stress part 2

Question 1

anxiolytics action

Answer 1

reduce anxiety by reducing over activity in CNS

binds to GABA receptors

Question 2

anxiolytics indication

Answer 2

ethanol withdrawal, insomnia, muscle spasms, seizure disorders, anesthesia, depression, anxiety

Question 3

anxiolytics contraindications

Answer 3

known drug allergy, narrow-angle glaucoma, pregnancy

Question 4

anxiolytics side effects

Answer 4

CNS depression
hypotension
drowsiness
dizziness
lethargy 
headache 
ataxia
slurred speech
depression
bradycardia 
hypotension 
constipation
diarrhea
nausea 
vomiting

Question 5

anxiolytics prototype class

Answer 5

Benzodiazepines

Question 6

anxiolytics prototype drug

Answer 6

Lorazepam

Question 7

anxiolytics overdose

Answer 7

not usually severe
experience excessive sedation, hypotension, seizures
no specific antidote, Flumazenil may be used

Question 8

Lorazepam (ativan)
route 
onset 
peak
half life
duration

Answer 8

intermediate acting benzodiazepine 
oral or injectable 
PO/SL/IV
30-60 min
2 hours 
11-16 hours 
8 hours

Question 9

nursing considerations for anxiolytics

Answer 9

carefully monitor clients condition
assess need for medication
asses for anxiety symptoms
educate on overdose symptoms

Question 10

non-pharmacological therapy

Answer 10

psychotherapy 
family, social, spiritual support systems 
physical exercise 
well balanced diet 
relaxation exercises

Question 11

coping responses

Answer 11

cognitive assessment
primary appraisal
secondary appraisal
engagement

Question 12

primary appraisal

Answer 12

initial assessment of stressor to determine if stressor is a threat

Question 13

secondary appraisal

Answer 13

evaluation of resources to:
overcome stressor
eliminate stressor
reduce stressor

Question 14

coping strategies

Answer 14

problem focused
emotion focused
meaning focused

Question 15

problem focused

Answer 15

evaluating the situation
taking action to manage or change the situation
focus on eliminating or reducing the stressor

Question 16

emotion focused

Answer 16

regulating the emotional response to the stressor

controlling response, not addressing specific stressor

Question 17

meaning focused

Answer 17

draws on values, beliefs, goals

modify the interpretation and response to the stressor

Question 18

maladaptive coping

Answer 18

inability to accurately assess stressor
denial/avoidance
actual/perceived lack of control/support
no/poor experience in managing stressful situations

Question 19

elements of assessment

Answer 19

Goal: determine individuals appraising stage and coping strategies
history
exam
use of instruments

Question 20

history

Answer 20

perception of threat
past coping patterns
medical history
social history

Question 21

examination

Answer 21

observation of behaviour

mental health assessment

Question 22

use of instruments

Answer 22

enhance objectivity to assessment
provide ability to monitor over time
multiple available, some for specific populations or situations

Question 23

collaborative care

Answer 23

education
developing an action plan
accessing resources
cognitive restructuring

Question 24

addiction

Answer 24

overwhelming compulsion that drives someone to take drugs despite health consequences

Question 25

variables to addiction

Answer 25

``` agent or drug factors (cost, availability, onset, length of use) user factors (genetic factors, prior experience with drugs, high risk behaviours) environmental influence (social norms, role models, peer influences) ```

Question 26

physiologic process of addiction

Answer 26

neurochemical interactions within reward centers of brain | addictive substances link to this reward center

Question 27

neurotransmitters involved in reward center

Answer 27

``` dopamine Y-aminobutyric acid (GABA) glutamate acetylcholine norepinephrine serotonin ```

Question 28

consequences of addiction

Answer 28

``` habituation adaptation tolerence withdrawal consequences dependent on individual and type of addiction ```

Question 29

physical dependence

Answer 29

nervous system adapts tp repeated substance use when drug is stopped very uncomfortable symptoms may arise (withdrawal) body responds as though it is normal for the substance to be continually present

Question 30

psychological dependence

Answer 30

no signs of physical discomfort when drug is discontinued overwhelming desire to continue use despite the consequences cravings may continue months to years

Question 31

withdrawal syndrome

Answer 31

prescription drugs can be used to decrease symptoms of withdrawal severe for clients using alcohol or sedatives best accomplished at treatment facility

Question 32

tolerance

Answer 32

body adapts to substance after repeated use | higher doses are required to get the same effect

Question 33

manifestations of withdrawal

Answer 33

``` appears older than actual age undernourished standard dose of sedatives do not have therapeutic effect fatigue insomnia headaches anorexia reported sexual dysfunction reported changes in mood reported weight loss vague physical complaints ```

Question 34

primary prevention

Answer 34

NIDA recommends identification of drug problems in communities and then building resources successful models promote healthy families and healthy communities promotion of individual positive coping strategies

Question 35

screening

Answer 35

NIAAA quantity and frequency questions CAGE questionnaire many other questionnaires and screening tools

Question 36

emergency management

Answer 36

prevent life threatening complications | treatment is substance and complication specific

Question 37

recovery

Answer 37

goal is to help patient to get the help needed to achieve and maintain sobriety collaborative care is used to facilitate