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ATI Module
Anxiety, Obsessive-Compulsive, and Related Disorders (Mental Health Exam)
| Question | Answer |
|---|---|
| adverse childhood experiences | Specific forms of physical and emotional abuse, neglect, and household dysfunction that have been linked to illness and premature death. |
| amygdala-centered circuit | A neural circuit in the brain that both informs and influences the manifestations of fear, panic, and phobia. |
| anxiety | The thoughts and feelings of experiencing a future threat. |
| cortico-striato-thalamo-cortical circuit (CSTC) | A neural circuit in the brain that both informs and influences the manifestations of worry, apprehension, and obsessive thought. |
| countertransference | A nurse’s unconscious attempts to process unresolved past relationship dynamics through their current relationship with the client. |
| diathesis-stress model | A model that explains both the presence and trajectory of a medical condition in relation to the dynamic interplay between nature (genetic factors) and nurture (environmental factors). |
| empathic linkages | An extension of Hildegard Peplau’s theory of interpersonal relations defined by the nurse’s ability to personally identify with and experience feelings the client experiences. |
| fear | An emotional response to a threat which is either actual or perceived. |
| general adaption syndrome | A pattern of predictable responses the body demonstrates in response to stress. |
| Peplau’s Theory of Interpersonal Relations | A middle-range descriptive classification theory that operationalizes four phases in the interpersonal relationship (e.g., orientation, identification, exploitation, and resolution). |
| phenotype | Observable characteristics or traits shared by an individual and can be seen in mental health disorders such as anxiety disorders. |
| positive childhood experiences | Various kinds of activities and experiences that enhance a child’s life, potentially leading to improved mental and physical outcomes. |
| transdiagnostic | A term that defines factors or mechanisms that are present in any disorder (clinical manifestations); may also be present across disorders or risk factors of other disorders. |
| transference | A client’s unconscious attempt to process unresolved past relationship dynamics through their current relationship with the nurse. |
| trauma-informed care | A service-based approach that is responsive to the impact of trauma and emphasizes the psychological, biological, and physical safety of clients and health care providers. |
| triggered | A psychological, physiological, or emotional reaction caused by an event, situation, or memory. |
| unconditional positive regard | An interpersonal technique that leverages complete support and acceptance of the client. |
| universal trauma precautions | Approach to client care with a trauma-informed lens to be aware, sensitive, and responsive. |
| How does anxiety transition from an adaptive response to a maladaptive state? | Anxiety transitions from adaptive to maladaptive when it becomes persistent, occurs at inappropriate times, or interferes with daily functioning, leading to physical and psychological distress. |
| What role does cognitive behavioral therapy (CBT) play in managing anxiety disorders? | CBT helps clients identify and challenge distorted thoughts and behaviors, teaching them healthier coping mechanisms to manage anxiety more effectively. |
| What nursing interventions are most effective when a client with anxiety reaches a panic state? | Effective interventions include guiding the client through deep breathing exercises, reducing environmental stimuli like dimming lights, and using active listening to provide reassurance and support. |
| What is a primary distinguishing feature of social anxiety disorder? | Social anxiety disorder involves marked fear or anxiety about social situations where the individual may be scrutinized, leading to avoidance of such situations or intense distress during them. |
| What types of information should client education for anxiety disorders include? | Education should cover the specific anxiety disorder, coping strategies, medication management, self-care practices, available community resources, and warning signs that require provider consultation. |
| Which DSM-5-TR criteria are used to diagnose generalized anxiety disorder? | excessive anxiety and worry occurring more days than not for at least 6 months, difficulty controlling the worry, and three or more symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, or sleep disturbance. |
| Which physiological tests might a nurse review to rule out underlying causes of anxiety symptoms? | Tests include thyroid function tests, blood glucose levels, echocardiography, and toxicology screenings. |
| How does the exhaustion phase of the General Adaptation Syndrome increase susceptibility to illness? | In the exhaustion phase, the body is depleted of energy and unable to self-regulate, leading to a weakened immune system and increased vulnerability to infections and chronic health conditions. |
