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ATI Mental Health > MOD. 3 ATI ch. 11, 21, unit 4 > Flashcards

MOD. 3 ATI ch. 11, 21, unit 4 Flashcards

1
Q

Anxiety: Types of Disorders

A 
Separation Anxiety Disorder
Specific phobias
Agoraphobia
Social anxiety disorder
Panic disorder
Generalized anxiety disorder (GAD)
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2
Q

Separation Anxiety Disorder

A

client experiences excessive fear or anxiety when separated from an individual to which the client is emotionally attached.

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3
Q

Specific phobias

A

experiences an irrational fear of a certain object or situation. (ex. monophobia- phobia of being alone, xoophobia- phobia of animals, acrophobia- phobia of heights).

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4
Q

Agoraphobia

A

client experiences an extreme fear of certain places

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5
Q

social anxiety disorder

A

social phobia.

client experiences excessive fear of social or performance situations

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6
Q

panic disorder

A

client experiences recurrent panic attacks

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7
Q

generalized anxiety disorder (GAD)

A

client exhibits uncontrollable, excessive worry for at least 6 months.

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8
Q

Obsessive Compulsive Disorder

A

not actual anxiety disorders but have similar effects

effects: OCD, hoarding disorder, body dysmorphic disorder

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9
Q

Anxiety Risk Factors

A 
gender
hyperthyroidism
pulmonary embolism
adverse effects of meds.
substance-induced anxiety
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10
Q

Expected Findings of Anxiety Disorders

A 
separation anxiety disorder
specific phobias
agoraphobia
social phobia
panic disorder
generalized anxiety disorder
OCD
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11
Q

Expected Findings of Anxiety Disorders

A 
separation anxiety disorder
specific phobias
agoraphobia
social phobia
panic disorder
generalized anxiety disorder
OCD
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12
Q

generalized anxiety disorder (GAD) manifestations

A

restlessness

muscle tension

avoidance of stressful activities or events

increased time and effort required to prepare for stressful activities or events

procrastination in decision making

sleep disturbance

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13
Q

Anxiety screening tools

A 
Hamilton Rating Scale for Anxiety
Fear Questionnaire (phobias)
Panic Disorder Severity Scale
Yale-Brown Obsessive Compulsive Scale
Hoarding Scale Self-Report
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14
Q

Anxiety Medications

A

SSRI antidepressants
SNRI antidepressants
Antianxiety medications- benzodiazepines, buspirone, beta blockers, antihistamines, anticonvulsants

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15
Q

SSRI antidepressants

A

first line for anxiety and OCD

sertraline or paroxetine

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16
Q

SNRI antidepressants

A

effective in treatment of anxiety

venlafaxine or duloxetine

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17
Q

Other antianxiety meds.

A

benzos (diazepam)- indicated for short term
busiprone- taken for long-term use
beta blockers and antihistamines- to decrease anxiety
anticonvulsants- mood stabilizer for a client experiencing anxiety

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18
Q

Anxiety: Therapeutic Procedures

A

cognitive behavioral therapy

behavioral therapy

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19
Q

Cognitive behavioral therapy

A

decrease anxiety by changing cognitive distortions.
Uses cognitive reframing to help client identify negative thoughts that produce anxiety, examine the cause, and develop supportive ideas that replace negative self-talk.

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20
Q

Behavioral Therapy

A

teach clients ways to decrease anxiety or avoidant behavior and allow an opportunity to practice techniques.

relaxation therapy
modeling
systematic desensitization
flooding
response prevention thought stopping
21
Q

Relaxation training

A

control pain, tension, and anxiety.

22
Q

modeling

A

allows client to see a demonstration of appropriate behavior in a stressful situation. Goal is for client to imitate behavior

23
Q

systematic desensitization

A

begins with mastering of relaxation techniques. Then client is exposed to anxiety stimuli so they can use the techniques. Goal is for client to tolerate higher and higher levels of anxiety. Used a lot with phobias

24
Q

flooding

A

exposing the client to a great deal of undesirable stimulus in attempt to turn off anxiety response. Used for clients with phobias

25
Q

Response prevention

A

preventing client from performing a compulsive behavior with the intent that anxiety will diminish.

26
Q

thought stopping

A

teaches client to say “stop” and change thought to a positive thought. Goal is for client to silently use the command.

27
Q

Medications for Anxiety Disorders

A

Benzos.
Atypical anxiolytic/ non-barbiturate anxiolytics
Others

28
Q

Benzos. Sedative Hypnotic Anxiolytics

A

Lorazepam
Alprazolam
Clonazepam
Diazepam

29
Q

Atypical Anxiolytic/ non-barbiturate Anxiolytic

A

Busiprone

30
Q

Selected Antidepressants

A

Selective Serotonin Reuptake Inhibitors (SSRIs): paroxetine, sertraline, fluoxetine, citalopram, escitalopram, fluvoxamine

Serotonin norepinephrine reuptake inhibitors (SNRIs): venlafaxine, duloxetine, desvenlafaxine

31
Q

Other Anxiolytics used

A

other antidepressants:

  • tricyclic antidepressants (TCAs): amitriptyline, imipramine, clomipramine
  • monoamine oxidase inhibitorss (MAOIs): phenelzine
  • Antihistamines: hydroxyzine pamoate, hydroxyzine hydrochloride
  • Mirtazapine
  • Trazodone

