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Mental Health > Stress and stress-related disorders > Flashcards

Stress and stress-related disorders Flashcards

1
Q

The two types of stress?

A

Eustress and distress

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2
Q

When individuals feel stressed they may?

A

Have trouble sleeping and eating. Experience headache or back pain, lose interest in favorite activities, feel tense and become irritable, feel powerless

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3
Q

What are physiologic and emotional results of prolonged stress?

A

Colds and the flu, asthma, stomach ulcers, eczema and other skin disorders, heart disease, cancer, depression, PTSD

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4
Q

Usually occurs after a traumatic event outside the range of usual human experience. Major depression frequently occurs.

A

PTSD. Fight or flight response. Factors that influence the likelihood of developing it include the severity of the stressor and the availability of the support systems.

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5
Q

The common elements in PTSD experiences/traumatic events are what?

A

Extraordinary fear, helplessness, powerlessness

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6
Q

What are signs and symptoms of PTSD?

A

Flashbacks, avoidance of stimuli associated with trauma, experience of persistent numbing of responses, persistent symptoms of increased arousal.

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7
Q

What are some interventions for PTSD?

A

Listen and provide support and reassurance. Reorient to present environment. Remain calm and speak with a low tone. Discharge planning, suggest group therapy. Resources.

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8
Q

Psychotherapeutic treatment strategies?

A

Cognitive behavioral therapy, SSRIs, group therapy with others who have had traumatic experiences, family therapy

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9
Q

What are treatments for PTSD?

A

Psychotherapy is the treatment of choice. When target symptoms arise and become serious, medications can be used and may serve to help the patient gain emotional control.

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10
Q

This is a result of witnessing or experiencing a violent or gruesome death of or by an intimate.

A

Acute stress disorder

Repeated exposure to aversive details of the event.

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11
Q

What are the kinds of symptoms for acute stress disorder?

A

Intrusive symptoms, dissociative symptoms, avoidance symptoms, arousal symptoms.
By definition, acute stress disorder resolves within 1 month

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12
Q

Examples of nurses who are at high risk of compassion fatigue and secondary trauma?

A

Hospice, pediatrics, emergency, oncology, forensics, psychiatric

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13
Q

The most basic human emotion, a universal human experience.

A

Anxiety. Dysfunctional behavior is often a defense against anxiety.
As anxiety decreases, dysfunctional behavior will frequently decrease.

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14
Q

Anxiety and fear are indistinguishable except for what?

A

The cause. Fear is a reaction to a specific danger. Anxiety is a feeling of apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat whose actual source is unknown or unrecognized.

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15
Q

What is highly co-occuring with anxiety disorders? Frequently?

A

Highly: Substance abuse, major depressive disorder (MDD)
Frequently: Eating disorders, depression, bipolar disorder

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16
Q

What are co-occuring medical conditions with anxiety disorders?

A

Cancer, heart disease, hypertension, irritable bowel syndrome, renal or liver dysfunction, reduce immunity.
Chronic anxiety is associated with increased risk for cardiovascular morbidity and mortality.

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17
Q

What are the main mediators of anxiety?

A

Serotonin, norepinephrine, gamma-aminobutyric acid (GABA). Limbic system.

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18
Q

What are the different theories about anxiety?

A

Neurobiology, genetics (twin studies), cognitive behavioral, cultural considerations

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19
Q

What are the three types of anxiety?

A

Normal, acute, chronic

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20
Q

Pathological anxiety differs from normal anxiety in terms of what? It’s usually more what?

A

Terms of duration, intensity, disturbance in a person’s ability to function.
Usually more chronic in nature and is anxiety the person has experienced for a long time.

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21
Q

What are the four levels of anxiety?

A

Mild, moderate, severe, panic

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22
Q

Interventions for mild to moderate anxiety?

A

Effective communication, identify triggers, use calm approach, explore effective coping

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23
Q

Interventions for severe to panic levels of anxiety?

A

Ensure safety, give concise instructions, stay with the patient, remain calm, reduce stimuli, reinforce reality

24
Q

Defense mechanisms in anxiety are?

A

Major means of managing conflict. Relatively unconscious. Discrete from one another. Hallmarks of major psychiatric syndromes, which are reversible. Adaptive as well as pathologic.

25
Q

What are healthy defenses for anxiety?

A

Altruism, sublimation (substituting constructive and socially acceptable activity), humor, suppression

26
Q

Refusal to accept reality or fact.

Reversion to an earlier stage of development.

A

Denial

Regression

27
Q

Unconscious blocking of unacceptable thoughts, feelings, and impulses.
Attributing unacceptable thoughts, feelings, or impulses onto another.

A

Repression

Projection

28
Q

Converting unwanted or dangerous thoughts, feelings, or impulses into their opposites
Transfer of emotions to another person or object.

A

Reaction formation

Displacement

29
Q

Justifying or explaining an unacceptable behavior or feeling in a rational or logical manner but avoiding the true reason for the behavior.
Thinking about events in an unemotional, clinical way. Focusing on the intellectual component.

A

Rationalization

Intellectualization

30
Q

Explain panic attacks?

