Anxiety Flashcards by Dyan Jones

emotional response to stressor which may be unknown
-provides motivation for achievement and necessary for survival
Most common psychiatric illness

anxiety

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Mild
Moderate
Severe
Panic

Levels of Anxiety

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Reduced perception
Reduced alertness
Learning, but not at optimal level
Decrease attention and concentration
**Increased Heart Rate, Respirations, Perspiration, Restlessness, Muscle tension

Moderate Anxiety

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Heightened perception
Learning is enhanced
Restless, irritable
Rarely distressed

Mild level of Anxiety

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Greatly diminished perception
May not notice events
Extremely limited attention span; No learning
Headaches, dizziness, nausea, insomnia, hyperventilation
**Feeling of Dread; Focus on self

Severe Anxiety

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Misperceptions common
No Learning; concentration or ability to comprehend
Dilated pupils, labored breathing, severe trembling, diaphoresis, pallor
**Sense of impending doom, terror, bizarre behavior, Hallucinations, delusions

PANIC Anxiety

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Recurrent attacks with unpredictable onset
Manifested by intense apprehension, fear or terror with physical discomfort
Must include at least 4:
*Palpations
*Sweating
*Shaking
*SOB
*Choking feeling
*Chest pain/discomfort
*Nausea
*Dizziness
*Chills
*Paresthesia-tingling down the arms
*Derealization
*Fear of "going crazy"
*Fear of dying

Panic disorder
*Most severe form of anxiety
can last mins or hrs
starts in 20’s

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Persistent, unrealistic and excessive anxiety and worry for at least **6 Months!

excessive anxiety difficult to control
restlessness
easily fatigued
difficulty concentrating
irritability
muscle tension
sleep disturbances

Generalized Anxiety Disorder (GAD)

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Fear of being in situation where escape is difficult or help not available in event attack may occur.
Phobias
*Social anxiety disorder
-acrophobia-heights
-algophobia-pain
-arachnophobia-spiders
belonephobia-needles
dementophobia-insanity
ophidiophobia-snakes
pyrophobia-fire
triskaidekaphobia-number 13
xenophobia-strangers
zoophobia-animals

Agoraphobia; afraid of being in public

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Recurrent obsessions or compulsions that are severe to be time consuming or cause significant impairment

Obsessive-Compulsive Disorder OCD

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Obsessions vs. Compulsions
-Related disorders
*Body Dysmorphic Disorder;
*Trichotillomania (hair pulling disoder)
*Somatic Symptoms &amp; Dissociative Disorders
Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder
Factitious Disorder
Dissociative Identity Disorder

OCD disorders

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Preoccupation with one or more defects or flaws in physical apperance not observable to others
Performed repetitive behaviors or mental acts in response to appearance concerns

Body Dysmorphic Disorder

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Recurrent pulling out of one’s hair that results in hair loss
Preceded by increasing sense of tension and results in sense of release or gratification

Trichotillomania * hair pulling disorder

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provides relief so they don’t have anxiety

compulsion

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intrusive, unwanted; trying to ignore or suppress compulsion, repetitive behavior response to obsession

obsession

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excessive thoughts of something physical that impairs life

somatic symptom disorder

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common for military, loss or change in body function that cant be explained Usually short term

Conversion Disorder

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Munchhausen

falsifying symptoms/injure self; to get emotional care and support- to be the “patient”

Facititous Disorder

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DID; multiple personality disorder
Dominant personalilty doesnt have awareness of other personalities; subpersonalities are aware of the others.
transition sudden or gradual

Dissociative Identity Disorder

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Buspar; own class-up to 2 weeks to be effective; Chronic GAD; having effects on serotonin & dopamine
Benzodiazepine;
Antihistamines; Vistaril, hydroxazine; drowsiness, dizziness, dry mouth, good for people with addictions and kids

Anti-anxiety (Anxiolytics)

Psychopharmocology

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SSRI’s; Antidepressants; Used for OCD, anxiety disorder

Antihypertensives; bringing heart rate down. social anxiety

Psychopharmocology for anxiety

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Xanax, Ativan, Klonopin; PRN Benzo’s, can be abused-drowsiness, dizziness can occur
Paxil, Prozac, Zoloft

Meds for Panic disorder

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Buspar

Paxil, Lexapro, Cymbalta, Effexor XR

GAD Meds

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Xanax, klonopin

Paxil, Zoloft

Phobic Disorders Meds

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Prozac, Paxil, Zoloft, Luvox

OCD Meds

For the last year, a college student, continually and unrealistically worries about academic performance and love life performance. The student is irritable and suffers from severe insomnia. This behavior is assoc. with which Axis I diagnosis:

GAD

When caring for a client who is experiencing a panic attack, which of the following nursing actions should be implemented?

Communicate with simple words and brief messages

Which statement is true about patients who have somatoform disorders? They..

Are difficult to convince to seek psychiatric help

What should the nurse plan to teach a client who is taking alprazolam (Xanax) three times a day?

That there is a potential for dependence and tolerance

A newly admitted client, diagnosed with OCD, spends one hour packing and unpacking, folding and refolding personal belongings. What is the most likely reason for this behavior?

