PsychosocialTest4 Flashcards
define anxiety
- feeling of uneasiness, uncertainty, and helplessness
- state of tension
- associated with feelings of dread or doom
- response to a real or imagined treat or stressor
what are the purposes for anxiety
- warning of impending danger
- increase learning
- provides motivation
- leads to in/effective and mal/adaptive behaviors
responses to anxiety occur on what four levels
mild
moderate
severe
panic
what are the types of anxiety
signal anxiety
anxiety state
anxiety trait
define signal anxiety
a learned response to an anticipated event
Ex: a cal student becomes nauseated during exams
define anxiety state
occurs when one’s coping abilities become overwhelmed and emotional control is lost
EX: emergencies, accidents, traumas
define anxiety trait
a learned component of the personality
EX: react with anxiety in relatively low stress situations
what are some physical symptoms of anxiety
muscle tension fidgeting headaches problems with sleep nausea dizziness sweating increased HR elevated BP
coping mechanics come in what 4 realms
physical
intellectual
spiritual
emotional
coping mechanism in the physical realm includes
efforts to directly face and handle the problem
intellectual coping mechanisms are aimed at what
making the threat less meaningful by changing one’s perception
spiritual coping methods include what
faith
prayer
ritual
emotional coping responses include what
crying
communicating or sharing one’s anxious feeling
common defense mechanism; dissociation
separation of emotions from situation; removal of painful anxieties from conscious awareness
Ex:a solider casually describes the battle in which he lost his leg
common defense mechanism; intellectualization
focusing of attention of technical or logical aspects of threatening situation
EX: a wife describes the details of nurse’s unsuccessful attempts to prevent the death of her husband
common defense mechanisms; projection
putting of one’s own unacceptable thoughts, wishes, emotions onto others
EX: a woman is afraid to leave her house because she knows ppl will riddle her
common defense mechanism; reaction formation
development of conscious attitudes and behavior patterns that are opposite to what one really would like to have
EX: a man with homosexual feelings, which he finds to be threatening, engages in excessive heterosexual activities
common defense mechanism; restitution
giving back to resolve guilt feelings
EX: a man argues with his wife and then buys her roses
common defense mechanism; suppression
removal of conflict by removing anxiety from consciousness
EX: a woman with a family history of breast cancer “forgets” her appointment for a mammogram
common defense mechanism; symbolization
use of an unrelated object to represent hidden idea
EX: a girl who feel insignificant draws a picture of her family in which she is the smallest character
common defense mechanism; undoing
inappropriate behavior that is followed by acts to take away or reverse action and decrease guilt and anxiety
EX: a man physically abuses his wife then cleans her wounds and nurses her back to health
what are the purposes of defense mechanisms
reduce or avoid negative states such as conflict, frustration, anxiety, and stress
- used when on feels threatened
- helps avoid negative emotional states
- reduce uncomfortable negative emotions
what is a crisis
when one’s ability to cope with anxiety is overwhelmed
-defense mechanisms are no longer useful
what is bad about having too little or too much anxiety
too little=lack of attention or focus in important situation
too much=overwhelm and immobilize an individual. inability to accomplish important tasks
the causes of anxiety are a combination of what factors
biological
psychosocial
environmental
biological model; theory relating to anxiety
find a biological or physical basis for anxiety
- role of neurotransmitters
- result from the dysfunction of two or more neurotransmitters
- inappropriately activated norepinephrine
- hormonal imbalances, substance abuse, eating and sleeping disorders, headaches, fatigue
psychodynamic model; theories relating to anxiety
result of a conflict btw two opposing forces within an individual
interpersonal model; theories relating to anxiety
interactions with others.