| When assessing anxiety, how can nurses differentiate between subjective and objective data? | Subjective data comes from the client’s personal reports of feelings like worry or fear, while objective data includes observable signs such as increased heart rate, restlessness, or behavioral changes. |
| What is the role of therapeutic rapport in the care of a client with anxiety or obsessive-compulsive disorders? | Therapeutic rapport builds trust, facilitates open communication, and helps the client feel supported, which is critical for effective assessment and intervention. |
| Why is it critical for nurses to use universal trauma precautions when caring for clients with anxiety disorders? | Universal trauma precautions help create a care environment that is sensitive to the potential trauma history of clients, ensuring that interventions do not inadvertently retraumatize them while maximizing beneficence. |
| Which clinical features are required to diagnose panic disorder according to DSM-5-TR criteria? | recurrent unexpected panic attacks with four or more symptoms such as palpitations, sweating, trembling, shortness of breath, and fear of losing control, followed by persistent worry about future attacks or behavioral changes lasting at least one month. |
| How do adverse childhood experiences (ACEs) influence the development of mental health disorders? | ACEs, such as physical and emotional abuse or neglect, significantly increase the risk for developing mental health disorders like anxiety and depression. |
| What are the key principles of trauma-informed care that nurses should apply to clients with obsessive-compulsive disorder? | Key principles include ensuring safety, showing respect, fostering trust, maintaining unconditional positive regard, and being sensitive to the client’s unique trauma history and needs. |
| Which physical symptoms are commonly associated with panic disorder during a panic attack? | Common physical symptoms include palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, chills, and paresthesia. |
| What is selective mutism, and how does it affect social and academic functioning? | Selective mutism is the consistent failure to speak in specific social situations where speaking is expected, despite speaking in other situations, which interferes with academic achievement and social communication. |
| What factors should nurses consider when evaluating the functional impact of anxiety on a client? | Nurses should consider the intensity, duration, and distress of symptoms, as well as how anxiety affects the client’s daily activities and relationships. |
| How does moderate anxiety affect an individual’s ability to concentrate and sleep? | Moderate anxiety leads to difficulty concentrating, increased worry, and sleep disturbances such as tossing and turning or being unable to sleep due to persistent thoughts about stressors. |
| What distinguishes social anxiety disorder from specific phobias? | Social anxiety disorder involves fear and anxiety related to social situations and potential scrutiny, while specific phobias involve marked fear and anxiety upon exposure to specific objects or situations, such as animals or heights. |
| What is the importance of using a trauma-informed care approach when treating clients with anxiety or obsessive-compulsive disorders? | A trauma-informed care approach ensures psychological, biological, and physical safety for clients. It prevents retraumatization, promotes trust, and creates a supportive environment sensitive to the client’s past experiences of trauma. |
| What factors should a nurse consider when assessing the manifestations of anxiety in a client without focusing solely on their mental health diagnosis? | intensity, duration, and distress of symptoms, pt relationship with anxiety over their lifespan, identify variables that aggravate or alleviate symptoms, review physiological causes and assess the client's readiness for change and ability to function. |
| What strategies can nurses use to overcome barriers to assessing clients with severe anxiety symptoms? | Strategies include using a trauma-informed approach, employing therapeutic communication, maintaining a calm demeanor, and providing positive regard to build trust and ease the assessment process. |
| How can a nurse incorporate unconditional positive regard when caring for a client with obsessive-compulsive disorder? | The nurse can project unqualified acceptance and goodwill toward the client, addressing their needs without judgment to reduce shame or stigma and build a therapeutic relationship. |
| What characterizes the resistance stage of Seyle’s General Adaptation Syndrome, and how does it relate to anxiety? | In the resistance stage, the body attempts to stabilize and repair itself while remaining in a heightened alert state. If the stressor resolves, the body returns to baseline; if not, prolonged anxiety can occur. |
| What behavioral manifestations are associated with body dysmorphic disorder? | Behavioral manifestations include mirror checking, excessive grooming, skin picking, and seeking reassurance about one's appearance. |
| Why does anxiety become maladaptive at the panic level? | At the panic level, individuals become overwhelmed with terror, unable to process stimuli, communicate verbally, or function effectively, leading to physical and psychological distress that interferes with daily life. |
