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NUR 210 > Anxiety > Flashcards

Anxiety Flashcards

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1
Q

what is anxiety

A

a subjectively distressful experience activated by the perception of threat which has both a potential psychological and physiologic etiology and expression

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2
Q

what are the feelings of anxiety

A

discomfot
apprehension
dread related to anticipation of danger

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3
Q

what is the source of anxiety

A

often nonspecific
known or unknown stressors

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4
Q

what is pathologic anxiety

A

when fears and anxieties are excessive and interfere with functioning

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5
Q

how can anxiety present itself

A

episodic
chronic
mild to panic
adaptive (motivating)
functionally impairing
a symptom
a disorder

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6
Q

what is the fight or flight response

A

activation of SNS
adrenal cortex releases adrenalin
heart speeds up…blood circulates faster
lungs dilate to increase o2 in blood
liver releases stored glucose for quick energy
pupils dilate to see better
digestion slows to conserve energy

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7
Q

observable signs of fight o flight

A

tachycardia
disambiguation
bladder relaxation
tremors
blushing
xerostomia
delayed digestion
hyperacusis

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8
Q

3 stages of selyes general adaption syndrome

A

alarm
resistance
exhaustion

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9
Q

what is the alarm stage

A

fight or flight response activated the bdys resources respond to the stressor

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10
Q

what is the resistance stage

A

parasympathetic nervous system activated to reduce the reaction some form of homeostasis while other systems remain hyperactive to ensure readiness to continue fight or flight

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11
Q

what is the exhaustion stage

A

intense continual stressor
body unable to continue compensating, susceptible to disease or death

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12
Q

what is the healthy function of fight or flight

A

negative feedback loop- production of stress hormones stops further production
we calm down after the initial; fight or flight SNS burst

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13
Q

what is unhealthy function of fight or flight

A

when cortisol and norepinephrine are chronically overproduced, the HPA axis eventually becomes desensitized to the negative feedback telling it to calm down
chronic stimulation of the hypothalamus, pituitary gland and adrenal glands result in more cortisol and stress

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14
Q

what is clinical threashold

A

observe and recognize anxiety in our patients

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15
Q

what is clinic perception

A

ability of the nurse to recognize anxiety based symptoms

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16
Q

what are symptomss of anxiety

A

fatigue
muscular tension
arousal
worry
irritability
phobia avoidance
compulsions
panic attacks
fight or flight symptoms

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17
Q

what are subtle symptoms of anxiety

A

impaired concentration
distracted
talkative
distracted during nsg assessment

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18
Q

physiological consequences are dependent upon…

A

symptom duration
symptom intensity
degree of functional impairment

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19
Q

what diseases are you at increased risk for morbidity with anxiety

A

cerebrovascular
atherosclerosis
ischemic heart
GI
HTN
resp
GU

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20
Q

what is a stressor (trigger)

A

an external pressure that an individual experiences
anxiety is the subjective emotional response to that stressor

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20
Q

anxiety is ….. while fear is …..

A

an emotional process
a cognitive one

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21
Q

what is mild anxiety

A

seldom a problem/not pathology
tension in response to day to day living
enhances senses
increases motivation for productivity
learning is enhanced

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22
Q

what is moderate anxiety

A

perceptual field beings to diminish
less alert to surroundings
decreased attention and concentration
muscular tension
restlessess

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23
Q

what is severe anxiety

A

concentration centers on one particular detail only or on many extraneous details
perceptual fields diminishes greatly
attn span is extremely limited
physical symptoms: headache, insomnia, GI distress
emotional symptoms: dread, confusion
all behavior aimed at relieving anxiety

