what are some anxiety disorders
panic disorder, phobias, generalized anxiety disorder, obsessive compulsive disorder, and post-traumatic stress disorder
what are some physiological responses to anxiety
the body goes into fight or flight mode which turns on the autonomic sympathetic nervous system. it is the Primitive reflex and response. some noticeable effects will include:
pupils dilate, mouth goes dry, neck and shoulder muscles tense, heart pumps, ch
how should the nurse work with a client who is experiencing moderate anxiety
moderate anxiety can cause clients attention to wonder. The nurse must redirect client back to topic and validate client has heard and understood
how should the nurse work with a client who is experiencing severe anxiety
severe anxiety causes impairment of many abilities. They cannot learn or problem-solve. The nurse must call him client and focus on lowering anxiety. the patient could hyperventilate and they may need meds to help their anxiety.
anxiety disorders are more common in what type of people?
women, divorced or separated people, persons of lower socioeconomic status
what are some psychological effects of anxiety
poor communication, aggression, poor focus and retention
what are the three stages the body goes through in response to general anxiety disorder as identified by Selye
1. Alarm reaction - stimulation of the sympathetic nervous system
2. resistance - different systems being stimulated
3. exhaustion - the body needs to go
etiology behind anxiety
biological theories anxiety may have an inherited component.
Neurotransmitters may be dysfunctional and persons with anxiety disorders.
Psychodynamic theories: overuse of defense mechanisms, results from problems and interpersonal relationships, as learne
functions of the dopamine pathways
reward or motivation, pleasure, euphoria, motor function including fine-tuning, compulsion, and perservation
functions of the serotonin pathways
mood, memory processing, sleep, and cognition
usual treatment of anxiety
usually involves a combination of medication(anxiolytics and antidepressants) and therapy
cognitive behavioral therapy for anxiety includes?
positive reframing and decatastrophizing.
positive reframing is turning a negative message into a positive one.
Decatastrophizing is making a more realistic appraisal of the situation
Crisis Intervention focuses on the person's coping ability
helps the cl
what is assertiveness training
helps the client learn to negotiate interpersonal situations smart successfully. If the person can assert themselves they can help prevent aggression
what is Obsession in regards to obsessive compulsive disorder
recurrent, persistent, unwanted thoughts, images or impulses they cause marked anxiety and interfere with social or occupational function. thoughts may be trivial, ridiculous, morbid, fearful or have to do with violence or contamination
what is compulsion
ritualistic repetitive Behavior or mental acts a person feels they must do to relieve anxiety. they are relying on an action that will reduce the thoughts that they are having
what are some common compulsions someone might do with OCD
counting rituals, checking rituals, washing and scrubbing, praying and chanting, touching, rubbing, tapping, hoarding, arranging and rearranging, rigid performance as in getting dressed in the same order
the client with OCD will experience what if they are not able to perform their compulsions
they become very anxious and lose control if they're not able to perform compulsions. They usually are fearful that they will harm someone or something
onset of OCD may occur as early as? Especially in female or male children?
early as childhood especially in male children
what is PANDAS
pediatric autoimmune Neuropsychiatric disorders associated with streptococcal infections
it is a syndrome where OCD behavior and ticks are seen in children following streptococcal infections. Symptoms usually subside but may occur with future strep infect
moderate symptoms of OCD
the person may be productive in society. They are extremely organized, always follow rules and regulations and get things done
severe symptoms of OCD
this can lead to a loss of function. The person spends too much time organizing and paying attention to detail. No Time Left to actually get the project done. Cannot function in society. The impulsion relieves anxiety but doesn't last
what 8 antidepressants are effective in treating OCD
SSRIs:
fluvoxamine
fluoxetine
sertraline
paroxetine
venlafaxine
citalopram
escitalopram
tricyclic antidepressant:
clomioramine
how do tricyclic antidepressants work
they block the reuptake of Serotonin and norepinephrine making them more available to the brain
education for the family of the OCD
interact I completion of performed ritual. Anxiety is lowest at this time.
do not interfere with compulsive Acts. As long as it's not harmful . interference increases anxiety. listen to obsessive themes. Acknowledge effects compulsions pass on the client.
it is shown that people with OCD have changes in what part of their brain
changes in the amygdala of the brain have been noted in people with OCD. It is the limbic system primitive part of the brain. it is a site that controls fear responses
what are some OCD nursing interventions that might help the client
emphasize medication compliance. Teach relaxation techniques to decrease anxiety. Provide resources for family support
what is a panic disorder
it involves a 15 to 30 minute episode of intense, escalating anxiety with emotional fear and physiologic discomfort. It is important that a client learn coping strategies when there is an impending panic disorder.
what is the patient feeling when going through a panic disorder
patient feels unreal and detached from self during the attack. fears losing control or going insane . has temporarily disorganized thought process, feels he or she is dying. Judgment is poor during an attack
what are some nursing outcomes for the client with anxiety panic disorder
the client will be free from injury, verbalize feelings, is effective coping techniques, manage own anxiety response, verbalize sense of personal control, sleep at least 6 hours per night
what are some nursing interventions for the client with anxiety panic disorder
promoting safety and comfort, using therapeutic communication, managing anxiety, client and family teaching
what is a phobia
a phobia is an illogical, intense, persistent fear of a specific object or social situation that causes extreme to stress and interferes with normal life functioning. a specific phobia is irrational fear of an object or situation, such as storms, Heights,
the first step in treating a client with phobia is?
