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PSYCH EXAM 2 Flashcards

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1
Q

“the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biological system

A

stress

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2
Q

what selye called the general reaction of the body to stress

A

general adaptation syndrome

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3
Q

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

A

precipitating event

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4
Q

a variety of elements that influence how an individual perceives and responds to a stressful event

A

predisposing factors

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5
Q

3 types of predisposing factors

A
  1. genetic influences
  2. past experiences
  3. existing conditions
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6
Q

are those circumstances of an individual’s life that are acquired through heredity.

A

genetic influence

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7
Q

examples of genetic influence

A

family history of physical and psychological conditions

&

temperment

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8
Q

are occurrences that result in learned patterns that can influence an individual’s adaptation response. They include previous exposure to the stressor or other stressors, learned coping responses, and degree of adaptation to previous stressors.

A

past experiences

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9
Q

incorporate vulnerabilities that influence the adequacy of the individual’s physical, psychological, and social resources for dealing with adaptive demands

A

existing conditions

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10
Q

ex of existing conditions

A 
current health status
motivation
developmental maturity
severity and duration of the stressor
financial and educational resources
age
existing coping strategies
support system
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11
Q

the initial step in managing stress.

A

awareness

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12
Q

to become aware of the factors that create the stress and the feelings associated with a stressful response.

A

awareness

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13
Q

can only be controlled when one recognizes that it is being experienced.

A

stress

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14
Q

engaging in large motor activities, such as sports, jogging, and physical exercise. Breathing exercises and progressive relaxation to relieve stress.

A

relaxation

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15
Q

involves assuming a comfortable position, closing the eyes, casting off all other thoughts, and concentrating on a single word, sound, or phrase that has positive meaning to the individual

A

meditation

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16
Q

sometimes just “talking the problem out” with an individual who is empathetic is sufficient to interrupt escalation of the stress response

A

interpersonal communication with caring other

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17
Q

an extremely adaptive coping strategy is to view the situation objectively (or to seek assistance from another individual to accomplish this if the anxiety level is too high to concentrate)

A

problem solving

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18
Q

studies show that those who care for ___, are better able to cope with the stressors of life

A

pets

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19
Q

can reduce depression and bring about measurable changes in mood and general activity.

stimulates motivation, enjoyment, and relaxation

A

music

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20
Q

4 levels of anxiety

A

mild moderate severe panic

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21
Q

this level of anxiety is seldom a problem for the individual. It is associated with the tension experienced in response to the events of day-to-day living.

prepares people for action

sharpens the senses, increases motivation for productivity

increases the perceptual field, and results in a heightened awareness of the environment.

learning is enhanced and the individual is able to function at his/her optimal level

A

mild anxiety

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22
Q

as the level of anxiety increases, the extent of the perceptual field _____.

A

diminishes

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23
Q

is less alert to events occurring in the environment

attention span and ability to concentrate decreases, although he/she may still attend to needs with direction.

assistance with problem solving may be required

increased muscular tension and restlessness are evident.

A

moderate anxiety

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24
Q

the perceptual field is so greatly diminished that concentration centers on one particular detail only or on many extraneous details.

attention span is extremely limited, and the individual has much difficulty completing event the simplest task.

physical and emotional symptoms may be evident.

discomfort is experienced to the degree that virtually all overt behavior is aimed at relieving the anxiety

A

severe anxiety

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25
Q

in this most intense state of anxiety, the individual is unable to focus on even one detail in the environment.

misperceptions are common, and a loss of contact with reality may occur.

hallucinations and delusions

behavior is characterized by wild and desperate actions or extreme withdrawal

A

panic anxiety

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26
Q

ways to treat mild anxiety

A

sleeping, yawning, eating, drinking, physical exercise, daydreaming, smoking, laughing, crying, cursing, pacing, nail biting, foot swinging, finger tapping, fidgeting, & talking with someone whom one feels comfortable

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27
Q

use defense mechanisms

A

mild to moderate anxiety

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28
Q

covering up a real or perceived weakness by emphasizing a trait one considers more desireable

A

compensation

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29
Q

refusing to acknowledge the existence of a real situation or the feelings associated with it

A

denial

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30
Q

the transfer of feelings from one target to another that is considered less threatening or that is neutral

A

displacement

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31
Q

an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis.