| Why might a child exposed to chronic stress for years display increased susceptibility to illness, according to Seyle’s General Adaptation Syndrome? | Prolonged exposure to chronic stress can lead to the exhaustion phase, where the child’s energy reserves are depleted, impairing immune function and increasing susceptibility to illnesses. |
| What distinguishes a phobia from generalized anxiety disorder? | A phobia involves marked fear or anxiety about a specific object or situation, whereas generalized anxiety disorder involves excessive worry about a wide range of situations and events. |
| What are the impacts of untreated anxiety disorders on children and adolescents? | Untreated anxiety disorders negatively affect academic, social, and family functioning and increase the risk for developing other mental health disorders. |
| What happens to cognitive and physical performance as anxiety increases to severe or panic levels? | As anxiety reaches severe or panic levels, cognitive and physical performance deteriorates. Individuals may experience overwhelming dread, inability to process environmental stimuli, and impaired communication and functionality. |
| What role does the amygdala-centered circuit play in the physiological response to anxiety? | The amygdala-centered circuit triggers the hypothalamic-pituitary-adrenal (HPA) axis, leading to hormone release that activates the survival response (fight-flight-freeze-fawn). This explains fear and panic manifestations in anxiety. |
| What is the median age of diagnosis for anxiety disorders in children and adolescents? | The median age of diagnosis for anxiety disorders is 6 years in children and 12 years in adolescents. |
| How does trichotillomania manifest, and what triggers this behavior? | Trichotillomania is characterized by repetitive hair-pulling, often triggered by boredom or anxiety, and results in tension reduction or a sense of gratification. |
| Why might children and adolescents with untreated anxiety disorders be at greater risk for developing other mental health conditions? | negatively impact academic, social, and family functioning, leading to increased vulnerability for developing conditions like depression, substance use disorders, and oppositional defiant disorder due to prolonged stress and maladaptive coping mechanisms. |
| Which therapeutic communication techniques are most effective in building trust with clients experiencing anxiety? | Techniques such as active listening, validating the client’s feelings, providing clear and consistent communication, and demonstrating empathy are effective in building trust. |
| What are SMART goals, and how are they applied in planning care for clients with anxiety disorders? | SMART goals are specific, measurable, achievable, relevant, and time-specific. They help create clear, actionable objectives for reducing symptoms and improving client functioning. |
| What epidemiological trend was observed in adults regarding anxiety and depressive disorders during the first half of 2020 compared to 2019? | Adults were three times more likely to screen positive for anxiety and depressive disorders during the first half of 2020 compared to the same period in 2019. |
| How can nurses evaluate the effectiveness of interventions for anxiety management? | Effectiveness can be evaluated by assessing reductions in anxiety symptoms, the client’s ability to use coping strategies, and their engagement in therapeutic activities. |
| How do evidence-based screening tools support the nursing assessment of anxiety disorders? | Screening tools, such as the GAD-7 or Hamilton Anxiety Rating Scale, help evaluate the severity of symptoms and inform clinical formulations, though they do not provide a formal diagnosis. |
| What happens physiologically when anxiety transitions from mild to moderate levels? | As anxiety transitions from mild to moderate, physiological symptoms intensify, including increased restlessness, edginess, difficulty sleeping, and a heightened focus on stressors. Thinking becomes less clear. |
| What distinguishes anxiety from stress in terms of their physiological and situational responses? | Stress is typically proportional to the stressor and resolves once the stressor is removed, while anxiety may occur without an identifiable cause, persist longer, and is often disproportionate to the situation. |
| What distinguishes generalized anxiety disorder from other anxiety disorders in terms of symptom duration? | Generalized anxiety disorder involves excessive anxiety and worry occurring more days than not for at least 6 months about various events or activities. |
| How can the diathesis-stress model explain the development of anxiety disorders in individuals exposed to prolonged stress? | The diathesis-stress model suggests that genetic predispositions (nature) combined with environmental stressors (nurture) can increase vulnerability to anxiety disorders over time. |
| Which risk factors for anxiety disorders are considered modifiable and could be targeted in nursing care plans? | Modifiable risk factors include cigarette smoking, recent job loss, illicit substance use, interpersonal stress, and poor lifestyle habits such as lack of exercise and unhealthy diet. These can be addressed through education, support, and interventions. |