childhood interaction resulting in negative outcomes
behavioral model; theories relating to anxiety
a learned response
when individual encounter a signal that reminds them of earlier anxious times
learn to react with anxiety
existential theory
result of a loss of life’s meaning
what are some examples of behavior that seem to soothe and lessen anxiety for young children
thumb sucking
nail bitting
hair pulling
rhythmic body movements
problems associated with anxiety in children include
compulsion phobias separation anxiety disorder overanxious disorder avoidance disorders
what is separation anxiety disorder
diagnosed when children are unable to be without their parents for any length of time
- physical complaints include headaches, nausea, vomiting, nightmares
- fear of death, animals, monsters, and harmful situations
in children; overanxious disorder
- unrealistic levels of anxiety lasting longer than 6 months
- worry about everything
- happens when parents focus on overachievement and downplay their actual accomplishments
in children; avoidance behaviors
- child refuses to cope with the anxiety-producing situation by ignoring it
- reactions to divorce, death, or separation
adolescence who ineffectively cope with anxiety often express themselves with inappropriate behavior such as
running away from home becoming angry defiant aggressive manipulative experimenting with drugs engaging in high-risk behaviors
when adult anxieties are not successfully managed, what help problems can result
generalized or situational anxiety disorder panic disorders phobias behavior addictions obsession compulsive activities
what are characteristics of anxiety in older adulthood. what are some behaviors indicating the presence of anxiety
often deny their anxiety
less likely to share feelings
-apathy, changes in eating, sleeping, ability to concentrate, impatience, fatigue
define anxiety disorder
exists when anxiety is expressed in ineffective or maladaptive ways and one’s coping mechanisms do not successfully relieve the distress
anxiety disorders are characterized by types. what are they
generalized panic phobic obsessive-compulsive behavioral post-traumatic
describe generalized anxiety disorder
- when an individual’s anxiety is broad, long lasting, and excessive
- primarily a disturbance in the emotional area
- eventually affects every other aspect of individual
- worried and anxious more often than not
- difficult to control their worries
- occurs in person with IBS, headaches, sleep disturbances, substance abuse
what is generalized anxiety called in children, and how does it differ from adults
overanxious disorder of childhood
-worry about their school performance and social interactions while adults concentrate on worrying about everyday events
describe panic disorder
brief period of intense fear or discomfort
- accompanied by various physical and emotional reactions
- 1 to 15 minutes long
- more common in women
- separated/dived a
- ages 24-44
what are the two kinds of panic disorder
those associated with agoraphobia and those that are not
what is agoraphobia
anxiety about possible situations in which panic attack may occur
avoid ppl, places, or events
-fear accompanies a sense of helplessness and embarrassment
-typically associated with public situations
treatment for panic disorders has what 3 goals
educate client about disorder
- block panic attacks pharmacologically
- assist clients in developing more adaptive ways of coping
define phobia
an internal fear reaction involve specific situations or objects -obsessive in nature -tend to dwell on their object of fear to almost point of fascination -immobilizing
what are some panic attack criteria
must have at least 4 symptoms and reach peak within 10 minutes
- palpitations, pounding heart, fast HR
- sweating
- trembling/shaking
- feelings of SOB
- feelings of choking
- CP or discomfort
- nausea or abdominal distress
- dizzy, unsteady, lightheaded or faint
- derealization or depersonalization
- far of losing control or going crazy
- fear of dying
- paresthesias
- chills or hot flashes
what is the difference btw obsession and compulsion
obsession is a distressing persistent thought
compulsion is a distressing recurring behavior
summarize OCD
- can begin early as 3
- usually begin in adolescence
- most common obsession relate to cleanliness, dirt, germs, aggressive and sexual impulse, health concerns, safety, order and symmetry
how is OCD treated
combination of drug and behavior therapy
-antidepressants and SSRI (selective serotonin re-uptake inhibitors)
what is traumatic stress reaction
series of behavioral and emotional responses following an overwhelming stressful event
what are important therapeutic interventions for clients with traumatic stress reaction
providing psychological stability, emotional support, advocacy
what is post-traumatic stress disorder
been exposed to a traumatic experience that was outside the realm of normal life experiences
- intense fear, horror, helplessness
- symptoms include flashbacks, anxiety, depression, and nightmares
how do you treat PTSD
drug therapy, mental health interventions, emotional support
what are three behavioral therapies used successfully in treating phobias
cognitive behavioral therapy
systematic desensitization
flooding
describe cognitive behavioral therapy
helps clients intellectually understand the ineffective behaviors used to cope with anxiety and replace them with more successful behaviors
describe systematic desensitization
clients leant to cope with one anxiety-provoking stimulus at a time
step by step method
allows clients to develop more effective ways of perceiving their anxiety
describe flooding
- the opposite of desensitization
- rapidly and repeatedly exposes clients to the feared object or situation
side effects of benzodiazepines on central nervous system and nursing interventions
dizziness, drowsiness, sedation, headache, tremors, depression, insomnia, hallucination
-ensure safety, prevent falls, assist with ambulation, use side rails. assess mental status routinely
side effects of benzodiazepines on GI and nursing interventions
- dry mouth, anorexia, nausea, vomiting, constipation, diarrhea
- give med with food/milk. oral care. offer candy, gum, sips of water. monitor intake/output