Beta blockers: propranolol

Centrally acting alpha- blockers: Prazosin

Anticonvulsants: gabapentin, preabalin

32
Q

major meds to treat trauma-and-stressor related disorders

A

Antidepressants: SSRI, SNRI, tricyclic antidepressants, MAOI, noradrenergic and specific serotonergic antidepressant (NaSSA)
beta blockers
centrally acting alpha-blockers
centrally acting 2 agonists

33
Q

SSRIs for trauma and stressor-related disorders

A

paroxetine, sertraline, fluoxetine, escitalopram, fluvoxamine

34
Q

Anxiety (study guide)

A

normal response to stress. Subjective feeling that includes feelings of apprehension, uneasiness, uncertainty, or dread.

normal= healthy
acute= imminent loss of change that threatens one's sense of security
chronic= persists
35
Q

Mild Anxiety

A

tense experiences that occur in everyday life, increased ability to grasp information, sense of sight and sound are increased. Can be motivating, produce growth, enhance creativity and increase learning.
Physical symptoms- restlessness, irritability or mild tension

36
Q

Moderate Anxiety

A

focus is on immediate concerns.
Narrowed perceptual field, sense of sight and sound diminish as selective inattentiveness occurs.
Learning and problem solving still occur.
Physical= increased heart rate, perspiration, gastric discomfort, headache, urinary urgency, and or mild tremors.

37
Q

Severe Anxiety

A

feeling something BAD is about to happen. Significant narrowing of perceptual fields, focus is on minute or scattered details, all behavior is aimed at relieving anxiety.
Learning and problem solving are not possible
Physical= caused by stimulation of SNS; headache, nausea, dizziness, sleep disturbance, increased tremors, pounding HR, hyperventilation.

individual needs direction to focus

38
Q

Panic Anxiety

A

dread and tremor and sense of impending doom.
Disorganization, difficulty perceiving perception occurs,. Is unable to communicate or function effectively.
If prolonged it can lead to exhaustion and death.
Physical= increased motor activity; pacing, shouting, screaming, or withdrawal, impulsive or erratic behavior

39
Q

Interventions for Mild to Moderate Anxiety

A
  • help client identify source of anxiety
  • encourage client to talk about feelings and concerns
  • help client identify thoughts and feelings that occurred before the onset of anxiety
  • encourage problem solving
  • encourage gross motor exercise
40
Q

Interventions for Severe to Panic Anxiety

A
  • reduce anxiety quickly: use calm manner
  • ALWAYS REMAIN WITH CLIENT
  • minimize environmental stimuli, provide clear statements, use low pitched voice
  • Attend to physical needs
  • provide gross motor activity
  • administer meds. as prescribed
  • ensure safety
41
Q

Assessment of GAD

A

restlessness and inability to relax
episodes of trembling and shakiness, chronic muscular tension, dizziness, inability to concentrate
chronic fatigue and sleep problems
inability to recognize the connections between anxiety and physical symptoms
client focused on physical discomfort

42
Q

Agoraphobia

A

fear of open spaces

43
Q

Interventions for OCD and related disorders

A
  • ensure basic needs are met
  • identify situations that precipitate compulsive behavior
  • encourage client to verbalize concerns and feelings
  • Be empathetic toward the client and aware of their needs to perform compulsive behavior
  • DO NOT interrupt compulsive behavior UNLESS they’re unsafe
  • allow client to perform compulsive behavior but…
  • SET LIMITS
  • set schedule that distracts them
  • establish written contract that assists client to decrease frequency
  • recognize and reinforce positive non-ritualistic behaviors
44
Q

PTSD

A

after traumatic event, individual is prone to re-experience the event.

45
Q

PTSD:

Diagnosis

A

diagnosis- symptoms last at least 1 month and can occur months to years after the traumatizing events

46
Q

PTSD:

Assessment

A
  • avoidance or numbness
  • irritability or outbursts of anger
  • detachment
  • depression that may involve suicidal thoughts
  • anxiety
  • sleep disturbances and nightmares
  • flashbacks
  • hypervigilance
  • exaggerated startle response
  • guilt about surviving event
  • poor concentration and avoidance of activities
47
Q

PTSD:

Interventions

A
  • non-judgmental
  • ensure feelings and behaviors are normal reactions
  • help recognize association between feelings and behaviors and trauma
  • encourage feeling expression
  • provide individual therapy that addresses loss of control or anger issues
  • monitor for suicidal risk
  • teach stress management technique
  • encourage support group
  • facilitate progressive review of the trauma ( FLOODING )
  • encourage relationship establishments
  • include family
  • hypnotherapy/ systematic desensitization may be recommended

*** cancer patients may develop PTS - can occur anytime during or after treatment. Symptoms similar to PTSD but not as severe

48
Q

Suicidal:

assessment

A 
# assess if client is thinking of suicide
# SAD  PERSONS scale
# comments or signals can be overt (direct) or covert (indirect): ex. overt= "there is just no reason to go on living"
covert= "everything is looking pretty grim to me"
# assess client's suicide plan
# how lethal is the plan?
# can client describe plan exactly
# does client have access to intended method?
# has the mood changed? sad to happy can indicate intention to commit suicide

Physical assessment findings= lacerations, scratches, scars

49
Q

Suicide:

Nursing Care

A

Primary intervention- focus on suicide prevention through the use of community education and screenings to identify individuals at risk.

Secondary interventions- focus on prevention for a client who is having an acute suicidal crisis. Suicide precautions are included at this level.

Tertiary interventions- providing support and assistance to survivors of a client who completed suicide.

ATI Mental Health (8 decks)

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