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Nursing 172 > Week 1 Anxiety and Panic > Flashcards

Week 1 Anxiety and Panic Flashcards

1
Q

Anxiety

A

a vague feeling of dread or apprehension

-it is a response to external or internal stimuli that can have behavioral, emotional, cognitive, and physical symptoms

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2
Q

Panic Attack

A

between 15 and 30 minutes of rapid, intense, escalating anxiety in which the person experiences great emotional fear as well as physiological discomfort
-rarely any discernible cause for the panic but the bodys fight or flight mechanism abruptly creates all the sensations of great danger

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3
Q

Panic Disorder

A

composed of discrete episodes of panic attacks

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4
Q

Anxiolytic Drugs (Anxiolytics)

A

used to treat anxiety and anxiety disorders, insomnia, obsessive compulsive disorders (OCD), depression, Post-Traumatic Stress Disorder (PTSD), and alcohol withdrawal

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5
Q

Anxiety Disorders

A

a group of conditions that share a key feature of excessive anxiety, with ensuing behavioral, emotional, cognitive, and physiological responses

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6
Q

When is Anxiety Pathological? (Involving, caused by, or of the nature of physical or mental disease)

A
  • no obvious threat exists or threat has passed but anxiety continues
  • internal conflict (repression)
  • out of proportion to situation
  • prevents fulfillment of roles
  • interferes with daily/ social activities
  • affects overall quality of life
  • defense mechanism overused
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7
Q

Anxiety Etiology

A

-anxiety/ panic may be an imbalance of Gamma-Aminobutynic Acid (GABA)

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8
Q

Symptoms of Anxiety

A

-unable to relax (restlessness)
-excessive worry
-easily startled
-easily fatigued
-difficulty in concentrating
-irritability
-trembling
-muscle tension
-sweating
-nausea
-shortness of breath
-sleep disturbances
-tachycardia
-angina
-increased BP
no 2 people present in exactly the same way

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9
Q

Acute Nursing Interventions

A
  • Safety: stabilize medically and give psychological reassurance
  • remain with the patient
  • focus on deep breathing, visual imagery
  • talk in a calm reassuring voice
  • benzodiazepines
  • Buspirone (buspar)- after benzodiazepines
  • relaxation techniques
  • maintain contact with community
  • maintain prescribed medication regimen and follow-up
  • time management techniques
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10
Q

When Assessing An Apparently Anxious Client, Questions about Anxiety Should Be?

A

Specific and Direct

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11
Q

Anxiety: Common Physiological Responses

A
  • increased heart rate
  • increased blood pressure
  • rapid, shallow respirations
  • dry mouth
  • tight feeling in throat
  • tremors
  • muscle tension
  • anorexia
  • urinary frequency
  • palmer sweating
  • feelings of gloom and doom
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12
Q

Anxiety Pharmacological Management

A
  • Anxiolytics (anti-anxiety agents)
  • Benzodiazepines and Non-benzodiazepines
  • SSRI (Selective Serotonin Re-uptake Inhibitors)
  • MAOI (Monoamine Oxidase Inhibitor Antidepressants)
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13
Q

Anxiety General Outcomes

A
  • reduce anxiety
  • enhance coping
  • maintain role performance
  • focus on problem-identification
  • demonstrate healthy ways of dealing with stress
  • interpret and respond to messages objectively
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14
Q

GABA

A

an inhibitory neurotransmitter, functions as the bodys natural anti-anxiety agent by reducing cell excitability, decreasing the rate of neuronal firing

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15
Q

Amino Acid Neurotransmitter Believed To Be Dysfunctional in Anxiety Disorders?

A

Gamma-aminobutyric acid (GABA)

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16
Q

Where Is GABA Available?

A

in one-third of the nerve synapses those in the limbic system and locus coerulus, area where norepinephrine is produced

17
Q

Why does GABA cause a problem in anxiety disorders?