side effects of benzodiazepine on cardiovascular and nursing interventions
- ECK changes, orthostatic hypotension, tachycardia
- asses BP, pulse. monitor complete blood count
side effects of benzodiazepine on eyes, ears, nose, throat and nursing interventions
- blurred vision, ringing in ears
- ensure safety
side effects of benzodiazepines on integument and nursing interventions
- itching, rash, dermatitis
- use tepid baths w/o soap. asses rash
side effects of benzodiazepines on emotional and nursing interventions
- feelings of detachment, irritability, increased hostility
- encourage social interactions, asses for loss of control
long term effects of benzodiazepines and nursing interventions
- increased drug tolerance, physical and psychological dependency, rebound anxiety and insomnia
- drug dose is papered slowly
side effects of antihistamines to treat anxiety
drowsiness, headache, think bronchial secretions, nausea, diarrhea, constipation
side effects of SSRI antidepressants to treat anxiety
dizziness, drowsiness, diarrhea, dry mouth, urinary retention, low blood pressure when standing, high blood pressure, acute renal failure
side effects of Buspirone (BuSpar, VanSpar) to treat anxiety
dizziness, headache, depression, insomnia, fast HR, blurred vision, nasal congestion, sweating, rash, weakness, chest congestion
what are the 5 stages of illness
symptoms sick role medical care dependency recovery/rehabilitation
stage one of illness, and what happens in this stage
- symptoms
- when one becomes aware that something is not right
stage 2 of illness, and what happens in this stage
- the sick role
- seeks to confirm illness
- can support the presence of an illness, and assume the sick role, or deny the illness
assuming the sick role serves what purposes
- person is excused from everyday responsibilities
- permission is given to rest and conserve energy for healing
- social responsibilities of interacting with others are relieved
- permission is given to focus on restoring health
what is stage 3 of illness and what happens
- medical care
- person seeks medical intervention
- professional confirms illness, provides treatment, informs individual of cause, course, and future
- either accept diagnosis or deny the problem
4th stage of illness and what happens
- dependency
- accepts the attentions of other
- one must rely on the kindness and energies of others
- relieved of obligation, allowed to be passive and dependent, expected to get well
stage 5 of illness and what happens
- recovery/rehabilitation
- can occur suddenly or slowly
what are 5 behavioral and emotional changes associated with illness
anxiety anger denial shock withdrawal
individuals who are hospitalized go through what 3 stages
- overwhelmed=intensity of being separated from loved ones/left alone
- stabilization=gradually gain the strength to reestablish some personal identity
- adaptation=regained enough of a personal identity to adapt. energies are replenished
what is the difference between internal and external loss
internal=more personal. include losses that involve some part of oneself
external=outside the individual. relate to objects, possessions, environment, loved ones, support
define loss
a state in which something valued that was formerly present is changed or gone. Can no longer be seen, felt, heart, known, or experienced
losses can be temporary, permanent, expected, unexpected. give explanation and example
temporary example=illness
permanent=forever. loss of arm
expected=old age.
unexpected=cancer diagnosis
what is difference between maturational and situational loss
maturational=individual must give up something to gain a higher level of development
situational=response to external events. individual has no control over the event leading to loss
at what age do most children have an adult concept of loss
9 or 10
define grief
the set of EMOTIONAL REACTIONS that accompany a loss
define mourning
the PROCESS of working through or resolving one’s grief
define bereavement
the BEHAVIORAL STATE of thoughts, feelings, and activities that follow a loss
what is the grieving process and name steps
a method for resolving losses and healing denial yearning depression and identification acceptance and recover
what is the denial stage
feeling of shock reject the loss refuse to give up object/person may not even acknowledge that a loss occurred behave as if nothing has happened
what is the yearning stage
reality of loss begins to be realized
becomes overwhelmed
griever falls apart
what happens in the depression and identification
third stage
guilt and remorse
cope with painful void left by the loss
may withdraw from social interactions, engage in unhealthy behaviors, experience overwhelming loneliness
what happens in acceptance and recovery stage
focus their energies toward the living
loss is a reality
what is anticipatory grief
process of grieving before the actual event occurs.
allows individuals time to prepare for the loss
what is unresolved grief
also termed dysfunctional grief/complicated bereavement
unhealthy or ineffective grief reactions
unable to shift their attention from their loss
unable to function effectively
there are two types
what are the two types of unresolved grief
bereavement related depression
complicated grief
describe bereavement related depression
feelings of despair and worthlessness overwhelm everything in life
changed in eating, sleeping, and activity levels
angry or hostile moods
inability to concentrate
more socially isolated
leads to suicide
what is complicated grief
a persistent yearning for a person
impaired psychological functioning and disturbances of mood, sleep, and self esteem
intolerant of others
socially isolated
how a person responds to and prepares for death depends on what two factors
the meaning of death
coping mechanisms used throughout life
what are Elisabeth Kubler Ross’s five stages of dying. what are the 3 simplified stages
denial anger bargaining depression acceptance -resistance, working, acceptance
what is hospice
philosophy of care for people with terminal illnesses or condition and their loved ones
what is the goal of hospice
make the remained of an individual’s life as meaningful and comfortable as humanly possible. focus of care is providing comfort.