| What is the significance of positive childhood experiences (PCES) in mitigating the effects of adverse childhood experiences (ACEs)? | Positive childhood experiences, such as having caring adults or positive peer relationships, can provide symptomatic protection from the effects of ACEs, although they do not neutralize them entirely. |
| What is the estimated 12-month prevalence rate for obsessive-compulsive disorder (OCD) in the United States? | The 12-month prevalence rate for OCD in the United States is estimated at 1.2%. |
| Which neurotransmitters play a role in the cortico-striato-thalamo-cortical (CSTC) circuit related to obsessive thoughts? | Serotonin, GABA, dopamine, glutamine, and norepinephrine are neurotransmitters involved in the CSTC circuit, which influence worry, apprehension, and obsessive thought processes. |
| What differentiates substance/medication-induced anxiety disorder from generalized anxiety disorder? | Substance/medication-induced anxiety disorder is directly related to exposure to or withdrawal from a substance or medication, whereas generalized anxiety disorder lacks this direct connection. |
| What comorbidities are commonly associated with obsessive-compulsive disorder (OCD)? | Common comorbidities include mood disorders, tic disorder, attention-deficit/hyperactivity disorder, eating disorders, and substance use disorders. |
| Which screening tools are specifically used to assess obsessive-compulsive disorder in clients? | Tools include the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Brief Obsessive-Compulsive Scale (BOCS). |
| What are some factors that have magnified the prevalence of anxiety during the COVID-19 pandemic? | The prevalence of anxiety has been magnified by a lack of healthy coping strategies, increased use of alcohol, and a rise in suicide rates. |
| What is the goal of exposure therapy for clients with anxiety-related disorders? | The goal is to gradually expose the client to anxiety-provoking stimuli in a controlled manner to reduce avoidance behaviors and increase their comfort over time. |
| How does trauma-informed care benefit clients with anxiety-related disorders during the nursing assessment? | Trauma-informed care acknowledges the impact of past trauma and ensures that the assessment process minimizes re-traumatization, promoting client comfort and trust. |
| How does the recovery model benefit clients with anxiety disorders in their long-term care? | The recovery model focuses on helping clients build meaningful lives through healthy relationships, satisfying work, personal growth, and supportive environments rather than aiming for symptom elimination. |
| How does trichotillomania manifest in behavior and emotional relief? | Trichotillomania involves intentionally pulling out one’s hair, often triggered by boredom or anxiety, leading to tension reduction and a sense of gratification or relief. |
| Why might an individual with severe anxiety experience an inability to respond to others or complete simple tasks? | Severe anxiety overwhelms coping mechanisms, heightens emotional responses, and reduces cognitive functioning, making it difficult to process information, interact with others, or perform basic tasks. |
| How does separation anxiety disorder differ from generalized anxiety disorder in terms of focus? | Separation anxiety disorder focuses on excessive fear or anxiety upon separation from attachment figures, while generalized anxiety disorder involves excessive worry about multiple situations and circumstances. |
| What are some key strategies nurses can use to manage their own stress when caring for clients with anxiety disorders? | Nurses can practice self-reflection, seek mentorship, maintain professional boundaries, engage in mindfulness activities, and utilize peer support to manage stress and prevent countertransference. |
| How does the risk of anxiety-related disorders differ between biological sexes? | Persons biologically born as women are twice as likely to develop an anxiety-related disorder compared to persons biologically born as males. |
| Which symptoms must be present for at least 1 month following a panic attack to meet diagnostic criteria for panic disorder? | Symptoms include persistent concern or worry about additional panic attacks or their consequences and/or significant maladaptive changes in behavior to avoid triggers of panic attacks. |
| What is the purpose of the survival response during anxiety, and how does it initially help an individual? | The survival response during anxiety increases blood flow to the heart, muscles, and brain, enhancing an individual's ability to function, think clearly, and take action. Initially, this motivates adaptive behaviors to address the stressor. |
| How does Peplau’s concept of empathic linkages apply to the nurse-client relationship in anxiety care? | Empathic linkages involve the nurse internalizing the client’s emotions, such as anxiety. While this can enhance understanding, it also requires the nurse to maintain self-awareness to avoid emotional overwhelm and ensure effective care. |