A

intellectualization

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32
Q

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

A

introjection

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33
Q

separating a thought or memory from the feeling, tone, or emotion associated with it.

A

isolation

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34
Q

attributing feelings or impulses unacceptable to one’s self to another person

A

projection

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35
Q

attempting to make excuses or formulate logical reasons to justify unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors

A

reaction formation

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36
Q

retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning

A

regression

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37
Q

involuntarily blocking unpleasant feelings and experiences from one’s awareness

A

repression

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38
Q

rechanneling of drives or impulses that are personally or social unacceptable into activities that are constructive.

A

sublimation

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39
Q

the voluntary blocking of unpleasant feelings and experiences from one’s awareness

A

suppression

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40
Q

symbolically negating or canceling out an experience that one finds intolerable.

A

undoing

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41
Q

if this level of anxiety remains unresolved over an extended period of time can contribute to a number of physiological disorders.

A

moderate to severe anxiety

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42
Q

can lead to neurosis if untreated

A

severe anxiety

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43
Q

psychiatric disturbances, characterized by excessive anxiety that is expressed directly or altered through defense mechanisms.

A

neuroses

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44
Q

at this extreme level of anxiety, an individual is not capable of processing what is happening in the environment, and may lose contact with reality.

A

panic anxiety

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45
Q

“a severe mental disorder characterized by gross impairment in reality testing, typically manifested by delusions, hallucinations, disorganized speech, or disorganized or catatonic behavior.”

A

psychosis

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46
Q

an external pressure that is brought to bear on the individual.

A

stressor

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47
Q

involves the threatening stimulus; anxiety involves the emotional response to the appraisal.

A

fear

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48
Q

the major inhibitory neurotransmitter in the brain.

A

GABA

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49
Q

involved in the reduction and slowing of cellular activity.

A

GABA

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50
Q

increases the affinity of the GABAa receptor for GABA

A

benzodiazepines

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51
Q

short term, quick, PRN use

A

benzodiazepines

52
Q

block repuptake of serotonin into the presynaptic nerve terminal, increasing synaptic concentration of serotonin

A

SSRIs

53
Q

long term use

A

SSRIs

54
Q

for chronic anxiety. Long term

A

buspirone

55
Q

is characterized by recurrent panic attacks, the onset of which is unpredictable

A

panic disorder

56
Q

panic disorder manifestations

A

intense apprehension

fear or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort

57
Q

this defines the fear that some patients have of being in open shops and markets, although “their true feat is being separated from a source of security.”

A

agoraphobia

58
Q

is an excessive fear of situations in which a person might do something emberassing or be evaluated negatively by others.

A

social anxiety disorder

59
Q

identified by fear of specific objects or situations that could conceivably cause harm, but the person’s reaction to them is excessive, unreasonable, and inappropriate.

are often identified when other anxiety disorders have become a focus of clinical attention.

A

specific phobia.

60
Q

Freud believed that phobias developed when a child experiences normal incestuous feelings toward the opposite gender parent. To protect themselves, these children repress this fear of hostility from the same-gender parent and displace it onto something safer and more neutral, which becomes the phobic stimulus.

A

Freud’s Psychoanalytic theory

61
Q

the manifestations of this disorder include the presence of obsessions, compulsions, or both, the severity of which is significant enough to cause distress or impairment in social, occupational, or other important areas of functioning.

they recognize that the behavior is excessive or unreasonable, but because of the feeling of relief from discomfort that it promotes, is compelled to continue the act

A

Obessive-compulsive disorder

62
Q

is characterized by the exaggerated belief that the body is deformed or defective in some specific way.

A

body dysmorphic disorder

63
Q

the recurrent pulling out of one’s hair that results in hair loss

A

trichotillomania

64
Q

“persistent difficulties discarding or parting with possessions, regardless of their actual value.”

A

hoarding disorder

65
Q

are characterized by physical symptoms suggesting medical disease but without demonstrable organic pathology or a known pathophysiological mechanism to account for them.

A

Somatic symptom disorders

66
Q

are defined by a disruption in the usually integrated functions of consciousness, memory, and identity.

A

Dissociative disorders

67
Q

(when crazy news doesn’t seem real and the situation doesn’t seem real)

A

Dissociative disorders

68
Q

Freud viewed dissociation as a type of _______, an active defense mechanisms used to remove threatening or unacceptable mental contents from conscious awareness.

