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Psych Stress and Anger
Chapters 1, 4, 9, 29 ATI
49
Nursing
Undergraduate 2
08/17/2016

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Term
What is the difference between mood and affect?
Definition
Mood is the stated emotion the patient feels. Affect is the expression of that mood.
Term
What are psychobiological interventions?
Definition
Administering, providing information on and watching for adverse effects/effectiveness of medications.
Term
What are the 3 cognitive and behavioral therapies?
Definition
Modeling
Operant conditioning
Systematic desensitization
Term
What are the 4 items examenined using the Mini-Mental State Examination?
Definition
Orientation to time and place
Attention span, ability to calculate backwards by 7
Registration and recalling of objects
Language, including naming, following commands and writing.
Term
What is involved in milieu therapy?
Definition
Orienting a client to the physical setting
Identifying rules and boundaries of the setting
Ensuring a safe environment
Assisting the client to participate in activities.
Term
What does the DSM-5 offer?
Definition
Identifies diagnoses
Identifies diagnostic criteria to guide assessment
Identifies nursing diagnoses
Plan, implement and evaluate care.
Term
Finish this line: Defense mechanisms are ____________, and can be ___________ or __________.
Definition
Defense mechanisms are reversible and can be adaptive or maladaptive.
Term
What two defense mechanisms are always healthy?
Definition
Altruisim (reaching out to others.)
Sublimation (Channeling the stress by substituting acceptable forms of expression, ie, going for a workout after anger and hostility from a supervisor)
Term
What are the 5 intermediate defense mechanisms?
Definition
Repression ("forgetting" to make a dental appt.)
Reaction formation (overcompensating to prove the opposite behavior of what is felt.)
Displacement (Breaking a kids toy after a bad day at work)
Rationalization (Creating reasonable explanations for unreasonable behavior.)
Undoing (Performing an act to make up for prior behavior.)
Term
What are the 4 immature defense mechanisms?
Definition
Projection (BLaming others for what you feel)
Dissociation (Blocking memories from conscious thought)
Splitting (Inability to reconcile negative and positive attributes of self or others.)
Denial (Pretending truth is not reality)
Term
What are the main points in mild anxiety?
Definition
Part of every day living
Increases the ability to see reality
Anxiety cause is identifiable
Some fidgeting.
Term
What are the main points of moderate anxiety?
Definition
Escalation of mild anxiety
Selective inattention
Learning and problem solving still available
^ HR and RR
Headaches, insomnia, backache, ^ persperation
Term
What are the main points of severe anxiety?
Definition
Perceptual field greatly reduced
No learning or problem solving
Ineffective function
Tachycardia, loud rapid speech, aimless, hyperventilation, impending doom
Not able to take direction
Term
What are the main points of panic level anxiety?
Definition
Disturbed behavior
May lose touch with reality
Extreme fright and horror
Immobility
SHakiness, speech dysfunction, delusions, inability to sleep.
Term
What are 2 damaging stressors that cause distress?
Definition
Anxiety and anger
Term
What word is typically goal directed with the intent of harming a erson or object?
Definition
Aggression
Term
What feelings may angry or aggressive people possibly have underlying?
Definition
Guilt, fear, rejection, inadequacy, insecurity
Term
What conditions are often comorbid with anger?
Definition
Depression, PTSD, Alzheimers, personality and psychotic disorders.
Term
What is the action of the antipsychotics Zyprexa and Geodon?
Definition
It is used to control aggressive and impulsive behaviors
Term
What is the action of the antipsychotic agent Haldol?
Definition
Used to control aggressive and impulsive behaviors.
Term
WHy are zyprexa and geodon used more often than haldol?
Definition
Fewer severe side effects than Haldol.
Term
What must you monitor on a patient taking Haldol?
Definition
Keep the client hydrated
Test for muscle rigidity
Risk of neuroleptic malignant syndrome.
Check vitals
Term
What other medication tpes can be used to prevent violent behavior?
Definition
Antiepressants (SSRI)
Lithium
Sedative/hypnotics (Benzodiazepines)
Term
What does Roy define an adaptive response as?
Definition
Behaviors that maintain the integrity of the individual.
Term
Stress as a biological response means what?
Definition
Changes to the biologic system. Fight or flight.
Term
List the stages of GAS.
Definition
Alarm
Resistance
Exhaustion
Term
THe pituitary, stimulated by the hypothalamus triggers what responses?
Definition
Adrenocorticotropic hormone (^ Glucogenesis, lower immune and inflammatory response, increase sodium/water retention)
Vasopressin ( ^ BP and Fluid retention)
Growth hormone (Increase glucose/fatty acid)
Thyrotropic hormone (Increase BMR)
Gonadotropins (Increase sex hormones, then decrease)
Term
What is stress as an environmental event?
Definition
A change from the existing steady state of life pattern. (Recent live changes stress measurement)
Term
What occurs in primary appraisal?
Definition
We decide if an event is irrelevant, benign-positive, and stressful.
Term
Stressful items in primary appraisal include sub-categories?
Definition
Harm/loss (already experienced), threat (anticipated harms or losses), challenge (potential for gain or growth.)
Term
When secondary appraisal happens, what 3 things does a person look at to try to resolve the stress?
Definition
1) Look at the availability of coping mechanisms.
2) Perceived effectiveness of the coping strat
3) Perceived ability to use the coping strat.
Term
Building on the work pioneered by Dorothea Dix, what person became the first American psychiatric nurse?
Definition
Linda RIchards in Boston
Term
What are the 6 indicators Jahoda listed as a reflection of mental health?
Definition
1) Positive attitude to self
2) Growth, development and the ability to achieve self-actualization
3) Integration in life
4) Autonomy
5) Perception of reality
6) Environmental mastery (satisfaction in life)
Term
Anger activates the sympathetic nervous system. What effect does this have on the body?
Definition
Increase heart rate and bp, epinephrine secretion. Increase serum glucose, body is prepared to fight.
Term
Some aggression may have a neurophysiological reason, what is this?
Definition
Epilepsy of temporal and frontal lobe regions.
Term
A patient has intractable aggression and the amygdaloid body is subsequently destroyed. What do you expect to see?
Definition
Reduction in aggressive outbursts.
Term
Biochemichal factors that can increase violent behavior have been linked to what hormonal dysfunctions?
Definition
Hyperthyroidism
Term
What are the 5 stages of violence?
Definition
Trigger -> Escalation -> Crisis -> Recovery -> post crisis
Term
What areas of the brain are linked to anger?
Definition
Frontal lobe, Amygdala, thalamus
Term
What are the stressors and linked mental health illnesses for African Americans.
Definition
Poverty, teenage pregnancy, street violence.

