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*N126-U4-PTSD*

Dobrisky-PTSD

QuestionAnswer
Name two antidepressant drugs that are used to treat PTSD paroxetine & sertraline
what is the adult dosage per day for paroxetine? 20-60mg/day
daily dose for sertraline? 50-200mg/day
which drug can cause a side effect of dry mouth? paroxetine
which drug can cause insomnia? sertraline
which drug can cuase loose stools? sertraline
which drug can cause nausea & drowsiness paroxetine
what is the NANDA diagnosis r/t PTSD? Post-Trauma Syndrome
PTSD is what type of disorder? anxiety
what one element of PTSD sets it apart from other anxiety disorders? the cause is identifiable
ptsd is defined as the development of characteristic symptoms following exposure to an extreme traumatic stressor
a patient with PTSD has what types of responses? intense fear, helplessness, or horror
PTSD is marked by what types of symptoms? clear biological changes & psychological symptoms
does PTSD usually occur alone in a patient? no, usually with related disorders
What are some of the clear biological changes evident in patients with PTSD h/a, dizziness, CP, anxiety, phobias
How is PTSD different from most mental-health diagnoses? tied to a particular life experience
Formal diagnosis of PTSD requires symptoms to persist for how long? over one month
what must the symptoms cause before a formal diagnosis of ptsd is made? significant distress and disturbance of the patient's ability to function socially, occupationally, or domestically
when is ptsd considered to be chronic? if symptoms persist for more than 3 months
acute stress disorder differs from PTSD in what three ways? client experiences at least three symptoms indicating dissociation, time frame of development is shorter and the duration of symptoms is shorter
acute stress disorder symptoms usually persist for two days to a month
the onset of dissociative symptoms of acute stress disorder occur during the trauma or immediately after
is PTSD more prevelant in a gender or race? no, affects all races, genders across the world
which gender is twice as likely to be diagnosed with ptsd and why? women, more likely to share their experience with healthcare provider
what percent of men and women who have spent time in a war zone experience ptsd? 30
in ptsd the trauma experienced can lead to changes in personality and an individual's sense of self-worth & trust
reactions to traumas vary related to what? the traumatic experience, the individual and the recovery environment
the CNS changes in a patient with PTSD include what? adrenergic hyperresonsiveness and depletion of neurotransmitters
what are some physiological symptoms of ptsd? increased hr, elevated blood sugar, muscle tension, perspiration, increased respiration & dilated pupils
ptsd causes a dysfunction in what neurotransmitters? gaba, norepinephrine & serotonin systems
what may happen to thyroid activity in the patient with ptsd? increases
increased thyroid activity, increased levels of coricotrphin-releasing factor and varied cortisol levels are all symptoms of what type of anxiety disorder? ptsd
PTSD causes an increased risk for what? addiction
stress increases the hormone production of CRF
drugs of abuse frequently increase levels of CRF
who is at risk to develop more complications from ptsd? the very young or very old
what occupations can lead to risk for ptsd? work with trauma or see people hurt or killed
what type of social environment increases a persons risk to develop ptsd? environment that produces shame, guilt, stigmatization, or self-hatred
what is the best way to be resilient to ptsd? find a support group after a traumatic event
what are the phases of traumatic response? immediate, delayed and chronic
the immediate phase of a traumatic response occurs when? during or immediately after the event
a patient within the immediate phase is often diagnoses with what type of disorder? acute stress disorder
when does the delayed phase of traumatic response occur? 1 week to 30 years after the event
when doeas the chronic phase of traumatic response occur? months to years after the event
during what phase does the patient experience insomnia, grief & mourning and withdrawal? delayed
what phase of traumatic response would include disappointment, resentment, sadness, persistent intrusive thoughts? chronic
what phase of traumatic response would include very strong emotions, disbelief, numbness, fear, confusion and anxiety? immediate
what are the three major types of symptoms that set ptsd apart from other disorders? re-experiencing symptoms, avoidance & numbing, arousal symptoms
loss of emotions, inability to recall an important aspect of a trauma and a sense of a short future or impending doom are all what type of symptoms associated with PTSD? avoidance & numbing (dissociative)
