Week 3 - ATI - Anxiety, Trauma, Stress-related disordes

Question 1

What are the types of anxiety disorders?

Answer 1

Generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder

Question 2

What are the psychological manifestations of anxiety disorders?

Answer 2

Fear, apprehension

Question 3

What are the physical manifestations of anxiety disorders?

Answer 3

Palpitations, tachycardia, shortness of breath

Question 4

What is the prototype medication for benzodiazepines?

Answer 4

Alprazolam

Question 5

List some other medications that are benzodiazepines.

Answer 5

• Diazepam
• Lorazepam
• Chlordiazepoxide
• Clorazepate
• Oxazepam
• Clonazepam

Question 6

What is the expected pharmacological action of benzodiazepines?

Answer 6

Enhance the inhibitory effects of gamma-aminobutyric acid (GABA) in the CNS

Question 7

What are the therapeutic uses of benzodiazepines?

Answer 7

• Generalized anxiety disorder (GAD)
• Panic disorder
• Acute stress disorder (ASD)
• Posttraumatic stress disorder (PTSD)
• Seizure disorders
• Insomnia
• Muscle spasm
• Alcohol withdrawal
• Induction of anesthesia

Question 8

What are the complications associated with benzodiazepines?

Answer 8

• CNS depression
• Anterograde amnesia
• Paradoxical response
• Withdrawal effects

Question 9

What are the signs of CNS depression that clients should observe for?

Answer 9

• Sedation
• Lightheadedness
• Ataxia
• Decreased cognitive function

Question 10

What should a client do if they experience anterograde amnesia?

Answer 10

Notify the provider if effects occur

Question 11

True or False: Benzodiazepines are safe for long-term use.

Answer 11

False

Question 12

What are the contraindications for benzodiazepines?

Answer 12

• Pregnancy Risk Category D
• Sleep apnea
• Respiratory depression
• Glaucoma

Question 13

What is the prototype medication for atypical anxiolytics?

Answer 13

Buspirone

Question 14

What is the expected pharmacological action of buspirone?

Answer 14

Binds to serotonin and dopamine receptors; dependency is much less likely

Question 15

What are the therapeutic uses of buspirone?

Answer 15

• Panic disorder
• Social anxiety disorder
• Obsessive-compulsive disorders
• Trauma- and stressor-related disorders
• Generalized anxiety disorder (GAD)

Question 16

What are common complications of buspirone?

Answer 16

• Dizziness
• Nausea
• Headache
• Lightheadedness
• Agitation

Question 17

What is the major disadvantage of buspirone?

Answer 17

Antianxiety effects develop slowly, requiring at least 2 to 4 weeks for full effects

Question 18

What are selective serotonin reuptake inhibitors (SSRIs) used for?

Answer 18

• Generalized anxiety disorder (GAD)
• Panic disorder
• Obsessive-compulsive disorder (OCD)
• Social anxiety disorder
• Trauma- and stressor-related disorders

Question 19

What is the prototype medication for SSRIs?

Answer 19

Paroxetine

Question 20

What are some early adverse effects of SSRIs?

Answer 20

• Nausea
• Diaphoresis
• Tremor
• Fatigue
• Drowsiness

Question 21

What can occur after 5 to 6 weeks of SSRIs therapy?

Answer 21

• Insomnia
• Headache
• Sexual dysfunction
• Weight changes

Question 22

What is serotonin syndrome?

Answer 22

Agitation, confusion, disorientation, difficulty concentrating, anxiety, hallucinations, myoclonus, hyperreflexia, tremors, fever, diaphoresis

Question 23

What should clients do to avoid complications with SSRIs?

Answer 23

Report adverse effects to the provider and take the medication as prescribed

Question 24

What is the risk category of paroxetine during pregnancy?

Answer 24

Pregnancy Risk Category D

Question 25

What is the recommended method for discontinuing medication after long-term use?

Answer 25

Slowly taper the dose of medication before stopping. ## Footnote Abrupt discontinuation can lead to withdrawal symptoms.

Question 26

What should be monitored in clients taking medications that can cause postural hypotension?

Answer 26

Monitor for hypotension and advise clients to change positions slowly.

Question 27

What are the nursing actions related to suicidal ideation?

Answer 27

Monitor and report manifestations of depression and thoughts of suicide.

Question 28

What pregnancy risk category is paroxetine classified under?

Answer 28

Pregnancy Risk Category D.

Question 29

Which medications are contraindicated for clients taking paroxetine?

Answer 29

MAOIs and TCAs.

Question 30

What substance should clients taking paroxetine avoid?

Answer 30

Alcohol.

Question 31

In which conditions should paroxetine be used cautiously?

Answer 31

Liver and renal dysfunction, seizure disorders, history of GI bleeding.

Question 32

What can the combination of St. John's wort, MAOI antidepressants, or TCAs cause?

Answer 32

Serotonin syndrome.

Question 33

What nursing actions should be taken regarding antiplatelet medications and anticoagulants when a client is on paroxetine?

Answer 33

Monitor for bleeding and avoid concurrent use.

Question 34

How should paroxetine be administered to a client?

Answer 34

Administer with food.

Question 35

How long can it take to achieve therapeutic effects from paroxetine?

Answer 35

Up to 4 weeks.

Question 36

What is a key client education point regarding the timing of medication intake?

Answer 36

Taking the medication at the same time daily promotes therapeutic levels.

Question 37

What is a recommended time to take medication to prevent sleep disturbances?

Answer 37

In the morning.

Question 38

What are the indicators of medication effectiveness for anxiety treatments?

Answer 38

* Verbalizing feeling less anxious and more relaxed * Description of improved mood * Improved memory retrieval * Maintaining regular sleep pattern * Greater ability to participate in social and occupational interactions * Improved ability to cope with manifestations and identified stressors.

Question 39

What is the priority action for a nurse caring for a client with benzodiazepine toxicity?

Answer 39

Identify the client’s level of orientation.

Question 40

What should a client understand about the new prescription for escitalopram?

Answer 40

I need to discontinue this medication slowly.

Question 41

How should buspirone be taken for optimal results?

Answer 41

On a regular basis, not as needed.

Question 42

What is a correct instruction for a client prescribed paroxetine?

Answer 42

It can take several weeks before you feel like the medication is helping.

Question 43

Which intervention can help manage bruxism associated with paroxetine?

Answer 43

* Use of a mouth guard * Changing to a different class of antidepressant medication.

Question 44

True or False: Paroxetine can cause decreased appetite and weight loss.

Answer 44

True.