PTSD, Depression, Schizophrenia, anxiety, ptsd.
Term
What are 2 mental health illnesses common in Asian Americans?
Definition
Anthrophobia, AMOK
Term
What mental health disorder was once linked to childhood only, but is now seen in Hispanics?
Definition
Adjusment Disorder (For immigrants.)
Term
Native Americans struggle with which mental disorders>
Definition
Identity, PTSD

Linked to alcoholism: Depression, suicide, Developmental disabilities.
Term
African Americans more commonly present with which 5 mental health issues?
Definition
Anxiety, PTSD, Substance abuse, depression, Schizophrenia.
Term
What is the culture-bound syndrome of African Americans?
Definition
Brain Fag: Difficulty concentrating, poor memory retention.
Term
American Indians have which culture bound syndrome?
Definition
Ghost Sickness, preoccupation with death and the deceased.
Term
The two culture bound syndromes for Latin America are which?
Definition
Attack of the nerves - Shouting, crying, some aggression.
Susto - The soul leaves the body, resulting in the illness.
Term
In Asia, Koro is a culture bound syndrome which includes what identifying features?
Definition
Anxiety that the penis, vulva or nipples will go into the body, causing death.
Term
Japan's culture bound syndrome includes anxiety and fear about offending others with bodily functions. What syndrome is this?
Definition
Taijin kyofusho.
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