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Townsend Psychiatric > Pg3-30 > Flashcards

Pg3-30 Flashcards

1
Q

Fight or flight syndrome

A

A syndrome of physical symptoms that result from an individual’s real or perceived notion that harm or danger is imminent

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2
Q

Define general adaptation syndrome and three stages

A

The general biological reaction of the body to a stressful situation, as described by Hans Selye. It occurs in three stages: the alarm reaction stage, the stage of resistance, and the stage of exhaustion.
Alarm reaction stage: during this stage,the physiological responses of the fight or flight syndrome are initiated.
Stage of resistance: the individual uses the physiological responses of the stage as a defense in the attempt to adapt to the stressor. If adaptation occurs, the third stage is prevented or delayed. Physiological symptoms may disappear.
Stage of exhaustion: this stage occurs when there is prolonged exposure to the stressor to which the body has become adjusted. The adaptive energy is depleted, and the individual can no longer draw from the resources for adaptation described in the first two stages. Diseases of adaptation (headaches, mental disorders, coronary artery disease, ulcers, colitis) May occur. Without intervention for reversal, exhaustion, and in some cases even death, ensues.

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3
Q

Stressor

A

A biological, psychological, social, or chemical factor that causes physical or emotional tension and maybe a factor in the etiology of certain illnesses.

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4
Q

Core concept: adaptation

A

Adaptation is set to occur when an individual’s physical or behavioral response to any change in his or her internal or external environment results in preservation of individual integrity or timely return to equilibrium.

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5
Q

What are the three concepts of stress

A

Stress as a biological response, stress as an environmental event, and stress as a transaction between the individual and the environment

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6
Q

What LCU score indicates a high level of recent life stress

A

500

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7
Q

Can stress be From something positive

A

Yes

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8
Q

Why have life changes questionnaires been criticized

A

They do not consider the individuals perception of the event, It fails to consider the individuals coping strategies and available support system at the time when the life change occurs

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9
Q

Precipitating event

A

A precipitating event is a stimulus arising from the internal or external environment and is perceived by the individual in a specific manner

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10
Q

Cognitive appraisal

A

And individuals evaluation of the personal significance of the event or occurrence

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11
Q

Cognitive response

A

Consists of a primary appraisal and a secondary appraisal

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12
Q

Three types of primary appraisal and define all

A

Irrelevant, benign-positive stressful
Irrelevant: when the outcome holds no significance for the individual

Benign-positives: outcome is one that is perceived as producing pleasure for the individual

Stress: appraisals include harm/loss, threat, and challenge. Harm/loss appraisals refer to damage or loss already experienced by the individual, Threatening appraisals are perceived as anticipated harms or losses, challenging appraisals are when the individual focuses on potential for gain or growth, rather then on risks associated with the event.

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13
Q

What happens when stress is produced in response to harm/loss, threat, or challenge?

A

A secondary appraisal is made by the individual

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14
Q

What is a secondary appraisal

A

An assessment of skills, resources, and knowledge that the person possesses to deal with the situation

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15
Q

What are predisposing factors

A

A variety of elements that influence how individual perceives and response to a stressful event. Types of predisposing factors include genetic influences, past experiences, existing conditions.

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16
Q

What are genetic factors

A

Circumstances of an individual’s life that are acquired through heredity. examples: family history of physical and psychological conditions, both strengths and weaknesses, and temperament – behavioral characteristics present at birth that involved with development

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17
Q

What are past experiences

A

Occurrences that result in learned patterns That can influence individuals adaptation response. Including- previous exposure to the stressor or other stressors, learned coping responses, and the degree of adaptation to previous stressors

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18
Q

What are existing conditions

A

Incorporate vulnerability that influence the adequacy of the individuals physical, psychological, and social resources for dealing with adaptive demands. Examples include current health status, motivation, developmental maturity, severity and duration of the stressor, financial and educational resources, age, existing coping strategies, and a support system of caring others.

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19
Q

When are coping strategies adaptive?

A

When they protect the individual from harm or strengthen the individuals ability to meet challenging situations.

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20
Q

What do adaptive responses help restore and what do they in impede?

A

To restore homeostasis and impede the development of diseases of adaptation

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21
Q

When are coping strategies considered maladaptive?

A

When the conflict being experienced goes under unresolved or intensifies.

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22
Q

What are the results of maladaptation

A

Energy resources become depleted as the body struggles to compensate for the chronic physiological and psychological arousal being experienced. Effect is a significant vulnerability to physical and psychological illness.

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23
Q

What is maladaptation

A

It occurs when an individual’s physical or behavioral responses to any change in his or her internal or external environment results in disruption of individual integrity or persistent disequilibrium

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24
Q

Name seven adaptive coping strategies

A

Awareness, relaxation, meditation, interpersonal communication with a caring other, problem-solving, pets, music.