It relieves anxiety

* C=Communicate * H=Health (nurtition, exercise) * I=Image * L=Lighten up (relaxation techniques) * L=Little by little (time management)

Chill

limbic system-stimulation to this area of brain produces anxiety and fear

Neuroanatomical Considerations

norepinephrine; hyperarousal & anxiety serotonin; OCD GABA; inhibits post synaptic excitation

Neurotransmitter assoc. with anxiety

stimulates alpha-adrenergic receptors; slow heart rate down

Clonidine meds

excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others

Social Anxiety Disorder (Social Phobia)

norepinephrine; hyper arousal and anxiety serotonin; OCD Gaba; inhibits post synaptic excitation -Elevated levels of norepinephrine; Panic disorder -Serotonin; OCD relief with SSRI's , fluoxetine and clomipramine GABA; enchancement of the GABA system is the mechanism of action by which benzo's produce calming effects

Neurotransmitter assoc. with anxiety

apprehension, tension or uneasiness from anticipation of danger, the source of which is largely unknown or unrecognized. Maybe regarded as pathological when it interfers with social and occupational functioning, achievement of desired goals, or emotional comfort.

Anxiety

promotes the motivation for achievement, is a necessary force for survival. -used interchangeably with the word Stress -Stressor; "external pressor brought on to bear with the individual. The subjective response to that stressor

Anxiety

Stimulates alpha-adrenergic receptors; slows the heart rate down.

Clonidine

usually considered a normal reaction to a realistic danger or threat to biological integrity or self-concept. -Normality considered by societal standards.

Anxiety

Characterized by recurrent panic attacks; onset of which is unpredictable and manifested by intense apprehension, fear or terror; often assoc with feeling of impending doom and accompanied by intense physical discomfort. -comes on unexpectedly (focus of others attention as social anxiety disorder)

Panic disorder

Ind. avoids activities or events that may result in neg. outcomes, or spends considerable time and effort preparing for such activities. -Result in procrastination in behavior or decision-making, and the ind. repeatedly seeks reassurance from others. -Can begin in childhood/adolescense `onset not uncommon after age 20 `depressive symptoms and somatic complaints common

Generalized anxiety disorder GAD

Fear cued by the presence or anticipation of a specific object or situation, exposure to which almost invariably provokes an immediate anxiety response or panic attack even though he subject recognizes that the fear is excessive or unreasonable. The phobic stimulus is avoided or endured with marked distress

Phobia

"fear of the marketplace"

Agoraphobia

excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others. `usually results in feelings of panic anxiety, with sweating, tachycardia, and dyspnea.

Social Anxiety Disorders (Social Phobia)

``` `alcohol `amphetamines `cocaine `hallucinogens `sedative-hypnotics `caffeine `cannabis `other substances ```

medication-induced anxiety

learns to engage in behaviors that provide relief from anxiety and discomfort assoc. with traumatic events.

active avoidance

client must imagine situations or participate in real life situations that is frightening for a prolonged time. `trigger anxiety -This technique works best for Phobias

Implosion Therapy (Flooding)

does not depress the CNS, it produces effects through interactions with serotonin, dopamine, and other neurotransmitter receptors

Buspirone; wellbutrion

effective in blocking the acute anxiety effects in conditions such as opioid and nicotine withdrawal.

Clonidine (betablockers, alpha-receptor)

agoraphobia and social anxiety

MAOI's

treatment (1st line) in social anxiety disorders

SSRI's

reducing symptoms of stage fright

Beta blockers

OCD relief

SSRI's

clomipramine (anafranil) and Prozac (fluoxetine)

Body Dymorphic Dysorder

chlorpromazine, amitriptyline, lithium carbonate

Trichotillomania (hair pulling)

the splitting off of clusters of mental contents from conscious awareness, a mechanism central to hysterical conversion and dissociative disorder `a type of repression

Dissociation

fabricating symptoms for emotional gain | `fabricated stories and fanciful exaggerations about ones self.

Munchausen Syndrome

aka hypochodriasis (fear of having a disease) `attention seeking through medical care. Often more doctors than 1 seen for treatment `dramatized, exaggerated -anxiety and depression common; suicidal thoughts and attempts -overmedicating/drug abuse and dependence `heightened emotions, impressionistic thought and speech, seductiveness, strong dependency needs, preoccupation with symptoms and oneself.

Illness anxiety disorder

involves conscious, intentional feigning of physical or psychological symptoms. Ind. with factitious disorder pretend to be ill in order to receive emotional care and support commonly assoc. with the role of the "patient"

Somatic Syndrome disorder

unrealistic or inaccurate interpretation of physical symptoms or sensations, leading to preoccupation and fear of having a serious disease. `becomes disabling and persists despite appropriate reassurance that no pathology detection.

Illness Anxiety Disorder

inability to produce voice

aphonia

inability to perceive smell

anosmia

false pregnancy

pseudocyesis

a disturbance in the perception of oneself

Depersonalization

An alteration in the perception of the external environment.

derealization

Anxiety Flashcards

(66 cards)