figuring out with a phobia is
what is a social phobia
social phobia involves severe anxiety, even panic, when confronting with situations involving people, eating in public, using public bathrooms, or being the center of attention
etiology of phobia
what is biologic, phobias run in families. it has to do with hormonal functions or neurotransmitter activities. It is also psychodynamic and that the person feels like they have faulty thinking, believes one doesn't control the environment, or has learned
treatment for phobias
psychopharmacology and Psychotherapy
psychopharmacology including anxiolytics, SSRI antidepressants, beta-blockers to slow heart rate and lower blood pressure
Psychotherapy including behavioral therapies which focus on systematic desensitization and flood
what is generalized anxiety disorder
excessive worry and anxiety that is unwarranted more days than not. the person cannot pinpoint what they have the anxiety about
treatment for generalized anxiety disorder
drugs are only half of the solution but can be treated with SSRI antidepressants and buspirone.
there are Community Mental Health Centers which focus on rehab medical management of symptoms, education, vocational needs, and support groups
With the person with an anxiety disorder what are some factors that may affect their stress response
culture, developmental stage, family Dynamics, personality, and past experiences
Crisis Intervention for the client with an anxiety disorder helps with? allows for? AIDS in learning? And provides the client with?
helps the client with resolution of immediate problem. allows for expression of events and factors that surround the crisis event. AIDS and learning and trying new effective coping skills. Provides client with empathetic listener, counseling and referral
what are some results of unresolved stress for the client experiencing an anxiety disorder crisis
their usual coping mechanisms did not work. mixed and conflicting emotions. increase frustration and anxiety period more negative use of coping mechanisms. May lead to abuse of others ourselves as in suicide. safety is the number one priority with a stres
what are some causes of post-traumatic stress disorder
individual trauma / stress such as abuse, criminal victimization common multiple stressors and Rapid succession like deaths illnesses and Trauma.
group trauma / stress such as War, terrorism common natural disasters, Community loss
what are some Disturbed patterns of behavior with post-traumatic stress disorder
intense memories of the trauma. Dreams / nightmares, trouble sleeping. Flashbacks. intense, recurrent, intrusive thoughts. Emotional numbing or feeling detached from others period increased irritability, bouts of anger or rage. Hyperarousal, jumpiness, ea
acute stress disorder occurs in what time period in relation to the trauma. post trauma stress disorder occurs in what time period in relation to the trauma.
acute stress disorder occurs Within three months of the trauma. Post trauma stress disorder occurs after 3 months of the trauma. post-traumatic stress disorder is chronic in nature with periods of exasperation during increased times of stress.
post-traumatic stress disorder can lead to other psychiatric disorders such as
depression, anxiety, and substance abuse
risk factors for post-traumatic stress disorder
if the person is directly involved in the traumatic event. Experiences of a physical injury. loss of a loved one. Lack of social support system to assist with processing event. previous psychiatric history or personality disorder. adolescents are at a hig
adolescents suffering from post-traumatic stress disorder have an increased risk for?
suicide, substance abuse, antisocial Behavior such as rebelliousness, problems in school, health concerns
what are some post-traumatic stress disorder treatment options
Psychotherapy either individual or group. medication such as antidepressants, anxiolytics, and sleep aids. Self-help groups period exposure therapy period relaxation techniques. Adaptive disclosure. Cognitive processing therapy. Mental health promotion
what is acting out
not coping and giving in to the pressure to misbehave
what is aim inhibition
lowering sites to what seems more achievable
what is attack
trying to beat down that which is threatening you
what is avoidance
mentally or physically avoiding something that causes distress
what is compartmentalization
separating conflicting thoughts into separated compartments
what is compensation
making up for weakness in one area by gaining strength in another
what is conversion
subconscious conversion of stress into physical symptoms
what is denial
refusing to acknowledge that an event has occurred
what is displacement
shifting of intended action to a safer Target such as kick the dog syndrome
what is disassociation
separating oneself from parts of your life
what is fantasy
escaping reality into a world of possibility
what is idealization
playing up the good points and ignoring limitations of things desired
what is identification
copying others to take on their characteristics
what is intellectualization
avoiding Emotion by focusing on facts and logic
what is introjection
bringing things from the outer world into the inner world
what is passive aggression
avoiding refusal by passive avoidance
what is projection
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what is rationalization
creating logical reasons for bad behavior
what is reaction formation
avoiding something by taking a polar opposite position
what is regression
returning to a child state to avoid
what is repression
subconsciously hiding uncomfortable thoughts
what is somatization
psychological problems turned into physical symptoms
what is sublimation
channeling psychic energy into acceptable activities
what is suppression
consciously holding back unwanted urges
what is symbolization
turning unwanted thoughts into metaphoric symbols
what is trivializing
making small of what is really big
what is undoing
actions that psychologically undo wrongdoings for the wrongdoer
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