A

Feelings of terror, fear of dying, suspension of normal function, severely limited perceptual field, misinterpretation of reality, sudden occurrence for no reason or stressor, increased rates of suicide

31
Q

Symptoms of a panic attack/disorder?

A

Palpitations, chest pain, diaphoresis, muscle tention, urinary frequency, hyperventilation, breathing difficulties, choking sensation, nausea/GI symptoms, chills, hot flashes

32
Q

An intense and excessive level of anxiety and a fear of being in places and situations from which escape is impossible. Feared places are avoided to control anxiety.

A

Agoraphobia

Systematic desensitization therapy

33
Q

What are nursing interventions for panic disorders?

A

Reassure. Teach about panic attacks, Benzodiazepines. Teach about the effects of caffeine, chocolate. Encourage treatment. Recognize suicide risk.

34
Q

What meds are effective for treating the physical symptoms of panic disorder? Short term or acute episodes?

A

Beta blockers for the physical. Benzos for the short term or acute episodes.

35
Q

Severe anxiety provoked by exposure to a social or performance situation.

A

Social anxiety disorders (SAD), social phobias.
Fear of saying something foolish, not being able to answer questions, eating in front of others, performing on stage, etc.

36
Q

Chronic disorder which typically leads to depressed mood. Persistent anxiety without phobias or panic attacks.

A

Generalized anxiety disorder.
Usually begins in childhood or adolescent. Triggered by stress or nothing. Sufferers worry excessively about everyday concerns.

37
Q

Symptoms of GAD?

A

Fatigue, muscular tension, restlessness, irritability, difficulty concentrating, sleep disturbance. Stress suppresses immunity, may lead to disease.

38
Q

What’s needed for diagnosis of GAD?

A

Excessive worry and anxiety occur more days than not for at least 6 months. Worry causes clinically significant distress, impairment in social, occupation, or other important areas of functioning.

39
Q

Buspirone hydrochloride

A

Buspar. Is a single agent. Alleviates anxiety. Works best before benzos are tried. Its less sedating than benzos. Has no physical or psychologic dependence. 3 weeks or more are needed for it to be effective.

40
Q

Unwanted, recurrent, inappropriate, intrusive, persistent ideas, thoughts, impulses, or images that cause significant anxiety or distress.

A

Obsessions

41
Q

Unwanted repetitive behavior patterns or mental acts intense to reduce anxiety but not to provide pleasure or gratification.

A

Compulsions

42
Q

More severe symptoms of OCD do what?

A

Center on dirtiness, contamination, and germs and occur with corresponding compulsions such as cleaning or hand washing. Persistent thoughts of sexuality, violence, illness, and death.

43
Q

Management of OCD?

A

Work, play, maintain relationships. Reveal problem and educate. Behavioral therapy. SSRIs.

44
Q

What are two diagnoses related to OCD?

A

body dysmorphic disorder and compulsive hoarding

45
Q

What are common features of phobic disorders?

A

Unreasonable behavioral response, persistent fears, avoidance behavior, disabling behavior.
Primary fear is fear of losing control.

46
Q

Fear of only one object or situation. Can arise after single unpleasant experience.

A

Specific phobia.

47
Q

Behavioral and affective characteristics of phobic disorders?

A

Behavioral are avoidance of the object or situation, dependent.
Affective are fear of the object, fear of exposure, fear of abandonment during phobic episode

48
Q

Medical management of phobic disorders?

A

Anxiolytics, relaxation, education, cognitive therapy, systematic desensitization (exposure to object or situation)

49
Q

Nursing interventions for phobic disorders?

A

Accept but do not support the phobia, explore client’s perception of the threat, discuss feelings that may contribute to irrational fears. Help client identify strategies for changes, education, relaxation, systematic desensitization, cognitive therapy

50
Q

SSRIs commonly used in the treatment of anxiety disorders?

A 
First line 
citalopram
escitalopram
fluoxetine
fluvoxamine
paroxetine HCl
sertraline
51
Q

Dual-action SNRIs commonly used in the treatment of anxiety disorders?

A

First line
duloxetine
venlafaxine

52
Q

Benzodiazepines for short-term treatment of anxiety?

A 
alprazolam
diazepam
lorazepam
oxazepam
chlordiazepoxide
chlorazepate
53
Q

Atypical benzodiazepines for anxiety?

A

estazolam
eszopiclone
zaleplon (an exception to the rule that most benzos suppress REM sleep, causing fatigue. preferable as a hypnotic agent)

54
Q

TCA’s for anxiety?

A 
amitriptyline
desipramine
dose-in
imipramine
clomipramine (effective with OCD, PD, GAD, SAD) 
maprotiline
nortriptyline
trimipramine
amoxapine
55
Q

How do beta blockers treat the physical symptoms of anxiety?

A

Cause modest decrease int eh HR at rest, but limits cardiac stimulation when SNS activated (exercise and emotional stress). Treats tremors, tachycardia.

56
Q

What are side effects of beta blockers?

A

Bradycardia in normal or heart failure with abnormal hearts, impaired exercise tolerance, bronchospasm or asthma attacks in asthmatics, fatigue, depression, nightmares, may block tachycardia indicating low blood sugar in diabetics

Mental Health (11 decks)

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