A

repression

69
Q

Somatic symptom disorders have been identified as hysterical neuroses and were thought to occur in response to _____.

A

repressed severe anxiety

70
Q

A syndrome of multiple somatic symptoms that can’t be explained medically and are associated with psychosocial distress and long-term seeking of assistance from health care professionals.

The disorder is chronic

Drug abuse and dependence are common complications

Personality characteristics are heightened emotionality, strong dependency needs, and a preoccupation with symptoms and oneself.

A

Somatic symptom disorder

71
Q

Unrealistic or inaccurate interpretation of physical symptoms or sensations leading to preoccupation and fear of having a serious disease.

Their behavioral response to even the slightest changes in feeling or sensation is unrealistic and exaggerated.

Anxiety and depression are common, and obsessive-compulsive traits frequently accompany the disorder

A

Illness Anxiety Disorder

72
Q

A loss or change in body function that cannot be explained by any known medical disorder or pathophysiological mechanism.

A

conversion disorder

73
Q

blindness after seeing something stressful

paralysis of legs in response of fear to “walk down the isle”

A

conversion disorder

74
Q

The most obvious and “classic” conversion symptoms are those that suggest ___ ____.

A

neurological disease

75
Q

With this diagnosis, there is evidence of a general medical condition that has been precipitated by or is being perpetuated by psychological or behavioral circumstances.

A

psychological factors affecting other medical conditions

76
Q

Conscious, intentional feigning of physical and/or psychological symptoms

individual pretends to be ill in order to receive emotional care and support commonly associated with the role of “patient.”

A

Factitious Disorder

77
Q

factitious disorder AKA

A

Munchausen syndrome

78
Q

predisposing factors associated with somatic symptom disorder

A 
genetic
biochemical
neuroanatomical
psychodynamic theory
family dynamics
learning theory
79
Q

in dysfunctional families, when a child becomes ill, focus shifts from the open conflict to the child’s illness and leaves unresolved underlying issues the family is unable to confront openly. Somatization brings some stability to the family and positive reinforcement to the child (called tertiary gain).

A

family dynamics

80
Q

primary
secondary
tertiary gain

A

learning theory

81
Q

may avoid stressful obligations or be excused from unwanted duties

A

primary gain

82
Q

may become the prominent focus of attention because of the illness

A

secondary gain

83
Q

may relieve conflict within the family as concern is shifted to the ill person and away from the real issue

A

tertiary gain

84
Q

past experiences with serious or life-threatening physical illness, either personal or that of close relatives, can predispose the person to this disorder

A

illness anxiety disorder

85
Q

defined as an inability to recall important personal info that is too extensive to be explained by ordinary forgetfulness and which is not due to the direct effects of substance use or a neurological or other medical condition. Onset usually follows severe psychosocial stress.

A

dissociative amnesia

86
Q

inability to recall all incidents associated with the traumatic event for a specific period following the event

A

localized amnesia

87
Q

inability to recall only certain incidents associated with a traumatic event for a specific period following the event.

A

selective amnesia

88
Q

the individual has amnesia for his or her identity and total life history

A

generalized amnesia

89
Q

A specific subtype of dissociative amnesia in which there is sudden, unexpected travel away from home with the inability to recall some or all of one’s past.

A

dissociative fugue

90
Q

Characterized by the existence of two or more personalities within a single individual
sudden & precipitated by stress.

A

Dissociative identity disorder (DID)

91
Q

is defined as a disturbance in the perception of oneself

A

depersonalization

92
Q

described as an alternation in the perception of the external environment.

A

derealization

93
Q

Characterized by a temporary change in the quality of self-awareness that often takes the form of: feelings of unreality, changes in body image, feelings of detachment from the environment, & a sense of observing oneself from outside the body.

A

Depersonalization-derealization disorder

94
Q

symptoms of Depersonalization-derealization disorder are accompanied by:

A

anxiety & depression
fear of going insane
obsessive thoughts

95
Q

predisposing factors to dissociative disorders

A

genetics
neurobioligical
psychodynamic theory
psychological trauma

96
Q

possible heredity factors associated with DID

A

genetics

97
Q

dissociative amnesia may be related to neurophysiological dysfunction.

