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NUR 210 A I
Patients with Anxiety Disorders
33
Nursing
Not Applicable
12/03/2009

Additional Nursing Flashcards

 


 

Cards

Term

Mild Anxiety

Definition

can be productive and does not require intervention

Term

Depersonalization

Definition

A sense that things are not real

an individual experiencing panic attacks can also experience depersonalization

Term

Obsessions

Definition

ritualistic or repetitive behaviors or mental acts that a person carries out continuously in an attempt to neutralize anxiety

Term

Positive Reframing

Definition

involves turning negative messages into positive messages

Term

Selye's General Adaptation Syndrome

Exhaustion Phase

Definition

the body has responded negatively to anxiety and stress and is depleted physically and emotionally

Term

Defense mechanisms

Definition

cognitive distortions that a person uses unconsciously to maintain a sense of control of a situation, and to deal with the stress

Term

Phobia

Definition

is an illogical intense persistent fear of a specific object or a social situation that caused extreme distress and interferes with normal functioning

Term

Exposure

Definition

a treatment used for obsessive compulsive disorder in which the client is assisted in deliberately confronting the situation and stimuli that the individual usually avoids

Term

Automatisms

Definition

are automatic, unconscious mannerisms that a person with panic disorder may exhibit

Term

Anti-anxiety Agents

Chemical Class 

Definition

Benzodiazepines (end in "am") - they are addicting, short acting and effect the seizure threshold

alprazolam (Xanax)

clonazepam (Klonipin) (a little longer acting than others)

diazepam (Valium)

lorazepam (Ativan) po, IM, IV

oxazepam (Serax)

 

Misc. (not a benzo)

buspirone (BuSpar) (not a CNS depressant, uses neurotransmitters, not addicting, takes 2wks to work, longer acting than benzo's)

Term

Anti-anxiety Agents

Benzo's & Buspar

Indications

Definition

for the treatment of anxiety d/o and anxiety symptoms

 

to treat alcohol withdrawl

 

to skeletal muscle spasms

 

to treat convulsive d/o status epilepticus and preoperative sedation

Term

Anti-anxiety Agents

Benzo's & Buspar

Actions

Definition

Short acting / half life 4 hours

 

depress subcortical levels of the CNS

 

potentiates the effects of the powerful inhibitory neurotrasmitter GABA in the brain, producing a calming effect

 

all levels of CNS depression can be effected, from mild sedation to coma

 

**Exception - Buspar does not depress the CNS and produces desired effects through interactions w/ serotonin, dopamine, & other neurotransmitters

Term

Anti-anxiety Agents

Benzo's & Buspar

Contraindications

Definition

Contraindicated in the following:

pts w/ known hypersensitivity to any drugs w/in the classification

do not take in combination w/ other CNS depressants

do not take in pregnancy, lactation, narrow-angle glaucoma, shock, coma

cautious use in hepatic or renal dysfunction, elderly or debilitated

cautious use in pt w/ hx of drug abuse, addiction, depressed or suicidal (CNS can exacerbate symptoms of depression)

do not take w/ alcohol (benzo's strongly enhance effects of alcohol CNS depressant)

Term

Anti-anxiety Agents

Benzo's & Buspar

Nursing

Definition

Monitor s/e

drowsiness, confusion, letharfy (most common), ↓ coordination, impaired memory, tolerance - physical & psychological dependence, orthostatic hypotension, dry mouth

exaggerates symptoms of depression

Considerations

abrupt w/drawl can be life threatening, do not take w/ other CNS depressants, benzo's can cause dependence

withdrawl sx include: depression, insomnia, increased anxiety, abd & musc cramps, tremors, vomiting, sweating, seizures

Term

Anti-anxiety Agents

Benzo's & Buspar

Patient Teaching

Definition

anti-anxiety agents releive sx, but DO NOT treat underlying problems causing anxiety

Benzo's potentiate alcohol

decreased response time, slower reflexes, & sedative effects (when driving/working)

Benzo's can bot be stopped abruptly / can be life threatening

do not operate dangerous machinery

 

Term

Agoraphobia

Definition

fear of being outside

Term

Anxiety

Definition

a vague feeling of dread or apprehension; a response to external or internal stimuli that can have behavioral, emotional, cognitive, & physical symptoms

Term

Anxiolytic

Definition

a type of drug used to treat anxiety, insomnia, OCD, Depression, PTSD and alcohol w/drawl

Term

compulsion

Definition

ritualistic or repetitive behavior or mental act that a person carries out continuously in an attempt to neutralize anxiety

Term

Generalized Anxiety D/O (GAD)

Definition

person worries excessively and feels highly anxious at least 50% of time for 6 months or more

Term

Levels of Anxiety

Definition

Mild -  sensation that warrants special attention, can motivate in goal directed activity, sensory stimulation increases

 

Moderate - a disturbing feeling that something is definitely wrong, person is nervous and agitated

 

Severe - trouble thinking and reasoning, is restless, irritable, and angry

 

Panic - fight, flight or freeze  Adrenaline surge ^VS, cognitive process focuses on persons' defense

Term

Panic Disorder

Definition

composed of discreet episodes of panic attacks, that is 15-30 minutes of rapid, intense, escalating anxiety in which a person experiences great emotional fear as well as physiologic discomfort

Term

Post Traumatic Stress Disorder (PTSD)

 

Definition

a disturbing pattern of behavior demonstrated by someone who has experienced a traumatic event, begins three months or more following the trauma

Term

Stress

Definition

the wear and tear that life causes on the body

Term

Treatment for anxiety disorders

Definition

involve medication (anxiolytics, SSRI and tricyclic antidepressants, and clonidine and propranolol) and therapy

Term

Cognitive Behavioral Techniques

Definition

positive reframing, decatastrophizing, thought stopping, and distraction

Term

Behavioral Techniques for OCD

Definition

exposure and response prevention

Term

mental health

Definition

state of well being in which individuals function well in society and are generally satisfied with their lives

Term

Mental Disorder

Definition

a disturbance in thoughts or mood that causes maladaptive behavior, inability to cope with normal stresses, and/or impaired functioning

Term

Stress Response & physical symptoms

Definition

3 phases occur w/in 10 minutes of a stressful event

 

1. Alarm

2. Resistance

3. Exhaustion

 

SNS - blood shunted to central, ^HR, narrow vision, ^temp, fingers/toes tingle

Term

Working with Anxious Clients

Definition

be aware of own anxiety level

assess pt anxiety level

speak in short, simple sentences

lower pt anxiety level to moderate or mild before proceeding 

talk to pt in low, calm, and soothing voice

walk while talking if pt cannot remain still

ensure safety during panic level anxiety

remain w./ pt until panic recedes

short term use of anxiolytics

Term

Cultural considerations for pts w/ anxiety D/O

 

Definition

Asian cultures express anxiety through somatic symptoms (h/a, backaches, fatigue, dizziness, and stomach problems)

 

Hispanics express high anxiety as sadness, agitation, weight loss, weakness, and HR changes (the symptoms are believed to occur b/c supernatural spirits or bad air from dangerous places or cemeteries invade the body)

Term

Elder Considerations

 

Definition

late-life anxiety d/o are often ass'd w/ another condition (depression, dementia, physical illness, medication toxicity or w/drawl)

 

phobias (agoraphobia & GAD) are the most common late life anxiety d/o

 

treatment in elderly = SSRI antidepressants

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