A

because GABA reduces anxiety and norepinephrine increases it, the regulation of these neurotransmitters occurs in anxiety disorders
-GABA is available where norepinephrine is produced (norepinephrine excites cell function)

18
Q 
Which of the four classes of medications used for panic disorder is considered safest because of low incidence of side effects and lack of physiological dependence?
A. Benzodiazepines
B. Tricyclics
C. MAOI
D. SSRI
A

D. SSRI

19
Q

The best goal for a client learning a relaxation technique is that the client will _____?
A. Confront source of anxiety directly
B. Experience anxiety without feeling overwhelmed
C. Report no episodes of anxiety
D. Suppress anxious feelings

A

B. Experience anxiety without feeling overwhelmed

20
Q

A client with GAD (Generalized Personality Disorder) states, “I have learned that the best thing I can do is to forget my worries”. How would the nurse evaluate this statement?
A. Client is developing insight
B. Clients coping skills have improved
C. Client needs encouragement to verbalize feelings
D. Clients treatment has been successful

A

C. Client needs encouragement to verbalize feelings

21
Q

4 Types of Anxiety

A
  • Mild
  • Moderate
  • Severe
  • Panic
22
Q

Mild/Normal Anxiety

A

helps people learn, grow and change

-is considered to be healthy and is accomplished by a level of mild anxiety

23
Q

Moderate Anxiety

A

increases focus on the alarm and learning is still possible

  • lingers and continues to influence the persons life
  • the person experiences feelings of being overwhelmed and troubled
24
Q

Severe Anxiety

A

greatly decreases cognitive function, increases preparation for physical responses and increases space needs

  • occurs when the person’s stress level has not been reduced and is now more obvious
  • negative behaviors begin to intrude such as somatic complaints, agitation, and anger
25
Q

Panic Anxiety

A

fight, flight, or freeze response, no learning is possible, and person is attempting to free themselves of the discomfort of high stage anxiety

  • results in a person that is physically and emotionally exhausted from stress
  • the ability to cope and exert self-control is virtually on-existent
26
Q

Nursing Interventions

A
  • provide safe environment and ensure privacy
  • remain with the client
  • focus on deep breathing
  • talk in a calm, reassuring voice
  • use relaxation techniques
  • cognitive restructuring techniques
  • explore how to decrease stressors
  • verbalize feelings
27
Q

Client and Family Education for Panic Disorder

A
  • breathing control and relaxation techniques
  • positive coping strategies
  • regular exercise
  • maintain prescribed medication regimen and follow-up
  • time management, “to do” list with realistic deadlines
  • maintain contact with community
28
Q

Benzodiazepines Medication List

A
  • Alprazolam
  • Lorazepam
  • Chlordiazepoxide
  • Clonazepam
  • Diazepam
  • Clorazepate
  • Oxazepam
29
Q

Non-Benzodiazepines Medication List

A

Buspirone

30
Q

SSRI Medication List

A
  • Sertraline
  • Fluoxetine
  • Paroxetine (Paxil)
  • Citalopram
  • Escitalopram
31
Q

MAOI Medication List

A
  • Phenelzine
  • Tranylcypromine
  • Isocarboxazide
32
Q

Nursing Actions for Mild/Normal Anxiety

A
  • allowing expressions of feelings
  • employ empathy in communication
  • demonstrate active listening
  • help patient identify problems
  • assist in problem solving
  • evaluate, explore results, plan
33
Q

Nursing Actions for Moderate Anxiety

A
  • offer a cool beverage
  • respect need for personal space
  • actively dialogue with patient to share feelings
  • create activities for distraction
  • explore alternative coping mechanisms
  • help patient focus on here and now
34
Q

Nursing Actions for Severe Anxiety

A
  • begin limit setting
  • make simple and direct statements
  • describe behavior needed
  • notify MD and administer medication
  • remove other patients from day room
  • explain consequences of behavior
35
Q

Nursing Actions for Panic Anxiety

A
  • assess potential for injury to self/others
  • conduct debriefing of unit community
  • call for therapeutic team support
  • call physician for onsite assessment
  • conduct debriefings of staff and patient post-containment

Nursing 172 (120 decks)

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