ANXIETY DISORDERS

Question 1

Diagnosed when anxiety becomes chronic and permeates major portions of a person’s life

Answer 1

Anxiety Disorders

Question 2

Most cases appear in childhood and adolescence

Answer 2

Anxiety Disorders

Question 3

Anxiety that is chronic, excessive, and unreasonable and may concern everyday events, such as work or school.

Answer 3

Generalized Anxiety Disorder (GAD)

Question 4

Often co-exists with other mental disorders

Answer 4

Generalized Anxiety Disorder (GAD)

Question 5

High risk for suicide

Answer 5

Generalized Anxiety Disorder (GAD)

Question 6

What’s the exact cause of Generalized Anxiety Disorder?

Answer 6

unknown

Question 7

Predisposing Factors of Generalized Anxiety Disorder

Answer 7

-Genetic
-Increased activity in the amygdala
-Dysregulation in the GABA- Norepinephrine, Serotonin- Glutamate system

Question 8

Diagnostic Criteria of Generalized Anxiety Disorder

Answer 8

Excessive worry and anxiety at least 50% of the time for 6 months or more.

Question 9

Accompanying Manifestations of Generalized Anxiety Disorders

Answer 9

-Uneasiness
-Irritability
-Muscle tension
-Fatigue
-Difficulty thinking
-Sleep alteration

Question 10

Medical Management for Generalized Anxiety Disorder (GAD)

Answer 10

-Escitalopram (Lexapro)
-A primary treatment for GAD

-Buspirone (BuSpar)

Question 11

Escitalopram (Lexapro) Classification and its side effects

Answer 11

-Class: Selective Serotonin Reuptake (SSRI)
-S/E: dizziness, somnolence, insomnia, confusion, seizures

Question 12

Buspirone (BuSpar) class and its side effects

Answer 12

-Class: Non-benzodiazepine anxiolytic
-S/E: nausea, headache, dizziness, nervousness/excitement
-Caution: -Emphasize avoidance of alcohol intake
- Inform patient that it may take up to 2-4 weeks before effects are seen.

Question 13

Management- Milieu of Generalized Anxiety Disorder (GAD)

Answer 13

-Cognitive therapy
-Recreational activities - to help reduce tension and anxiety
-Relaxation exercises and tapes, meditation, and biofeedback - these decreases tension and promote relaxation and comfort
-Group therapy - Focuses on stress management, problem solving, self- esteem, assertiveness, and goal setting

Question 14

Management- Nursing of Generalized Anxiety Disorder (GAD)

Answer 14

-Provide a calm and quiet environment
-Ask patient to identify what and how they feel
-Encourage patient to describe and discuss their feelings
-Help patient identify possible cause of feelings
-Listen carefully for patients’ expression of helplessness and hopelessness
-Directly ask patient whether they feel suicidal or have plans to hurt themselves
-Plan and involve patients in activities such as going for walks or playing recreational games

Question 15

Recurrent panic attacks and persistent worry about having more attacks

Answer 15

Panic Disorder

Question 16

It occurs even without a life-threatening situation

Answer 16

Panic Disorder

Question 17

Predisposing factor of panic disorders

Answer 17

Genetics

Question 18

Precipitating Factor of Panic Disorder

Answer 18

Life Stressors

Question 19

Diagnostic Criteria of Panic Disorder

Answer 19

-Panic attacks of 15 to 30 minutes, followed by at least one (1) month of persistent concern about future attacks

-Somatic symptoms (Fight- or- flight response)
-Avoidance behavior

Question 20

Fear of being outside

Answer 20

Agoraphobia

Question 21

Causes the person to be homebound

Answer 21

Agoraphobia

Question 22

Management of Panic Disorder

Answer 22

-Cognitive- Behavioral Therapy (CBT)
(First- line treatment for panic disorder with agoraphobia)

-Gross motor activities
(used when anxiety levels has moved down to further decreased tension and anxiety)

Question 23

Medical Management of Panic Disorder

Answer 23

-Benzodiazepines for immediate relief of panic
Alprazolam (Xanax), Lorazepam (Ativan), Diazepam (Valium)

-S/E: Sedation, psychomotor impairment, depression, amnesia, agitation, dependence

Question 24

A drug that is commonly used for the long-term treatment of panic symptoms

Answer 24

-SSRs
- Escitalopram (Lexapro), Sertraline (Zoloft)

Question 25

Management-Nursing of Panic Disorder

Answer 25

-Stay with the patient who is having a panic attack, and acknowledge patient’s discomfort -Maintain -a calm style and demeanor -Speak in short, simple sentences, and give one direction at a time in a calm tone of voice -If hyperventilating, provide a brown paper bag and focus on breathing with patient -Allow the patient to pace or cry -Communicate to patients that you are in control and will not let anything happen to them -Move or direct patients to a quieter, less- stimulating environment -Do not touch patient - touching can increase feelings of panic -Ask patient to express their perceptions or fears about what is happening to them

Question 26

an illogical, intense, and persistent fear of a specific object or a social situation that causes extreme distress and interferes with normal functioning.

Answer 26

Phobia

Question 27

Predisposing factor of Phobia

Answer 27

Genetics

Question 28

Precipitating factor of Phobia

Answer 28

Environmental (bad first encounter with fear object)

Question 29

Without history of panic disorder

Answer 29

Agoraphobia

Question 30

Fear of being humiliated, scrutinized, or embarrassed in public

Answer 30

Social Phobia

Question 31

Irrational fear of an object or situation

Answer 31

Specific Phobia

Question 32

What are the types of phobias?

Answer 32

-Agoraphobia -Social Phobia -Specific Phobia

Question 32

Fear of heights

Answer 32

Acrophobia

Question 33

Fear of flying

Answer 33

Aerophobia

Question 34

fear of enclosed places

Answer 34

claustrophobia

Question 35

fear of spiders

Answer 35

Arachnophobia

Question 36

Fear of dogs

Answer 36

Cynophobia

Question 37

Fear of blood

Answer 37

Hematophobia

Question 38

Fear of snakes

Answer 38

Ophidiophobia

Question 39

Fear of being buried alive

Answer 39

Taphophobia

Question 40

Fear of injections

Answer 40

Trypanophobia

Question 41

Fear of strangers

Answer 41

Xenophobia

Question 42

Patient Characteristics of Phobic Disorders (Phobia)

Answer 42

-Awareness of having unusual and irrational fear -Powerlessness to stop fear -Anticipatory anxiety -Avoidance behavior

Question 43

Management of Phobic Disorders (Phobia)

Answer 43

-Cognitive-Behavioral Therapy Most successful treatment for phobic patients -Systematic desensitization- progressive exposure to feared object in a controlled environment until anxiety decreases -Flooding- Therapist abruptly confronts patient with phobic object until it no longer produces anxiety

Question 44

Medical Management of Phobic Disorders (Phobia) Drugs

Answer 44

-SSRIs -Paroxetine (Paxil), Sertraline (Zooloft) -Used to reduce anxiety and depression, and back panic attacks, if present

Question 45

Management-Nursing of Phobic Disorders (Phobia)

Answer 45

-Accept patient and their fears with a non-judgmental attitude -Provide and involve patients in activities that do not increase anxiety but rather increase involvement -Help patients with physical safety and comfort needs -Help patients recognize that their behavior is a method of avoiding anxiety