Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 419 > Quiz #1: Anxiety/OCD/Crisis/PTSD > Flashcards

Quiz #1: Anxiety/OCD/Crisis/PTSD Flashcards

1
Q

What is anxiety?**

A
  • A vague sense of apprehension that is accompanied by feelings of uncertainty, helplessness/intimidation, isolation and insecurity.
  • A person senses that the core of his/her personality is being threatened.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anxiety: Emotion/Fear

A
  • Emotion WITHOUT specific object.

- Fear has a specific object/source

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is anxiety communicated?

A

Interpersonally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Anxiety is about

A

Self preservation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anxiety and Hospitalization

A

Rarely hospitalized for anxiety alone - usually comorbid with suicidal patients or MDD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Levels of Anxiety: Mild

A

Day-to-day living; grasps more information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Levels of Anxiety: Moderate

A

Person focuses only on immediate concerns and involves narrowing of the perceptual fields (selective inattention)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Levels of Anxiety: Severe

A

Marked by significant reduction in the perceptual field.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Levels of Anxiety: Panic

A

Dread and terror as the person experiences panic and is unable to do things, even with direction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Etiology of Anxiety

A
  • Anxiety is related to decrease in GABA (an inhibitory neurotransmitter (decreases excitability))
  • Other inhibitory neurotransmitters include dopamine and serotonin -> calms the brain
  • Excitatory neurotransmitters increases stimulation (dopamine (both excitatory and inhibitory), NE and epinephrine)
  • Substances such as alcohol and benzodiazepines, increase GABA levels to allow the brain to balance the excitement.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of Anxiety Disorders

A
  • Generalized Anxiety Disorder*
  • Separation Anxiety Disorder (usually <18 y/o)
  • Panic Disorders
  • Specific Phobia
  • Social Anxiety Disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Panic Disorder

A
  • Sudden onset of fear and impending doom
  • Cause cannot be identified
  • Severe, recurrent, intermittent attacks lasting from 5-30 minutes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Specific Phobias

A
  • I.e acrophobia (heights), agoraphobia (crowds/open places), claustrophobia (closed-in spaces), hydrophobia (water), nyxtophobia (dark), thanatophobia (death)
  • With fear there is specific stimulation
  • Bottom line is anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anxiety Defense Mechanisms Include

A
  • Denial
  • Displacement
  • Dissociation
  • Identification
  • Intellectualization
  • Isolation
  • Projection
  • Rationalization
  • Reaction Formation
  • Regression
  • Repression
  • Splitting
  • Suppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Defense Mechanisms: Denial

A

avoidance of reality; unconscious failure to acknowledge an event, thought, or feeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anxiety Defense Mechanisms: Displacement

A

shift emotion from a person/object to another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Anxiety Defense Mechanisms: Dissociation

A

disruption in consciousness, memory, identity, or perception (compartmentalizing uncomfortable or unpleasant aspect of oneself)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Anxiety Defense Mechanisms: Identification

A

try to be like someone they admire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Anxiety Defense Mechanisms: Intellectualization

A

excessive reasoning / logic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anxiety Defense Mechanisms: Isolation

A

splitting off emotions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Anxiety Defense Mechanisms: Projection

A

putting thoughts/impulses to another person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Anxiety Defense Mechanisms: Rationalization

A

justify an unacceptable feeling/behavior using logical explanations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anxiety Defense Mechanisms: Reaction Formation

A

attitudes/behaviors opposite of real feelings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Anxiety Defense Mechanisms: Regression

A

retreat to earlier levels of development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Anxiety Defense Mechanisms: Repression

A

involuntary exclusion of thoughts from memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Anxiety Defense Mechanisms: Splitting

A

(two meanings in mental health)

  1. Viewing people/situations as all good or bad
  2. Viewing and treating one person as good and another as bad
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Anxiety Defense Mechanisms: Suppression

A

intentional exclusion of feelings/ideas

28
Q

Page 305 of HESI review

Page 283 textbook

A

…

29
Q

Anxiety DSM-5 Criteria

A

A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as school or work performance)
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months). (Note: only one item is required in children) 1) restlessness or feeling keyed up or on edge 2) being easily fatigued 3) difficulty concentrating or mind going blank 4) irritability 5) muscle tension 6) sleep disturbance.
D. The anxiety, worry or physical symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning
E. The disturbance is not attributable to the physiological effects of a substance or another medication condition
F. The disturbance is not better explained by another mental disorder.

30
Q

Defense Mechanisms

A
  • A type of coping mechanism that to help alleviate anxiety and discomfort so you can manage.
  • Most are unconscious. Except for SUPRESSION. It’s a conscious effort.
31
Q

Treatment for specific phobia

A
  • Treatment is the same.