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25
Q

What is awareness

A

The initial step in managing stress.. to become aware of the factors that create stress and the feelings associated with a stressful response. Stress can be controlled only when one recognizes that is that it is being experienced. As one becomes aware of stressors he or she can omit, avoid, or accept them.

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26
Q

How often should a person meditate to produce a lasting reduction in blood pressure and other stress – related symptoms

A

20 minutes once or twice daily

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27
Q

What could someone do if they didn’t feel they had someone they could talk to (Interpersonal communication with caring other)

A

Write in a journal or diary

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28
Q

What are the eight steps of problem-solving

A
  1. Assess the facts of the situation.
  2. formulate goals for resolution of the successful situation.
  3. study the alternatives for dealing with the situation
  4. determine the risks and benefits of each alternative.
  5. Select an alternative
  6. implement the alternative selected.
  7. Evaluate the outcome Of the alternative implemented.
  8. If the first choice is ineffective, select and implement the second option.
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29
Q

What do studies show that those who care for pet, especially dogs, are better able to cope with

A

Stressors of life

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30
Q

What did studies show about per owners who had heart attacks

A

They had 1/5 the death rate of those who did not have pets

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31
Q

What happens when individuals remain in a state of aroused response to stress for an extended period of time?

A

They become susceptible to diseases of adaptation, some examples of which include headaches, mental disorders, coronary artery disease, ulcers and colitis.

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32
Q

Name 3 limitations of this concept of stress

A

Failure to consider the individuals perception of the event, coping strategies, and available support systems at the time when life change occurs

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33
Q

Sondra, who lives in Maine, hears on the evening news that 25 people’s were killed in a tornado in south Texas. Sondra experiences no anxiety upon hearing of this stressful situation. This is most likely because Sondra:
A. Is selfish and doesn’t care what happens to other people
B. appraises the event as irrelevant to her own situation
C. Assesses that she has the skills to cope with the stressful situation
D. Uses suppression as her primary defense mechanism

A

B

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34
Q

Cindy regularly develops nausea and vomiting when she is faced with a stressful situation. Which of the following is most likely a predisposing factor to the maladaptive response by Cindy?
A.cindy inherited her mother’s nervous stomach
B. Cindy is fixed in a lower level of development
C. Cindy has never been motivated to achieve success
D. When Cindy was a child, her mother pampered her and kept her home from school when she was ill

A

D

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35
Q 
When an individuals stress response is situated over a long period, the endocrine system involvement results in which of the following:
A. Decreased resistance to disease
B. increased libido
C. Decreased blood pressure 
D. Increased inflammatory response
A

A

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36
Q

Management of stress is extremely important in today’s society because:
A.evolution has diminished human capability for fight or flight
B. the stressors of today tend to be ongoing, resulting in sustained response
C. We have stress disorders that did not exist in the days of our ancestors
D. One never knows when one will have to face a grizzly bear or saber-toothed tiger in today’s society

A

B

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37
Q 
Nancy has just received a promotion on her job. She is very happy and excited about moving up in her company, but she has been experiencing anxiety since receiving the news. Her primary appraisal is that she most likely views the situation as which of the following?
A. Benign-positive
B. irrelevant
C.challenging
D. Threatening
A

C

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38
Q 
Precipitating stressors, past experiences, existing conditions, and genetic influences are components of the transactional model of stress adaptation, and influence an individuals response to stress identify each of these conditions in the following examples:
A. Precipitating stressors
B. past experience
C. Existing conditions
D. Genetic influences

____ mr t is on a lower level of development
____ mr t’s father has diabetes mellitus
____ mr t has been fired from his last five jobs
____ mr t’s baby was stillborn last month

A

C, d, b, a

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39
Q

Mental health

A

The successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate incongruent with local and cultural norms.

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40
Q

Mental illness

A

Maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms, and interfere with the individuals social, occupational, and/or physical functioning.

41
Q

When did psychiatric care plant it’s roots

A

In ancient times, when etiology was based in superstition and ideas related to the supernatural.

42
Q

Describe primitive psychological treatment

A

Brutal beings, starvation, or other torturous means

43
Q

Who began the movement of psychiatric care away from the belief in the supernatural?