| What are some self-care strategies nurses can use to manage the emotional challenges of empathic linkages? | Nurses can practice mindfulness, seek supervision or mentorship, engage in regular self-reflection, and maintain professional boundaries to manage the emotional impact of empathic linkages. |
| Which factors are considered modifiable when assessing a client’s risk for panic disorders? | Modifiable factors include cigarette smoking, illicit substance use, recent job loss, and interpersonal stress. |
| What are the key triggers for agoraphobia according to the DSM-5-TR criteria? | Triggers for agoraphobia include situations like being in open spaces, closed spaces, using public transportation, being in a crowd, or being outside the home alone, often due to fear of being unable to escape or get help. |
| What are the common diagnostic categories for anxiety-related disorders as per the DSM-5-TR? | The DSM-5-TR identifies 11 diagnostic variations of anxiety disorders and 8 diagnostic variations of obsessive-compulsive and related disorders. |
| What does the term 'transdiagnostic' imply in the context of mental health disorders? | Transdiagnostic refers to factors or mechanisms that are present across multiple mental health disorders, such as anxiety being a common feature in disorders like depression, PTSD, and OCD. |
| What behaviors characterize obsessive-compulsive disorder? | OCD is characterized by repetitive behaviors or mental acts such as handwashing, checking, counting, or ordering objects, performed to reduce anxiety caused by intrusive obsessive thoughts. |
| What are some identified risk factors for developing anxiety disorders? | Risk factors include trauma or negative life experiences, personality traits such as shyness, family history of mental health disorders, history of illness, genetic predisposition, and unhealthy lifestyle choices like alcohol or substance use. |
| What is the nurse's priority when caring for a client with an anxiety-related disorder in an acute setting? | The nurse’s priority is to ensure client safety, particularly monitoring for risk of harm to self or others, before addressing other manifestations. |
| What are common physiological symptoms of anxiety disorders? | Common physiological symptoms include increased heart rate, increased respiratory rate (hyperventilation), sweating, fatigue, difficulty concentrating, gastrointestinal disturbances, and sleep disruptions. |
| What techniques can be used to establish trust with a client who has experienced trauma? | Techniques include maintaining consistent communication, demonstrating empathy, validating the client’s feelings, and following through on promises made to the client. |
| What actions can help reduce environmental stimuli for a client experiencing severe anxiety in a hospital setting? | Actions include dimming lights, minimizing noise, ensuring privacy, reducing interruptions, and creating a calm, supportive environment to help lower anxiety levels. |
| When is separation anxiety considered developmentally inappropriate and excessive? | Separation anxiety is considered developmentally inappropriate when fear or anxiety upon separation from attachment figures exceeds what is typical for the individual's age and significantly impairs functioning. |
| How should a nurse handle countertransference to maintain professional care for clients with anxiety? | The nurse should recognize signs of countertransference, engage in self-reflection, seek mentorship from experienced colleagues, and focus on maintaining professional boundaries to ensure high-quality care. |
| What lifestyle modifications can a nurse recommend to a client to help manage their anxiety symptoms? | Recommendations include maintaining a balanced diet, regular physical activity, avoiding caffeine and substances, practicing mindfulness or relaxation techniques, and ensuring adequate sleep. |
| How does the DSM-5-TR define the obsessions in obsessive-compulsive disorder? | Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, causing marked anxiety or distress. |
| Why is it important for nurses to focus on manifestations and stressors rather than the client’s mental health diagnosis during assessment? | Focusing on manifestations and stressors allows nurses to understand the client's functional state, identify specific triggers or alleviating factors, and provide a holistic and client-centered approach to care. |
| What are the key clinical manifestations a nurse should assess when evaluating a client for anxiety-related disorders? | Key clinical manifestations include tachypnea, tachycardia, psychomotor agitation, impaired concentration, anxious mood, ruminative worry, and social isolation. |
| What behavioral examples might indicate obsessive-compulsive disorder in children compared to adolescents? | In children, compulsive behaviors such as repetitive handwashing are more noticeable, while adolescents may display obsessions related to religion or sexuality, reflecting developmental differences. |
| What are some common comorbidities associated with anxiety disorders that may worsen symptoms and quality of life? | depressive disorders, obsessive-compulsive disorders, substance use disorders, trauma-related disorders (such as PTSD), eating disorders, sleep-wake disorders, and medical conditions like chronic pain, irritable bowel syndrome, and asthma. |