- Benzodiazepines and antianxiety medications**

32
Q

Generalized Anxiety Disorder

A
  • Unrealistic anxiety over everyday worries that persist over time.
  • Not associated with another psychiatric or medical disorder.
33
Q

Symptoms of Mild, Moderate, Severe, Panic

A
  • Appearance (Behavior): restlessness, physical tension, lack of coordination, flight, avoidance, hyperventilation
  • Mood and Affect: impatient, edginess, impatience, uneasiness, tension, nervousness, fear, alarm, terror, jitteriness, guilt, frustration
  • Speech (rapid)
  • Thought Process
  • Cognition (Orientation and concentration)
  • Judgment (Ability to make decisions, insight)
  • Physiological (Blood pressure, heart rate, respirations, etc)
34
Q

Anxiety: Planning

A
  • These patients are usually encountered in a community setting
  • Shared planning should be done with these patients, especially those with mild to moderate anxiety
  • Patients with more severe anxiety may not be able to participate in their planning
  • Patients need to develop ability to tolerate mild anxiety and use it consciously and constructively
35
Q

Mild to Moderate Anxiety: Implementation

A
  • Help patient focus and solve problems
  • Use open-ended questions, giving broad openings and exploring and seeking clarification
  • Provide a calm presence, recognizing the anxious person’s distress, and being willing to listen
  • Offer patient alternatives to problem situations and offer activities that may temporarily relieve feelings of inner tension (i.e encourage patient to talk about feelings or concerns; focus on patient’s concerns; role play or model behaviors; explore behaviors that have worked to relieve anxiety in past; provide outlets for working off excess energy)
36
Q

Severe to Panic Anxiety: Implementation includes

A
  • Providing quiet environment with minimal stimulation
  • Medications
  • Firm, short, and simple statements are useful
  • Relaxation techniques, if possible
  • Promote self-care activities (sleep, hygiene, nutrition and fluid intake)
37
Q

Generalized Anxiety Disorder 7-item (GAD-7) scale

A

…

38
Q

Medications used to treat Anxiety include

A
  1. Benzodiazepines
  2. Anti-depressants: SSRI’s, SSNRI’s, MOAI’s
  3. Antipsychotics and anticonvulsants
  4. Others: Diphenhydramine (Benadryl), Hydroxyzine (Vistaril), Propanolol (Inderal)*
39
Q

Treatments for Anxiety Disorders include

A
  • Cognitive Therapy
  • Behavioral Therapy: Relaxation Therapy, systematic desensitization, through stopping
  • Cognitive Behavioral Therapy
  • Biofeedback
40
Q

Anxiety Medications: Benzodiazepines

A
  • Most commonly used because they have a quick onset of action; however, due to the potential for dependence, these medications ideally should be used for short periods, only until other medications or treatments reduce symptoms.
  • NOT recommended for people with known substance abuse problems.
  • Includes alprazolam, buspirone, chlordiazepoxide, clonazepam, diazepam, lorazepam
41
Q

Anxiety Meds: Benadryl

A
  • Anschlitic

- Makes sleepy but calms them down

42
Q

Anxiety Treatment: Biofeedback

A
  • Incorporate relaxation and teaching how to monitor certain VS as well as muscle relaxation.
  • Guided with imagery and biofeedback.
43
Q

What is the immediate nursing action for client with anxiety?

A

Decrease stimuli in the environment/ make environment calm and quiet

44
Q

Obsessive Compulsive Disorder Terms: Obsessions

A

Thoughts, impulses, or images that persist and recur, so that they cannot be dismissed from the mind even though individuals attempt to do so.

45
Q

Obsessive-Compulsive Disorder Terms: Compulsions

A

Ritualistic behaviors an individual feels driven to perform in an attempt to reduce anxiety.

46
Q

Obsessive Compulsive Disorder

A

-Exists on a continuum - mild to pathological

47
Q

Mild OCD

A

Nagging doubts as to whether door is locked or stove is turned off (obsession) or timeliness and orderliness (compulsion)

48
Q

Pathological OCD

A
  • Obsessions or compulsions cause marked distress to individuals, who often feel humiliation and shame.
  • Rituals are time-consuming and interfere with normal routines.
49
Q

Nursing Interventions for OCD

A
  • Allow performance of compulsion with attention given to safety
  • Avoid criticizing or punishing
  • Take them away from thinking of it but don’t stop them when they are in the action of doing so
  • Help establish routine for patient
  • Limit amount of time for performance of ritual and gradually decrease
50
Q

