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MENTAL HEALTH
13 14 MED HEALTH
| Question | Answer |
|---|---|
| anxiety is | vauge, internal feeling of dread |
| fear | respsone to identiable external threat |
| stress | physiolgic "wear and tear " on the body -"i am afraid of..statments |
| anxiety affects | thinking, comminication, sftey |
| trauma impact | longterm mental and physical health |
| medications affect | CNS and saftey risk (falls and sedadtions) |
| GAS General adaption syndrome (hans selye) affects | sympathetic nervous system - foght or flight |
| GAS stages | alarm resistance exaustion |
| Alarm stage | fight or flight hr ^ bp^ glucose ^(adrelal gland ) adrenaline and norepinephrine released |
| resistance stage | body adapts vital organs working harder attemot to resore balance |
| exasution stage | resources depleted decrease immunity risk for illness |
| exasution = | highest risk for breakdown |
| levals of anxiety | mild moderate sever panic |
| mild | increased alertness motivates learning (GOOD anxiety ) |
| moderate | narrowed focus diffiuculty concentratiing USE SHORT SIMPLE INSTRUCTIONS focuses on problem itself |
| severe | poor thinking , confusion physical symptoms increase focus on sympt if anxiety more than problem REDUCE ANXIETY FIRST before teahcing moerate or mild |
| PANIC | fight/flight/freeze loss of control hyperventaling, dont knwo where is |
| panic disorder= | no reason |
| nursing priority | saftey FIRST STAY WITH PATIENT CALM VOICE |
| PSYCHOLOGICAL | DECREASED ATTENTION FEAR, HELPESSNESS DISORTED THINKING |
| PHYSICAL | INCREASE HR, AND BP TREMORS NAUSEA DILATED PUPILS |
| BEHAVIORAL | PACING RESTLESNES POOR IMPULSE CONTROL |
| ANXIETY DISORDERS | PANIC DISORDER GAD SOCIAL ANXIETY DISORDER PHOBIAS AGRORAPHOBIA |
| AGROPHOBIA | FEAR OF OUTDOORS AND OPEN SPACES |
| PHOBIAS | IRRATIONAL FEARS |
| SOCIAL ANXIETY DISORDERS | SOCIAL, AFRAID OF PEOPLE, TALKING LOOKING AT THEM |
| GAD - GENRAL ANZIETY DISORDER | LASTS HALF THE DAY, SYMPTOMS CAUSED BY ANXIETY, 6 MONTHS OR MORE |
| PANIC DISORDER | SUDDEN INTESNE EPISODE OF PANIC NO clear trigger- 15min-30min or longer heart attack symptoms / unexpected spends atleast half the time fearing next attack reccurent unexpected panic attack folowed by atleast 1 month of fear of next |
| panic disorders | sudden intense episode 15-30 min no clear trigger symptoms: chest pain, SOB, palpitations, fear of dying |
| phobias | irrational, persistent fear leads to avoidence behavior |
| types of phobias | social specific agoraphobia |
| GAD | Excessive worry more than 6 months symptoms : fatigue, irratablity, muslce tension, slep issues |
| mild- moderate anxiety | encourage expression teach coping strategies use simple communication |
| severe - panic anxiety | stay with patient reduce stimuli speak calmly DO NOT : ask complex questions- or force decisions |
| priority | saftey and calming |
| Trauma definition | extreme event beyound normal stress of daily living |
| trauma examples | abuse war natural disasters COVID related trauma adolescents asault #1PTSD |
| COMMON responses during and after trauma | anxiety insomnia grief difficultly coping |
| PTSD key fetures | night mares re- experiencing flashbacks avoidance negitive thoughts hyperarousal "on gaurd" |
| acute sress | 3 days to 1 month |
| PTSD | More than 1 month often chronic |
| risk factors | previous trauma (layers) combat exposure child hood abuse low supprt |
| Treatment | CBT - cognitive behavioral therapy SSRIs exposure therapy - cognive therapy, behavioral |
| dissociative disorders purpose | protect mind from trauma - discactiate-trauma/peri trauma |
| types of dissociative disorders | dissociative amnesia dissociative identity disorder depersonalization/derealization |
| dissociative amnesia | memory loss relatd to trauma |
| dissociative identy disorder | multiple identies |
| depersonaliztion/derealization | not yourself , looking at yourself" detached from enviroment - domnt reconginze envirment - feling detahced / unreal |
| nursing focus for dissociative disorder | grounding disorders- pt aware of space and time reality orientation saftey |
| benzodiazapines - exmamples | diazepam (valium) alprazolam (xanx) ADDICTIVE |
| Effects of benzos | sedation muslce relaxation lower anxiety |
| side affeects of benzos | drowsiness fall risk (ederly) cognitive impairment |
| over dose of benzos | ANTIDOTE- flumazenil consuion, coma |
| NON benzos | zolpidem eszopiclone |
| non benzos used for | SLEEP |
| Diffrence between seditive and hypnotic is the | DOSE |
| BARBITUATES | phenobarbitol- anti convulsant |
| barbituate | HIGH RISK respiroty depression LOW theraputic index- which means distance between thereputic and OVERDOSE |
| nursing implications anxiety | SAFET FIRST FAL PRECAUTIONS ASSIST AMBULATION BED ALARMS |
| Patient teaching | NO alcohol - riskk of resp deperession avoid CNA deperessants take befoere bed time (hypnotics) |
| monotor for : | sleep imporvment reduced anxiety side afects |
| key points | benzos = fall risk withdrawel- rebound insomnia always asess respitory and LOC |
| anxiety= | spectrum (mild- panic) sever/panic saftey frist PTSD = truama and long term symptoms benzos= effctive but risky |
| best treatment is | meidcation and CBT |
| STRESS MILD = | ALERT MOTIVATED, NO INTERVATION NEEDED |
| STRESS MODERATE | NARROW FOCUS, DIFFICULTY CONENTRATING USE SIPLE INSTRUCTIONS |
| STRESS SEVER | CONFUSIN - POOR THINKING DIFF CONCENTRATING SIMPLE INSTRUCTIONS |
| SEVVER | CONFUSION- POO THINKING REDUCE ANXIETY FIRST |
| PANIC | LOSS OF CONTROL- FIGHT/FLIGHT SAFTEY STAY WITH PATIENT |
| PANIC LEVAL AXIETY | SAFTEY FRIST - stay with the patien |
| control decreses | as leval rises |
| GAS | 'ARE' alarm resistance exaustion |
| exuaston stage = | highest risk for illness and breakdow |
| acute stress | 3days - 1 month short tem |
| PTSD | More than one month chronis and delayed |
| PTSD requires | exposure to trauma and symptoms lasting longer than 1 month |
| benzos | vallium, xanax SEDATION FALLS |
| NOnbenzos | zolpidem- sleep aid less abuse |
| babrs | [henobarb- esp depresson |
| benzo overdose | flumazenil |
| benzos= brin slows = | fall risk |
| nurs proiorites | stay wth patient - reeduce stimuli- calm voice,ensure saftey |
| never leave patient | in panic anxiety alone |
| panic= | protect first, teach later |
| trauma leads to | PTSD Medications rewuire saftey monotoring |
| best treatment= | medication and CBT |
Created by:
mmishue