paxil

Generic paroxetine

Answer 32

PO
contraindicated in concurrent administration with MAOIs or administering within two weeks of discontinuation of MAOIs.
Caution in history of seizures, mania, renal, or cardiac disease.

Question 33

Acute benzodiazepine toxicity

Answer 33

Benzodiazepine receptor antagonist may be given.

Such as Romazicon

Question 34

First tier alternate therapies for anxiety

Answer 34

Kava, inositol, magnesium, valerian, melatonin, chamomile, Passion flower

Question 35

Points to remember

Answer 35

Important to educate and be educated regarding side effects or adverse reactions.
Supposed to be natural does not mean its safe.
Always include vitamin supplements and herbals in list of patients medications

Question 36

Alternative therapies

Answer 36

Acupuncture
Cognitive behavior therapy
Acupressure
Massage therapy
Reduction of caffeine and stimulants

Question 37

Defense mechanisms and coping strategies

Answer 37

Response or adaptation to stress(anxiety).
May be conscious, usually unconscious response.
Responses vary with individual.
Some functional some dysfunctional. Vary in degrees.
Dysfunctional can increase anxiety.