Anxiety Disorders

Question 0

Separation Anxiety Disorder

Answer 0

The client experiences excessive fear or anxiety when separated from an individual to which the client is emotionally attached.

Question 1

Anxiety Disorders Recognized and defined by DSM-5

Answer 1

1. Separation Anxiety Disorder
2. Panic Disorder
3. Phobias
4. Generalized Anxiety Disorder (GAD)

Question 2

Panic Disorder

Answer 2

The client experiences recurrent panic attacks

Question 3

Phobias

Answer 3

The client fears a specific object or situation to an unreasonable level.

Question 4

Generalized Anxiety Disorder (GAD)

Answer 4

The client exhibits uncontrollable, excessive worry for more than 3 months.

Question 5

Obsessive compulsive and related disorders

Answer 5

1. Obsessive compulsive disorder (OCD)

2. Hoarding disorder

Question 6

Obsessive Compulsive Disorder (OCD)

Answer 6

The client has intrusive thoughts of unrealistic obsessions and tries to control these thoughts with compulsive behaviors.

Question 7

Hoarding Disorder

Answer 7

The client has difficulty parting with possessions, resulting in extreme stress and functional impairments.

Question 8

Trauma and stressor related disorders

Answer 8

1. Acute stress disorder

2. Posttraumatic stress disorder (PTSD)

Question 9

Acute Stress Disorder

Answer 9

Exposure to a traumatic event causes numbing, detachment, and amnesia about the event for at least 3 days but for not more than 1 month following the event.

Question 10

Posttraumatic Stress Disorder (PTSD)

Answer 10

Exposure to a traumatic event causes intense fear, horror, flashbacks, feelings of detachment and foreboding, restricted affect, and impairment for longer than 1 month after the event.

Question 11

Risk Factors for Anxiety Disorders:

Answer 11

1. Anxiety- Female, OCD= in Men & Women
2. Genetics
3. Exposure to traumatic event or experience, military combat, threat of death of a loved one.
4. Medical condition
5. Adverse effects of medications can mimic anxiety
6. Substance-induced anxiety.

Question 12

Manifestations of Panic disorder:

Answer 12

• Typically lasts 15-30 min.
• 4 or more are present during a panic attack
  1. Palpitations
  2. SOB
  3. Choking or smothering sensation
  4. Chest pain
  5. Nausea
  6. Feelings of depersonalization
  7. Fear of dying or insanity
  8. Chills or hot flashes.

Question 13

Types of Phobias:

Answer 13

1. Social Phobia
2. Agoraphobia
3. Specific Phobias

Question 14

Social Phobia

Answer 14

The client has a fear of embarrassment, is unable to preform in front of others, has a dread of social situations, believes that others are judging him negatively, and has impaired relationships.
-excessive blushing, sweating, trembling, rapid HR, muscle tension, Nausea, extreme anxiety.

Question 15

Agoraphobia

Answer 15

An abnormal and persistent fear of public places or open areas, especially those from which escape could be difficult or in which help might not be immediately accessible.

Question 16

Specific Phobias

Answer 16

1. The client has a fear of specific objects, such as spiders, snakes, strangers
2. The client has a fear of specific experiences, such as flying, being in the dark, riding in an elevator, being in an enclosed space.

Question 17

Generalized Anxiety Disorder

Answer 17

• The client exhibits uncontrollable, excessive worry for more than 3 months.
  1. Restlessness
  2. Muscle Tension
  3. Avoidance of stressful activities or events
  4. Increased time and effort required to prepare for stressful activities or events.
  5. Procrastination in decision-making
  6. Seeks repeated reassurance.

Question 18

Acute Stress Disorder & PTSD

Precipitating Event

Answer 18

1. In both disorders, the client witnesses or experiences an actual event that threatens severe injury or death to the client or others
2. The client responds with fear, helplessness, or horror to the event.

Question 19

Acute Stress Disorder

Onset and Duration

Answer 19

1. Manifestations often begin immediately following the traumatic event and persist for at least 3 days.
2. Duration is 3 days to 1 month.