flashbacks, recurrent distressing dreams, intense distress at exposure to cues that resemble an event are all what type of symptoms associated with ptsd? re-experiencing symptoms (intrusion)
arousal symptoms of ptsd _________ return to previous baseline do not
arousal symptoms of ptsd reflect excessive physiological activation of what neurotransmitter? dopamine
arousal symptoms include a heightened sense of what? being on guard, hypervigilance
an exaggerated startle response is an example of what type of ptsd symptom? arousal symptom
difficulty falling asleep and staying asleep and difficulty concentrating are all examples of arousal symptoms
what can continuous arousal lead to? impatience, irritability, and sleep deprivation
DSM-IV diagnostic criteria of PTSD states a patient must esxperience at least ______ symptom of re-experiencing one
how many symptoms of avoidance & numbing must be present to confirm a ptsd diagnosis? three
how many symptoms of increased arousal must be present to confirm ptsd? two
how long must ptsd symptoms occur before diagnosis is made? atleast one month
children with ptsd may be misdiagnosed with adhd, conduct disorder, anxiety disorder or mood disorder
how might ptsd be expressed in children? disorganized or agitated behavior, increased arousal, hypervigilance, irritability, impulsivity & sleep difficulty
themes or aspects of the trauma are sometimes expressed by children during repetitive play
describe the dreams of children with ptsd frightening, without recognizable content
what condition may develop in ptsd children that previously didn't have that problem? inuresis-night time bed wetting
guilt and/or revenge may be a prevelant theme among what age group experiencing ptsd? teens
what is the most common cause of ptsd? family abuse
ptsd survivor profile of symptoms includes naivete vs __________ cynicism
ptsd profile symptom-worthlessness vs _______ specialness
ptsd profile symptom-self-punitive vs _______ self-indulgent
ptsd profile symptom-intense dependency vs ________ excessive caretaking
who is most at risk for ptsd r/t combat? younger troops who signed up for cash, heavy combat involvement, no chance to talk about experiences after returning, those whose values were invalidated and older members of natl guard units never mobilized before
sleep deprivation is requires emergency intervention in order to prevent what? psychotic episodes
which symptoms should be addressed first in a ptsd patient?` symptoms that are most disruptive to the patient
in a ptsd patient we should assess for and prevent what? drug and alcohol abuse
a goal for treatment of ptsd would be to strengthen the survivor's sense of?? control over their lives
when should treatment for ptsd be initiated? as early as possible, when there is a risk
while treating ptsd patients we should be attentive to maintenance of family relationships and prevention of employment problems
patient teaching should include helping the patient to recognize and control their reaction to triggers
anger management techniques should include time outs, anger diary, letter-writing, drawing pictures
name a few ways to help reduce sleep problems physical excercise during day, relaxation tapes at bedtime, prayer or meditation, elimination of stimulants and promoting bedtime hygiene
Cognitive behavioral therapy for the tx of ptsd should include exposure therapy, cognitive restructuring and stress inoculation therapy
eye movement desensitization and reprocessing is an affective treatment for what anxiety disorder? ptsd
what is the most common choice of pharmaceutical agents for the treatment of ptsd? ssri
what is the most effective treatment for ptsd? the combination of ssri & group therapy
anticonvulsant agents are used to stabilize what? mood
antipsychotic agents are used for tx of both psychosis and what anxiety disorder? ptsd
what are the stages of recovery of ptsd? victim, survivor, thriver
when a patient is in the early awareness phase of ptsd what recovery stage is that? victim
when goals replace trauma as the central organizing principle of life what stage of recovery of ptsd are they in? thriver
when a person begins taking control of one's environment and inner self what phase of ptsd recovery are they in? survivor
the ability to return to pretrauma role and the absence of physical disfigurement r/t trauma are factors that enhance recovery
ptsd client outcomes include ______ rather than avoiding emotional triggers, __________ feelings of self-blaming, improved mood & ________ and improved family _______ confronting triggers, decreased self-blaming, improved sleep, family coping
Created by: Lori Dobrisky
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