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Nurs 327 > Week 2- anxiety/mood/affect/ de-escelation techniques > Flashcards

Week 2- anxiety/mood/affect/ de-escelation techniques Flashcards

(68 cards)

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1
Q

types of

adverse childhood experiences

ACEs

A
  • abuse
  • neglect
  • household dysfunction
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2
Q

impact of ACE’s on health through lifespan

order at which it occurs-7 steps

A

adverse event –> disrupted neurodevelopment –> cognitive impairment –> health risk behavior –> social problems/disease –> early death

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3
Q

trauma informed approach

emphasis on

A
  • heavy emphasis on safety and choice/collaboration
  • not problem focused but strength focused
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4
Q

core principles

trauma informed care

A
  • safety
  • transparency
  • peer support
  • collaboration
  • empowerment
  • humility
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5
Q

trauma informed care

what to do vs not do

A

avoid medicalized jargon, be careful with labels, education about trauma and management is NOT the first priority

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6
Q

recovery oriented care

definition

A

the process through which people find ways of living meaningful lives with or without symptoms of their condition

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7
Q

recovery model

A
  • what is needed for well being
  • individual focused
  • promote personal recovery
  • share control
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8
Q

recovery orient care

components

A

expect periods or relapse or difficulty and know that mental health problems can be lifelong

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9
Q

relapse

if it occurs you should

A

learn (triggers), review (careplan), renew (action plan)

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10
Q

anxiety

A

most common mental illness defined as the fight, flight, or freeze response or reaction that occurs in response to perceived threat
- often begins in childhood

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11
Q

GAD

generalized anxiety disorder

A

general feeling of dread linked to perception of unpredictability of situations
- will seek constant reassurance
- difficulty focusing
- difficulty sleeping
- irritability

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12
Q

panic disorder

A

fear of panic attacks or consequences
- will avoid activities linked to strong sensations
- avoids places where prior attacks have occured

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13
Q

OCD

obsessive compulsive disorder

A

fear of unwanted thoughts, image, or urges
- constant worries about germs
- worry about harming others
- ritualized activities

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14
Q

compulsions

A

any behavior performed to help make the anxiety go away

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15
Q

PTSD

post traumatic stress disorder

A
  • symptoms will begin in first 3 months after trauma but can be delayed
  • can affect anyone experiencing trauma
  • associated with SI
  • intrusive memories
  • substance use may be common for coping

not an anxiety disorder

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16
Q

mild anxiety

peplaus levels of anxiety

A

enhanced learning and optimal function
- some anxiety can be good

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17
Q

moderate anxiety

peplaus levels of anxiety

A

decreased concentration and decreased problem solving

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18
Q

severe anxiety

peplaus levels of anxiety

A

serious impairment in cognition, physical and emotional symptoms

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19
Q

panic anxiety

peplaus levels of anxiety

A

complete loss of focus, marked functional impairment

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20
Q

typical presentation of anxiety in children

A

will focus more on somatic such as headache, body pain, sore tummy

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21
Q

typical preentation of anxiety in adults

A

may go unrecognized such as disturbed sleep and any physical symptoms will be seen as other illnesses

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22
Q

euthymia

definition

A

the “normal” or tranquil mental state/mood

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23
Q

euthymia

mood/energy/cognition

A

healthy fluctuations in energy, mood, and cognition

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24
Q

mild to severe melancholy

mood/energy/cognition

A

low to no feelings of energy or mood, no information processing

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25
mild to severe mania | mood/energy/cognition
little to no information processing and mood and energy will be very high or none at all
26
major depressive disorder
depressed mood most of the day nearly every day - vegetative shift - will cause significant disruption in life
27
depressive state | symptoms associated
decreased: appetite, energy, libido increased: sleep
28
manic state | symptoms associated
decreased: sleep increased: appetite, energy, libido
29
risk factors for mood disorders
- stress - trauma - neglect - abuse - genetics - medical issues - social issues
30
bipolar disorder I
usually presents as major fluctuations between major depression and severe mania
31
cyclothymia
fluctuations in mood but not to the extent of bipolar
32
bipolar disorder II
fluctuates from mild mania to major depression
33
impacts/consequences of bipolar disorder
- financial - impulsivity - sexual - physical harm - substance use - violence
34
primary prevention | anxiety and mood disorders
reduce poverty, racism, violence, stress, social inequity and exclusion
35
secondary prevention | anxiety and mood disorders
screening aimed at early detection but that is not a diagnosis - PHQ-2 - GAD-7 - BDI - GDS - Ham-D
36
physical signs to assess for anxiety and mood disorders
- thyroid palpation - cranial nerves - lab tests (TSH, CBC, electrolytes) - GI or sleep disturbances
37
highest risk for suicide | signs
low mood, high energy, elevated cognitive capacity - sometimes people with severe mania
38
escelating risk of suicide | signs
low mood, energy and cognition cycling up - moderate depression
39
decreasing risk of suicide | signs
low or "suicidal" mood, energy and cognition cycling down - mild state of mania to mild state of depression
40
common nursing priorities
ineffective coping/role performane, insomnia, imapired communication, social isolation, risk of trauma or harm
41
interventions | anxiety
calm and simple instructions, clear statements, disrupt negative thibking and distortions
42
interventions | for panic
direct to breathing and different types - pursed lip or alternate nostril breathing is best
43
basic care
- establish routine - high calorie meal replacements (finger foods for manic patients) - establish healthy sleep - break down tasks into smaller steps
44
goal setting
- start small and then expand to higher level - should be obtainable - provide positive reinforcement
45
intervening for safety | mania
- use activities to expand energy - observation levels - distraction techniques - positive reframe
46
47
SSRI's
first choice for anxiety and depression
48
novel antidepressants
bupropion, mitrazapine, trazadone
49
MAOIs
not 1st choice but can also be helpful for OCD
50
benzodiazepines
used for panic or mania - high risk for addiction
51
mood stabilizers
used for bipolar disorder - anticonvulsants, abilify (3rd gen antipsychotic) - need blood monitoring
52
atypical antipsychotics
used for severe OCD, PTSD, or psychotic symptoms
53
lithium | therapeutic range
very narrow therapeutic range; 0.6-1.2
54
lithium toxicity | symptoms
blurred vision, tinnitus, thirst, polyuria
55
behavioral incident | interviewing strategy
helps obtain concrete data to get around those who hide SI - questions should recreate behavior in running narrative
56
symptom amplification | interviewing strategy
assumes behavior occured and uses overestimation so the patient will provide true estimate
57
gentle assumption | interviewing strategy
the behavior is assumed - go back to broad if gentle assumption questions dont work
58
normalization | interviewing strategy
gives permission for patient to feel or act a certain way
59
aggression
emotion that results in verbal or physical attack
60
violence
includes the intent to harm
61
impulsive aggression
is externally provoked
62
psychotic aggression
is related to symptoms of illness
63
organized aggression
is driven by a motive or goal
64
trigger | stage of crisis development
early signs of escelating behavior
65
escelation | stage of crisis development
begining to lose ability to behave rationally
66
outburst | stage of crisis development
behavior poses a risk to self or others - loss of control
67
recovery | stage of crisis development
decrease is physical and emotional energy
68
steps for de-escelation
1. identify issue 2. validate 3. provide opportunity to talk 4. offer choices (no more than 2) 5. give time to make choice 6. reinforce positive outcomes 7. prepare for restraints 8. control environment

Nurs 327 (8 decks)

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