describe mood
prolonged emotional state that influences one’s whole personalty and life functioning
possible causes of mood disorder
defects in the immune systems genetics biochemical imbalances environmental and other stressors childhood/adult experiences social circumstances
psychoanalytical theories believe what
see mood disorders as anger turned inward
behaviorists view depression how
learned responses
social theorists consider depression the result of what
faulty social interactions
what is situational depression
aka acute depression
- tied to a specific event or situation
- traced to a recognizable cause
- relieved once the stressors are removed or decreased
emotions in children
-feelings of hopelessness, low self esteem
-take blame for every situation
-respond with irritability, tearfulness, sadness
-clinging and dependent
aggressive or disruptive behaviors
-changes in eating and sleeping behaviors
emotions in adolescence
depression in adolescence is usually related to what four factors
self esteem
loneliness
family strengths
parent teen communications
define affect
outward expression of one’s emotions
define mood disorder
a disturbance in the emotional dimension of human functioning
aka affective disorder
define mania
emotional state in which a person has an elevated, expansive, and irritable mood
-accompanied by loss of identity, increased activity, and grandiose thoughts and actions
mood disorders are divided into what two basic categories
depression
mania
define dysthymia
moderate depression
describe major depressive episode
depression severe and lasts more than 2 weeks
- feelings of worthlessness, guilt, despair
- eating and sleeping patterns are disrupted
- feelings of powerlessness and helplessness
- suicidal thoughts are entertained
describe major depressive disorder
- more than 2 years, routinely repeat
- twice as often in adolescent girls and adult woman as in men
- symptoms being at any age
- average age is early 20s
- low immune system functions
describe dysthymic disorder
- daily moderate depression that lasts for more than 2 years
- chronically sad and self critical
- consider themselves incapable and uninteresting
- low energy levels, poor decision making skills, eating or sleeping difficulties
- negative point of view of world
- difficult to recognize and diagnose
describe bipolar disorder
sudden and dramatic shifts in emotional extremes
has 3 stages
describe 3 stages of manic behavior
hypomania-exaggerated sense of cheerfulness. outgoing. free of worry. euphoric.
mania=unstable high. angers quickly. flight of ideas. dresses inappropriately
delirium=extreme excitement, anger, elation. grandiose or religious delusions. disoriented. death from exhaustion may occur
what is the difference btw bipolar 1 and 2
1=episodes of depression alternating with episodes of mania. delusions and hallucinations. more severe of the two
2=hypomanic moods that do not progress to full manic states
define cyclothymic disorder
pattern that involves repeated mood swings alternating between hypomania and depressive symptoms
no periods of normal
describe phases of treatment for depression
acute treatment=6 to 12 wks. reduce symptos and inappropriate behaviors
continuation=4 to 9 mo. prevent relapses into distresssing emotional states. clients educated and encouraged to try new coping behaviors
maintenance=indefinite. prevent recurrences
antidepressants are divided into what groups
tricyclics nontricyclics monoamine oxidase inhibitors (MAOIS) SSRIs atypical antidepressants
physical realm. nursing interventions
focus on personal hygiene, maintaining adequate nutrition, encouraging physical activity
emotional real. nursing interventions for mood disorders
revolves around therapeutic relationship. acceptance and support. encouragement and emotional support
intellectual realm. nursing interventions for mood disorders
need extra patience
nonjudgmental guidance
give instructions slowly and clearly
define religiosity
believing that they have powers to communicate with god or become a spirit
define health
embodying the whole person
state of well being
psychological realm is in balance with the physical realm
state of homeostasis
what is physiological stress response mechanism
biological survival tool designed to provide the energy to fight opponents or flee from threat
what are four major stress hormones
dopamine
epinephrine
norepinephrine
cortisol
stress response theory
individuals are biochemically patterned to react to stress
psychoanalytical theory of psychophysical disorders
focuses on the symbolism attached to a symptom or illness
biological theory of organic weakness
states that every individual has one body system that is more sensitive than other systems
all theories of psychophysical disorders have what in common
- unconscious emotional conflict that increases anxiety is the basis for many psychophysical problems
- development of physical symptoms is the result of attempts to lower anxieties
- illness is real to the person
- onset of the illness or problem is related to a stressful event
what is the difference between primary gain and secondary gain
primary=symptoms reduce anxiety
secondary=assuming the sick role
define somatization
feeling physical symptoms in the absence of disease or out of proportion to ailment
somatoform disorder
demonstrate no object causes or physical dysfunctions for the signs and symptoms. person’s symptoms suggest the presence of a medical illness
what are three feature that differentiate a somatization disorder from a medical problem
- involvement of multiple organ systems
- early onset and chronic condition with no physical changes over time
- absence of any significant laboratory values
conversion disorder
somatoform disorder in which the individual presents problems related to the sensory or motor functions
what is a malingering individual
produces symptoms to meet a recognizable goal