EEG abnormalities have been observed in some clients withDID.

A

neurobiological

98
Q

freud described dissociation as repression of distressing mental contents from conscious awareness. Current psychodynamic explanations reflect Freud’s concepts.

A

Psychodynamic theory

99
Q

a growing body of evidence points to the etiology of DID as a set of traumatic experiences that overwhelm the individuals capacity to cope by any means other than dissociation.

these experiences usually take the form of severe physical, sexual, or psychological abuse by a significant other in the child’s life.

DID is thought to be a survival method.

A

psychological trauma

100
Q

similar to PTSD in terms of precipitating traumatic events and symptomatology.

symptoms are time limited–up to 1 month following the trauma

A

Acute Stress Disorder

ASD

101
Q

if ASD lasts longer than 1 month it is considered…

A

PTSD

102
Q

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

A

PTSD

103
Q

characteristic symptoms of PTSD include

A

reexperiencing the traumatic event

a sustained high level of anxiety or arousal

a general numbing of responsiveness

intrusive recollections or nightmares

amnesia to certain aspects of the trauma

depression, survivors, guilt

substance abuse

anger and aggression

relationship problems

104
Q

when may symptoms begin for PTSD

A

within the first 3 months after the trauma, or there may be a delay of several months or even years.

105
Q

predisposing factors for trauma related disorders

A

psychosocial theory

learning theory

cognitive theory

106
Q

dysregulation of the opiod, glutamatergic, noradrenergic, serotonergic, and neuroendocrine pathways may also be involved in the pathophysiology of PTSD

A

biological aspects

107
Q

nursing dx for posttrauma syndrome

A

complicated grieving

108
Q

outcome criteria….

the client:

A

can acknowledge the and the impact on his/her life

can demonstrate adaptive coping strategies

has worked through feelings of survivors guilt

attends support group of individuals recovering from similar traumatic experiences

109
Q

nursing care of the client with a trauma related disorder is aimed at

A

reassurance of safety

decrease in maladaptive symptoms

demonstration of more adaptive coping strategies

adaptive progression through the grieving process

110
Q

evaluation of care for the client with trauma-related disorder is based on

A

successful achievement of the previously established outcome criteria

111
Q

examples of evaulation

A

can the client discuss the traumatic event without experiencing panic anxiety?

has the client learned new, adaptive coping strategies for assistance with recovery?

112
Q

trauma related disorders

A

cognitive therapy

prolonged exposure therapy

group/family therapy

eye movement desensitization and reprocessing

psychopharmacology –client education

113
Q

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

A

adjustment disorders

114
Q

symptoms occur within 3 months of the stressor and last no longer than 6 months

A

adjustment disorders

115
Q

types of adjustment disorders

A

with anxiety

with mixed anxiety and depressed mood

116
Q

predisposing factors for adjustment disorders

A

biological theories

genetics

vulnerability related to neurocognitive or intellectual developmental disorders

psychosocial theories

transactional model of stress/adaptation

117
Q

nursing dx of adjustment disorders

A

complicated grieving

risk–prone health behavior

anxiety

118
Q

outcome criteria for adjustment disorders..

the client:

A

verbalizes acceptable grieving behaviors

accomplishes ADLs independently

demonstrates ability to function adequately

accepts change in health status

sets realistic goals for the future

demonstrates ability to cope effectively with change in lifestyle

119
Q

nursing intervention for the client with an adjustment disorder is aimed at:

A

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

120
Q

evaluation of pt with adjustment disorders is based on…

A

accomplishment of previously established outcome criteria

121
Q

examples of adjustment disorder evaluations

A

does the client demonstrate progression in the grief process?

does the client discuss the change in health status and modification of lifestyle it will affect?

does the client set realistic goals for the future?

122
Q

tx for adjustment disorders

A

individual psychotherapy

family therapy

behavior therapy

self-help therapy

crisis intervention

psychopharmacology

123
Q

first like med of choice in the tx of ptsd

A

paroxetine

SSRIs

124
Q

are considered first-line tx of choice for PTSD because of their efficacy, tolerability, and safety ratings.

A

SSRIs

125
Q

ex of SSRIs

A

paroxetine and sertraline

PSYCH (5 decks)

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