Other Obsessive-Compulsive Disorders

A
  • Body Dysmorphic Disorder
  • Hoarding Disorder
  • Trichotillomania (hair pulling)
  • Dermotillomania (skin picking)
51
Q

Body Dysmorphic Disorder

A
  • Preoccupation with an imagine defective body.
  • Constant mirror checking and camouflaging
  • Frequently concerned with skin, hair, nose, stomach, teeth, weigh and breast/chest
52
Q

Hoarding Disorder

A

-Accumulation of belongings - may literally fill every available surface and area in residence

53
Q

PTSD

A
  • Defined as an anxiety disorder that arises when a person has been exposed to a life-threatening traumatic event that provokes terror, horror and helplessness.
  • i.e combat experiences, rape, childhood neglect, physical attack and being threatened with a weapon.
  • others: natural catastrophes, car accident, plane crash or life-threatening medical diagnosis.
54
Q

PTSD Etiology

A

Caused by a complex mix of:

  • Genetics (stress-related genes)
  • Female sex
  • Past history, family history of mental illnesses (anxiety or depression)
  • Previous life experiences
55
Q

Acute Stress Disorder

A
  • Meets PTSD diagnosis criteria but anxiety occurs within one month after exposure to an extreme traumatic stressor
  • Total duration of disturbance is two days to a maximum of four weeks (i.e., occurs and resolves within one month
56
Q

PTSD: Characteristics of Symptoms

A
  • Can be severe and last long enough to significantly impair the person’s daily life.
  • Typically begins within 3 months of traumatic event. (In some cases, symptoms may not occur until years after the event)
  • Results from excessive activity of the SNS (*exaggerated fight or flight response) and is responsible for physiological symptoms associated with hyperarousal and re-experiencing phenomena.
57
Q

Symptoms of PTSD include

A
  • Re-experiencing symptoms (one or more)
  • Avoidance symptoms (three or more)
  • Hyperarousal symptoms (two or more)
58
Q

PTSD: Re-experiencing Symptoms (one or more) include

A
  • Recurrent intrusive thoughts
  • Disturbing dreams (nightmares)
  • Flashbacks
  • Emotional distress from reminders
  • Physical reaction from reminders
59
Q

PTSD: Avoidance Symptoms include

A
  • Avoids thoughts or feelings reminding them of trauma
  • Avoids people, places, or things reminding them of trauma
  • Traumatic events blocked from memory (Repression if unconscious. Suppression if conscious. Over use of defense mech causes disturbance in pt behavior.)
  • Decreased interest in activities
  • Feeling detached/aloof
  • Blunted affect
  • Sense of foreshortened future – pt who is extra careful
60
Q

PTSD: Hyperarousal Symptoms

A
  • Sleep disturbance
  • Increased anger/irritability
  • Decreased concentration
  • Hypervigilance
  • Hyperactive startle
61
Q

What is hyperarousal?

A

a state of increased psychological and physiological tension marked by such effects as reduced pain tolerance, anxiety, exaggeration of startle responses, insomnia, fatigue and accentuation of personality traits.” [1] It has also been described as a chronic state of fight or flight.

62
Q

Treatment for PTSD: Pharmacological

A
  • SSRIs – first line treatment (Prozac, paxcil, lexopril (all brand names))
  • SNRI (especially venlafaxine)
  • Atypical antipsychotics (Respridone)
63
Q

Nonpharmacological Treatment of PTSD includes

A
  • Cognitive Behavioral Therapy

- Prolonged Exposure Therapy (Re-experience painful memories in a therapeutic and controlled environment)

64
Q

PTSD: Implementation/Nursing Care (Acute Episode)

A
  • Important to assess patient’s level of functioning and safety: Risk for suicide and potential to harm others
  • Goal is to establish a therapeutic alliance*
  • Ensure physical and psychological safety: Reinforce to patient that they are safe
  • Remain calm and supportive
  • Do not startle them
65
Q

PTSD comorbidities include

A
  • Suicide
  • Substance use disorders
  • Military sexual trauma
  • Traumatic brain injury
66
Q

Traumatic Brain Injury

A
  • Damage to the brain triggered by externally acting forces (e.g., direct penetration, sustained forces, etc.)
  • Mild, moderate or severe based on intensity of injury
  • 11-24% of military personnel reporting one or more TBI
  • TBIs during deployment are linked to high rates of PTSD, depression, and many other physical and psychological problems.
67
Q

Challenges to Care of Patients with PTSD

A
  • Psychological health
  • Access to services and support
  • Communication challenges
  • Deployment
  • Frequent relocation

NURS 419 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions