Week 3 - ATI - Anxiety, Trauma, Stress-related disordes Flashcards
What are the types of anxiety disorders?
Generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder
What are the psychological manifestations of anxiety disorders?
Fear, apprehension
What are the physical manifestations of anxiety disorders?
Palpitations, tachycardia, shortness of breath
What is the prototype medication for benzodiazepines?
Alprazolam
List some other medications that are benzodiazepines.
- Diazepam
- Lorazepam
- Chlordiazepoxide
- Clorazepate
- Oxazepam
- Clonazepam
What is the expected pharmacological action of benzodiazepines?
Enhance the inhibitory effects of gamma-aminobutyric acid (GABA) in the CNS
What are the therapeutic uses of benzodiazepines?
- Generalized anxiety disorder (GAD)
- Panic disorder
- Acute stress disorder (ASD)
- Posttraumatic stress disorder (PTSD)
- Seizure disorders
- Insomnia
- Muscle spasm
- Alcohol withdrawal
- Induction of anesthesia
What are the complications associated with benzodiazepines?
- CNS depression
- Anterograde amnesia
- Paradoxical response
- Withdrawal effects
What are the signs of CNS depression that clients should observe for?
- Sedation
- Lightheadedness
- Ataxia
- Decreased cognitive function
What should a client do if they experience anterograde amnesia?
Notify the provider if effects occur
True or False: Benzodiazepines are safe for long-term use.
False
What are the contraindications for benzodiazepines?
- Pregnancy Risk Category D
- Sleep apnea
- Respiratory depression
- Glaucoma
What is the prototype medication for atypical anxiolytics?
Buspirone
What is the expected pharmacological action of buspirone?
Binds to serotonin and dopamine receptors; dependency is much less likely
What are the therapeutic uses of buspirone?
- Panic disorder
- Social anxiety disorder
- Obsessive-compulsive disorders
- Trauma- and stressor-related disorders
- Generalized anxiety disorder (GAD)
What are common complications of buspirone?
- Dizziness
- Nausea
- Headache
- Lightheadedness
- Agitation
What is the major disadvantage of buspirone?
Antianxiety effects develop slowly, requiring at least 2 to 4 weeks for full effects
What are selective serotonin reuptake inhibitors (SSRIs) used for?
- Generalized anxiety disorder (GAD)
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Social anxiety disorder
- Trauma- and stressor-related disorders
What is the prototype medication for SSRIs?
Paroxetine
What are some early adverse effects of SSRIs?
- Nausea
- Diaphoresis
- Tremor
- Fatigue
- Drowsiness
What can occur after 5 to 6 weeks of SSRIs therapy?
- Insomnia
- Headache
- Sexual dysfunction
- Weight changes
What is serotonin syndrome?
Agitation, confusion, disorientation, difficulty concentrating, anxiety, hallucinations, myoclonus, hyperreflexia, tremors, fever, diaphoresis
What should clients do to avoid complications with SSRIs?
Report adverse effects to the provider and take the medication as prescribed
What is the risk category of paroxetine during pregnancy?
Pregnancy Risk Category D
What is the recommended method for discontinuing medication after long-term use?
Slowly taper the dose of medication before stopping.
Abrupt discontinuation can lead to withdrawal symptoms.
What should be monitored in clients taking medications that can cause postural hypotension?
Monitor for hypotension and advise clients to change positions slowly.
What are the nursing actions related to suicidal ideation?
Monitor and report manifestations of depression and thoughts of suicide.
What pregnancy risk category is paroxetine classified under?
Pregnancy Risk Category D.
Which medications are contraindicated for clients taking paroxetine?
MAOIs and TCAs.
What substance should clients taking paroxetine avoid?
Alcohol.
In which conditions should paroxetine be used cautiously?
Liver and renal dysfunction, seizure disorders, history of GI bleeding.
What can the combination of St. John’s wort, MAOI antidepressants, or TCAs cause?
Serotonin syndrome.
What nursing actions should be taken regarding antiplatelet medications and anticoagulants when a client is on paroxetine?
Monitor for bleeding and avoid concurrent use.
How should paroxetine be administered to a client?
Administer with food.
How long can it take to achieve therapeutic effects from paroxetine?
Up to 4 weeks.
What is a key client education point regarding the timing of medication intake?
Taking the medication at the same time daily promotes therapeutic levels.
What is a recommended time to take medication to prevent sleep disturbances?
In the morning.
What are the indicators of medication effectiveness for anxiety treatments?
- Verbalizing feeling less anxious and more relaxed
- Description of improved mood
- Improved memory retrieval
- Maintaining regular sleep pattern
- Greater ability to participate in social and occupational interactions
- Improved ability to cope with manifestations and identified stressors.
What is the priority action for a nurse caring for a client with benzodiazepine toxicity?
Identify the client’s level of orientation.
What should a client understand about the new prescription for escitalopram?
I need to discontinue this medication slowly.
How should buspirone be taken for optimal results?
On a regular basis, not as needed.
What is a correct instruction for a client prescribed paroxetine?
It can take several weeks before you feel like the medication is helping.
Which intervention can help manage bruxism associated with paroxetine?
- Use of a mouth guard
- Changing to a different class of antidepressant medication.
True or False: Paroxetine can cause decreased appetite and weight loss.
True.