| What clinical manifestations are common at the severe level of anxiety? | Severe anxiety is characterized by overwhelming stress, intensified anxiousness, restlessness, decreased cognition, heightened emotional responses like anger or irritability, and an inability to complete simple tasks. |
| What is a defining feature of obsessive-compulsive disorder that differentiates it from generalized anxiety disorder? | Obsessive-compulsive disorder is characterized by the presence of obsessions (intrusive, unwanted thoughts) and/or compulsions (repetitive behaviors), whereas generalized anxiety disorder involves pervasive worry without the compulsive component. |
| What factors should be considered when planning effective client education for managing anxiety symptoms? | Factors include choosing a distraction-free environment, using therapeutic communication, tailoring evidence-based content to the client’s needs, and offering multiple learning methods such as visual aids or demonstrations. |
| What clinical signs indicate that an individual has entered the exhaustion phase of Seyle’s General Adaptation Syndrome? | In the exhaustion phase, the body depletes its energy reserves and loses the ability to self-regulate, leading to fatigue, immune system suppression, and increased vulnerability to illness and anxiety disorders. |
| What clinical features differentiate body dysmorphic disorder from generalized anxiety disorder? | Body dysmorphic disorder is characterized by persistent preoccupation with perceived physical flaws and behaviors like mirror checking or excessive grooming, while generalized anxiety disorder involves excessive worry about varied situations. |
| What are common obsessions and compulsions seen in individuals with OCD? | Obsessions include fears of harm, cleanliness, offending a higher power, or forgetting something. Compulsions include checking, handwashing, repeating phrases, counting items, or performing rituals to reduce anxiety. |
| What interventions should a nurse prioritize for a child admitted to a mental health unit with severe anxiety? | Interventions include establishing therapeutic rapport, orienting the child to the milieu, monitoring for self-harm, and fostering connections with peers in the therapeutic setting. |
| How do the resistance and exhaustion phases of Seyle’s General Adaptation Syndrome differ? | In the resistance phase, the body stabilizes and repairs itself while remaining on alert. In the exhaustion phase, energy reserves are depleted, and the body can no longer self-regulate, leading to vulnerability to illness. |
| What percentage of individuals affected by anxiety disorders seek or receive treatment? | Less than 40% of individuals affected by anxiety or diagnosed with an anxiety-related disorder seek or receive treatment |
| When should a nurse suspect substance-induced anxiety disorder? | A nurse should suspect substance-induced anxiety disorder when manifestations of anxiety, fear, and worry occur in relation to substance exposure or withdrawal. |
| How does a family history of mental health disorders contribute to anxiety or OCD risk? | A family history of mental health disorders suggests a genetic predisposition and learned responses to stress, increasing the risk for anxiety or OCD. |
| What should a nurse explore about a client’s relationship with anxiety over their lifespan during assessment? | The nurse should explore the client’s history of anxiety, triggers, coping mechanisms used in the past, and their developmental and familial history related to anxiety. |
| How can a nurse ensure psychological safety for a client with a trauma history during care delivery? | The nurse can ensure psychological safety by creating a calm environment, using respectful communication, avoiding potentially triggering language or actions, and actively listening to the client’s concerns. |
| What is excoriation disorder, and how does it manifest physically? | Excoriation disorder involves recurrent skin-picking behavior resulting in lesions, commonly found on the hands, face, arms, or other body sites. |
| What physiological changes occur in the body during the alarm phase of Seyle's General Adaptation Syndrome? | During the alarm phase, the heart rate increases, adrenal glands release cortisol to provide extra energy, and the brain's acuity heightens to navigate the stressor. This is also known as the fight-flight-freeze-fawn response. |
| What is the diathesis-stress model, and how does it explain the development of anxiety disorders? | The diathesis-stress model explains that genetic predispositions (diathesis) combined with environmental stressors increase the likelihood of developing anxiety disorders. It highlights the interplay of nature and nurture. |
| Seyle’s General Adaptation Syndrome | Alarm phase, resistance stage, exhaustion phase |
| Seyle’s General Adaptation Syndrome: Alarm phase | When the client is exposed to stress, the human body enters an alarm (fight-flight-freeze-fawn) stage where the body’s heart rate increases, the adrenal glands release the stress hormone cortisol—and the brain reaches a heightened acuity |