A

Hippocrates

44
Q

What did Hippocrates associate insanity with

A

An irregularity in the interaction of the 4 body fluids– blood, blac bile, yellow bile, and phlegm

45
Q

How would Hippocrates treat insanity

A

Induction of vomiting and diarrhea with potent cathartic drugs

46
Q

Ship of fools

A

The term given during the middle ages to sailing boats filled with severely mentally ill people who were sent out to sea with little guidance and in search of their lost rationality

47
Q

Was the father of American psychiatry

A

Benjamin Rush

48
Q

For the first people to consider mentally ill patients actually ill

A

Middle eastern Islamic countries

49
Q

What did Benjamin Rush do

A

He was a doctor in the first hospital to admit mentally ill clients in Philadelphia. Initiated the provision of humanistic treatment and care for the mentally ill, including kindness, exercise, and socialization, he also employed harsher methods such as bloodletting, purging, various types of physical restraints, and extremes of temperatures, reflecting the medical therapies of that era

50
Q

Who is Dorothea Dix

A

19th-century New England schoolteacher who lobbied on behalf of of the mentally ill population bringing about the establishment of a system of state asylums

51
Q

When did the emergence of psychiatric nursing begin

A

1873

52
Q

Who is the first American psychiatric nurse

A

Linda Richards from the nursing program at the New England Hospital for women and children in Boston

53
Q

When and where was the first school psychiatric nursing

A

The McLean Asylum in Waverly Massachusetts in 1882

54
Q

How did Maslow describe self-actualization

A

Psychologically healthy, fully human, highly evolved, and fully mature.

55
Q

List the six indicators that suggests a reflection of mental health per Jahoda

A

A positive attitude toward self, growth development and the ability to achieve self actualization, integration, autonomy, perception of reality, environmental mastery.

56
Q

Certain elements are associated with individuals perceptions of mental illness. Identify 2 of these elements

A

Incomprehensibility and cultural relativity

57
Q

Incomprehensibility

A

Relates to the inability of the general population to understand the motivation behind the behavior

58
Q

Cultural relativity

A

Considers that the rules, conventions, and understandings used to interpret behavior are conceived within ones culture

59
Q

Anxiety

A

A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness

60
Q

Name 4 levels of anxiety

A

Mild, moderate, severe, and panic

61
Q

Describe mild anxiety

A

Associated with the tension experienced in response to the events of day to day living. Seldom a problem for the individual. Prepares people for action. Sharpens the senses, increases motivation productivity, increases the perceptual field, and results in heightened awareness. Learning is enhanced. Functioning is at optimal level.

62
Q

Describe moderate anxiety

A

Moderately anxious individual is less alert to events occurring in the environment. Individuals attention span and ability to concentrate decrease. Assistance with problem-solving may be required. Increased muscular tension and restlessness are evident.

63
Q

Describe severe anxiety

A

Perceptual field is so greatly diminished concentration centers on one particular detail only or on many extraneous details. Attention span extremely limited. Difficulty completing even the simplest task. Physical symptoms include headaches, palpitations, insomnia. Emotional symptoms consist of confusion, dread, and horror. Discomfort experienced to the degree that virtually all overt behavior is aimed at relieving anxiety.

64
Q

Describe panic anxiety

A

Unable to focus on even one detail in the environment. Misperceptions are common, loss of contact with reality may occur. May experience hallucinations or delusions. Characterized by wild desperate actions or extreme withdrawal. Functioning and communication with others is ineffective. Associated with a feeling of terror. Individuals make it be convinced that they have a life-threatening illness or fear that they are going crazy or losing control. Prolonged panic anxiety can lead to physical and emotional exhaustion. Can be a life-threatening situation.

65
Q

Behavioral adaptation responses to mild anxiety

A

Sleeping, eating, yawning, drinking, physical exercise, smoking, crying, pacing, foot swinging, fidgeting, daydreaming, laughing, cursing, nailbiting, finger tapping, talking to someone with whom one feels comfortable.

66
Q

behavioral adaptation responses for mild to moderate anxiety

A

Ego defense mechanisms

67
Q

What are defense mechanisms used as

A

A protective device for the ego in an effort to relieve mild to moderate anxiety. Become maladaptive when they are used by individual to such a degree that there is interference with the ability to deal with reality, with effective interpersonal relations, or with occupational performance.

68
Q

What does maladaptive use of defense mechanisms promote

A

Disintegration of the ego

69
Q

Name the 15 defense mechanisms

A

Compensation, denial, displacement, identification, intellectualization, introjection, rationalization, reaction formation, regression, depression, subordination, depression, isolation, projection, undoing

70
Q

Compensation

A

Covering up a real or perceived weakness by emphasizing the trait one considers more desirable
Example: a physically handicapped boy is unable to participate in football, so we compensates by becoming a great scholar

71
Q

Denial

A

Refusing to acknowledge the existence of a real situation or the feelings associated with it
Example: woman drinks alcohol every day and cannot stop, failing to acknowledge that she has a problem.

72
Q

Displacement

A

The transfer of feelings from one target to another that is considered less threatening or that is neutral
Example: client is angry with his physician, but does not express it, because verbally abusive with the nurse.