Question 20

Acute Stress Disorder

Reexperience of the event

Answer 20

• The client persistently reexperiences the event through:
  1. Distress when reminded of the event
  2. Dreams of images
  3. Reliving through flashbacks

Question 21

Acute Stress Disorder

Manifestations

Answer 21

1. Dissociative manifestations- Amnesia of the trauma event, absent emotional response, decreased awareness of surroundings, depersonalization.
2. Indications of severe anxiety, such as irritability, sleep disturbance.

Question 22

PTSD

Onset and duration

Answer 22

-Manifestations may occur any time following the traumatic event with potential delays of months or years. The duration of manifestations lasts more than 1 month.

Question 23

PTSD

REexperience of the event

Answer 23

• The Client persistently reexperiences the event through:
  1. Recurrent, intrusive recollection of the event
  2. Dreams or images
  3. Reliving through flashbacks, illusions, or hallucinations

Question 24

PTSD | Manifestations

Answer 24

- Indications of increased arousal, irritability, difficulty with concentration, sleep disturbance - Avoidance of stimuli associated with trauma, such as avoiding people, inability to show feelings.

Question 25

Nursing Care

Answer 25

1. Provide a structured interview, keep client focused on present 2. Assess for Comorbid condition 3. Provide safety and comfort during crisis 4. Remain with the client during the worst of the anxiety 5. Preform suicide assessment 6. Relaxation techniques 7. Identify defense mechanisms that interfere with recovery

Question 26

Cognitive behavioral therapy

Answer 26

The anxiety response can be decreased by changing cognitive distortions. This therapy uses cognitive reframing to help the client identify negative thoughts that produce anxiety, examine the cause, and develop supportive ideas that replace negative self-talk.

Question 27

Modeling

Answer 27

demonstration of appropriate behavior in a stressful situation. The goal of therapy is that the client will imitate the behavior.

Question 28

Systematic desensitization

Answer 28

Begins w/ mastering of relaxation techniques. Then a client is exposed to increasing levels of an anxiety producing stimulus and uses relaxation to overcome the resulting anxiety.

Question 29

Flooding

Answer 29

exposing the client to a great deal of an undesirable stimulus in an attempt to turn off the anxiety response. Most useful in clients who have phobias.

Question 30

Response prevention

Answer 30

preventing the client from preforming a compulsive behavior with the intent that anxiety will deminish

Question 31

Thought Stopping

Answer 31

Teaches the client to say "stop" when negative thoughts or compulsive behaviors arise, and substitute a positive thought.

Question 32

Eye movement desensitization and reprocessing (EMDR)

Answer 32

Therapy for clients who have PTSD. | EMDR encourages eye focus on separate stimuli while thinking of or talking about the traumatic event.

Question 33

Medications

Answer 33

1. SSRI 2. Sedative hypnotic anxiolytics 3. Nonbarbiturate anxiolytics 4. Betablockers 5. Antihistamines 6. Anticonvulsants are used a mood stabilizers for anxiety.

Question 34

SSRI

Answer 34

sertraline (Zoloft) First line of treatment for trauma and stressor related disorders. Clients who have anxiety can also benefit from other types of antidepressants.

Question 35

Sedative hypnotic anxiolytics

Answer 35

diazepam (Valium) - short term use

Question 36

Nonbarbiturate anxiolytics

Answer 36

buspirone (BuSpar) used to manage anxiety

Question 37

Small Amygdala= ?

Answer 37

Greater risk for PTSD!!! Amygdala deals with emotionally charged memories Prefrontal cortex and hypocampus become hypoactive

Question 38

Classifications of PTSD

Answer 38

1. Acute- duration of symptoms is less than 3 months 2. Chronic- duration of symptoms is longer than 3 months 3. Delayed onset- at least 6 months have passed between the traumatic event and the onset of symptoms.

Question 39

Psychological Symptoms of PTSD

Answer 39

1. Depression 2. Anxiety 3. Guilt 4. Avoidance 5. Intrusive thoughts 6. Halluninations

Question 40

Behavioral symptoms of PTSD

Answer 40

1. Extreme Rage 2. Short Fuse 3. Isolating yourself 4. Alcohol or Drug abuse 5. Always being on guard 6. Feeling Numb 7. Memory problems 8. lack of concentration 9. Nightmares 10. Unable to sleep or stay awake 11. Easily startled 12. Low self esteem 13. feeling hopeless about the future 14. Lack of appetite 15. Overeating 16. headaches