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24
what is panic anxiety
unable to focus on even 1 detail within the environment loss of contact w/ reality may occur: sometimes hallucinations feeling of terror: "I'm going insane" and "I'm dying" human functioning and communication with others are ineffective prolonged panic anxiety can lead to exhaustion and be life threatening
25
how do you want to communicate to someone who is having severe/panic anxiety
give clear and direct communication
26
what are some healthy adaptive coping strategies
minduflness sublimination (channeling anxiety into work/productivity) exercise deep breathing
27
what are some ineffective maladaptive coping strategies
compulsive behaviors substance abuse avoidance interpersonal violence
28
who is at risk
most prevalent subgroup of mental illness in US 12 mo prevalence: 18.1% adults and 25.1% children avg age onset: 11 y/o women are 60% more likely than men to have significant anxiety white appears more vulnerable compared to black or hispanic
29
what are individual risk factors
temperament environmental genetic physiologic
30
what is temperament
how an individual interacts in society affects how society will interact w/ the individual
31
how is temeprament a risk factor for anxiety
selective mutism specific phobia social anxiety disorder panic disorder agoraphobia - avoiding crowds GAD
32
what enviornmental factors are linked to physiologic and psychological manifestations
stress event of loss, death, or a profound change is seen in separation anxiety development of phobias seen from parental overprotectiveness, parental loss or separation, physical or sexual abuse childhood maltreatment and adversity during childhood are risks for social anxiety disorder physical and sexual abuse are common with panic disorder stressful life events in early childhood are a risk factor for agoraphobia
33
what is genetic vulnerablity
neuroanatomy, neural circuits, neurotransmitter systems are genetic twin studies: separation anxiety disorder saw a 73% heritability rate among a sample of 6y/o twins some ppl more vulnerable to anxiety and some more resistant to stress
34
what is physiologic anxiety
children w/ separation anxiety show a sensitivity to respiratory complications vasovagal syncope when exposed to needles for blood draws medical conditions: cancer, heart disease, COPD, diabetes
35
what is PTSD
an extended reaction to an extreme trauma which is likely to cause pervasive distress to almost anyone natural/manmade disasters, combat, serious accidents, witnessing violent death or others, being the victim of torture or abuse, terrorism, rape or other crimes "shell shock" "soldiers heart" "post traumatic neurosis" more than 1/2 of all individuals will experience a traumatic event in their lifetime, but less than 10% will develop PTSD neurotransmitters be,eived to be dysregulated (norepi, dopamine, GABA) dysfunction in the HPA axis r/t chronic stress and or traumatic event
36
what is a truamatic event
event outside the range of usual human experience
37
whcih gendere is PTSD more comon in
women
38
symptoms of PTSD
dissociated amneasia flashbacks intrusive recollections emtional numbness r/t event nightmares substance abuse explosiveness self-destruction verbalization of survival guilt guild ab behavior that was required for survival
39
risk for panic disorder
genetic vulnerability tendency toward neg emotions hx or trauma respiraotry disturbances (asthma, COPD, smoking) fearful spells that do not fully meet criteria for panic attack
40
what is panic disorder
characterized by recurrent panic attacks onset which is unpredictable tense apprehension, fear, terror, often associated with feelings of impending doom and accompanied by intense physical discomfort symptoms are sudden not triggered by situations panic attacks last minutes, nervousness and apprehension betwn attacks
41
pt must have 4 of what symptoms for it to be a panic attack
palpitations, pounding heart, or accelerated hr sweating trembling or shaking sensations of sob or smothering feelings of choking chest pain or discomfort nausea or ad distress feeling dizzy, unsteady, lightheaded or faint chills or heat sensations paresthesia derealization or depersonalization
42
what is separation anxiety
excessive fear or anxiety r/t the separation from an individual to whom an individual is attached interferes w/ social, academic, occupational or other areas of functioning most commonly diagnosed aroundage 5 or 6 when a child goes to school 43% pf those diagnosed are 18 y/o and older more common in girls than boys diagnosed after lasting 4 weeks in children and adolescent, 6 mo in adults
43
common behaviors of separation anxiety
tantrums crying screaming complaints of physical problems clinging behaviors reluctant or refusal to attend school nightmares involving the person of separation younger children shadow person they don't want to be separated from adolescents may refuse to sleep away from home specific phobias depressed mood
44
common comorbidities associated w/ SA
panic disorder social anxiety specific phobias depression bipolar
45
what is ocd
obsessive thoughts that manifest as compulsive behavior presence of obsessions, compulsions or both behavior lasting > 1 hour is a problem
46
biological implications of ocd
brain structure- limbic system neurotransmitter hypothesis- decreased levels of serotonin possible endocrine correltation- increased corisol levels possible genetic link- twin sitdues suggest a possible link
47
what is obsession
recurrent and persistent thoughts, urges or images that are experienced at some time during the disturbance as intrusive and unwanted, in most individuals it causes marked anxiety or distress
48
what are compulsions
inability to fulfill the ritual is commonly associated w/ profound anxiety excessive time engaged in the repetitiuos thoughts or behaviors interfere with the individuals daily life
49
examples of compulsions
repeatedly washing hands checking things repeat an action counting things a preoccupation w/ symmetry hoarding
50
what is the HAM-A scale
not a screening or disgnostic tool rates how someone is managing their anxiety while in treatment
51
planning and implementation of anxiety (panic)
stay with client during panic anxiety maintain calm nonthreatening approach keep the immediate surroundings low in stimuli teach pt signs of escalating anxiety and explore cause after anxiety has been reduced
52
planning and implementation of fear
reassure pt of safety include pt in making deciosns encourage pt to explore underlying feelings
53
planning and implementation of ineffective coping
initially meet the pt's dependence needs provide structured schedule of activities gradually limittime for riualistic behaviors
54
planning and implementation of disturbed body image
help pt see his/her body image is distorted involve in activities that reinforce sense of self make referrals to support groups
55
what are SSRIs and SNRIs considereed
1st and 2nd line agents
56
what is buspirone
an anxiolytic with no dependence
57
what is concern with benzos
dependence/tolerance paradoxical rxn sedation resp depression w/draw symptoms (taper) cant take during pregnancy
58
what is hydroxyzine
an anithistamine similar to benadryl reduces CNS activity
59
what are beta blockers used for with anxiety
performance anxiety tramatic nightmares take 1 hr before event
60
what is cognitive behaviroal thapy
model of therapy that uses evidence to challenge automatic negative thoughts that reinforce anxiety typically 5-20 sessions pt completes homework btwn sessions
61
what is individual psychotherapy
supportive psychotherapy is deisgned to help pt identify their personal strengths and explore adaptivecoping mechanisms helps pt identify, explore, and resolve internal psychological conflicts that are contributing to anxiety
62
what is systematic desensitization
training in relaxation techniques progressive expoure to a hierarchy of fear stimuli while in the relaxed state
63
what is implosion therapy
therapist floods the pt with info concerning situations that trigger the pts anxiety by describing anxiety provoking situations in vivid detail technique works best for specific phobias contraindicated if extreme anxiety would be detrimental to pt's health
64
what is acceptance and commitment therapy
uses acceptance and mindfulness to increase the pts fleixibitly thereby decreasing avoidant and other behaviors that interfere with fxn
65
what is habitat reversal training
system of positive and negative reinforcement in an effort to modify the hair pulling behavior individual leanrs to become more aware of the hair pulling identifies times of occurrence and sustitues a more adaptive coping strategy
66

NUR 210 (10 decks)

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