73
Q

Identification

A

An attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires
Example: a teenager who required lengthy rehabilitation after an accident decides to become a physical therapist as a result of his experiences

74
Q

Intellectualization

A

An attempt to avoid expressing actual emotions associated with a stressful situation but using the intellectual process of logic, reasoning, and analysis
Example: a patient’s husband is being transferred with his job to the city far away from her parents. She hides anxiety by explaining to her parents the advantages associated with the move.

75
Q

Introjection

A

Integrating the beliefs and values of another individual into one’s own ego structure

76
Q

Rationalization

A

Attempting to make excuses Or formulate logical reasons to justify unacceptable feelings or behaviors
Example: John tells the rehab nurse I drink because it’s the only way I can deal with my bad marriage and my worse job

77
Q

Reaction formation

A

Preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behavior
Example: Jane hates nursing. She attended nursing school to please her parents. During career day, she speaks to prospective students about the excellence of nursing as a career.

78
Q

Regression

A

Retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning
Example: when 2-year-old Jay is hospitalized for tonsillitis he will drink only from a bottle, even though his mom states he’s been drinking from a cup for six months.

79
Q

Repression

A

Involuntarily blocking unpleasant feelings and experiences from one’s awareness
Example: an accident victim can remember nothing about his accident

80
Q

Sublimination

A

Rechanneling of drives or impulses that are personally or socially unacceptable into activities that are constructive
Example: a mother whose son was killed by drunk driver channels her anger and energy into being the president of the local chapter of MADD

81
Q

Suppression

A

The voluntary blocking of unpleasant feelings and experiences from one’s awareness
Example: Scarlett O’Hara says ‘ I don’t want to think about that now. I’ll think about that tomorrow. ‘

82
Q

Isolation

A

Separating a thought or memory from the feeling tone, or emotion associated with it
Example: a young woman describes being raped with no emotion

83
Q

Projection

A

Attributing feelings or impulses unacceptable to one’s self to another person
Example: Sue feels a strong sexual attraction to her track coach and tells her friend he’s coming on to her

84
Q

Undoing

A

Symbolically negating or canceling out an experience that one finds intolerable
Example: Joe is nervous about his new job and yells at his wife. On his way home he stops and buys her some flowers.

85
Q

Behavioral adaptation responses to moderate to severe anxiety

A

Can contribute to a number of physiological disorders if left unresolved over an extended period of time. Psychological and behavioral factors may affect the course of almost every major category of disease, including cardiovascular conditions, dermatological conditions, endocrinological conditions, gastrointestinal conditions, neoplastic conditions, neurological conditions, pulmonary conditions, renal conditions, and rheumatological conditions.

86
Q

Behavioral adaptation responses to severe anxiety

A

Can result in psychoneurotic patterns of behaving. The following disorders are examples of psychoneurotic responses to severe anxiety: Anxiety disorders, somatoform disorders, dissociative disorders

87
Q

Define anxiety disorders

A

Disorders in which the characteristic features are symptoms of anxiety and avoidance behavior. Examples are: phobias, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, posttraumatic stress disorder.

88
Q

Define somatoform disorders

A

Disorders in which the characteristic features are physical symptoms for which there is no demonstratable original pathology. Psychological factors are judged to play significant role in the onset, severity, exacerbation, or maintenance of the symptoms. Symptoms include: hypochondriasis, conversion disorder, somatization disorder, pain disorder.

89
Q

Describe dissociative disorders

A

Disorders in which the characteristic feature is a disruption in the usual integrated functions of consciousness, memory, identity, or perception of the environment. Examples include – dissociative amnesia, dissociative fugue, dissociative identity disorder, and depersonalization disorder.

90
Q

Psychosis

A

A loss of ego boundaries or gross impairment in reality testing. Psychoses are seriously psychiatric disturbances characterized by the presence of delusions or hallucinations in the impairment of interpersonal functioning in relationship to the external world.

91
Q

At what level of anxiety would you find psychosis

A

Panic anxiety

92
Q

What are examples of psychotic responses to anxiety

A

Schizophrenic, schizoaffective, and delusional disorders

93
Q

Grief

A

Grief is a subjective state of emotional, physical, and social responses to the loss of valued entity

94
Q

Describe the normal mourning process

A

It is adaptive and characterized by feelings of sadness, guilt, anger, helplessness, hopelessness, and despair

95
Q

Is it normal to experience mourning after a loss

A

Yes. An absence of mourning after a loss maybe considered maladaptive

96
Q

What did Kubler Ross identify

A

The five stages of feelings and behaviors that individuals experience in response to a real, perceived, or anticipated loss

97
Q

List the five stages of grief

A

Denial, anger, bargaining, Depression, acceptance

98
Q

Do individuals need to experience the stages of grief in a particular order

A

No. In fact not all individuals experience each of the stages of grief in response to loss.

Townsend Psychiatric (1 decks)

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