| Seyle’s General Adaptation Syndrome: resistance stage | attempts to stabilize and repair itself. autonomic nervous system begins to cautiously downregulate Provided the stressor resolves and no long-term consequence to the body’s ability to self-regulate. stress response system will return to baseline. |
| Seyle’s General Adaptation Syndrome: exhaustion phase | The body finds itself depleted of energy reserves and unable to self-regulate independently and reliably. |
| Anxiety disorders | Anxiety becomes a disorder when the anxiety interferes with daily life, relationships, and ability to function. |
| Separation anxiety | Experiencing developmentally inappropriate and excessive fear or anxiety upon separation from those to whom they are attached. Reluctant to leave who they are attached to Nightmares Physical manifestations of distress |
| Selective mutism | Demonstrating consistent failure to speak in specific social situations in which there is an expectation for speaking. Not able to speak even when spoken to Affects achievement academically or socially Interferes with regular communication |
| Phobias | Experiencing marked fear and anxiety upon exposure to a specific object or situation. Examples of phobias include: Animals Nature Heights Inoculations Blood |
| Social anxiety | Experiencing marked fear and anxiety upon exposure to social situations and the potential for scrutiny associated with them. Social interactions include: Meeting new people Being observed eating or drinking |
| Panic disorder | Experiencing distinct and extreme periods of physiologic and psychologic hyperarousal. Usually unexpected and occurs for no apparent reason Results in changed behaviors, including: Avoidance of situations, people, or events that may trigger attack |
| Agoraphobia | Experiencing marked fear and anxiety upon exposure to circumstances associated with travel or location. Common situational causes: Closed spaces, such as an elevator Leaving home alone Fear and anxiety focus: Not being able to escape |
| Generalized anxiety disorder | Experiencing excessive anxiety and worry in response to numerous situations and circumstances. |
| Substance/ medication-induced anxiety disorder | Experiencing manifestations of anxiety, fear, and worry in relation to either exposure to or withdrawal from a substance or medication. |
| Anxiety disorder due to another medical condition | Experiencing manifestations of anxiety directly related to a medical condition. Common medical causes of anxiety: Chronic obstructive pulmonary disease Heart failure Hyperthyroidism |
| Obsessive-compulsive disorders and related disorders | Obsessive-compulsive disorder is characterized by the presence of obsessive or compulsive thoughts and behaviors. The related disorders are characterized by specific compulsive or repetitive behaviors. |
| Obsessive-compulsive disorder | Experiencing a pattern of uncontrollable obsessive thought and associated compulsive behaviors or rituals. Manifestations of OCD behaviors include: Cleaning Washing hands Ordering or counting objects or behaviors Taboo or forbidden thoughts |
| Body dysmorphic disorder | Experiencing a persistent preoccupation with perceived defects or flaws on one’s physical appearance. Manifestation of behaviors can include: Mirror checking Excessive grooming Skin picking Seeking reassurance about looks |
| Hoarding disorder | Demonstrating a persistent difficulty or inability to discard or part with possessions. Differs from collecting as symptoms result in excess accumulation of possessions that clutter and overwhelm living areas. |
| Trichotillomania | a pattern of ritualized behavior defined by serially and intentionally pulling out one’s hair. Behaviors are triggered by boredom and/or anxiety Results of behavior reduce tension, lead to form of gratification, and pleasure or a sense of relief |
| Excoriation disorder | Demonstrating a pattern of behavior defined by the recurrent picking at one’s skin, resulting in lesions. Physical manifestations commonly found on hands, face, arms, or multiple body sites Extensive time daily is spent picking |
| Substance/medication-induced obsessive-compulsive and related disorder | Encountering a pattern of obsessive-compulsive manifestations in relation to either exposure to or withdrawal from a substance or medication. |
| Obsessive-compulsive and related disorders due to another medical condition | Encountering a pattern of obsessive-compulsive manifestations in relation to the presence of a specific medical condition. |
| Strategy: Active listening | Definition: A pattern of listening and responding to others that maximizes mutual understanding and social connection. Example: The nurse demonstrates, both verbally and non-verbally, that they are engaged and genuinely interested |
| Strategy: Therapeutic communication | Definition: Adapting communication strategies to the client’s needs and being mindful of their clinical presentation and abilities. Example: The nurse strips away complicated and unnecessary medical jargon . |
| Strategy: Modeling | Definition: Demonstrating the kind of behavior that a nurse would want to see from a client by modeling it in real time. Example: Nurse encounters a client panic stop what they are doing, sits down next to the client, begins to breath slowly & deeply. |
| Strategy: Milieu (therapy) management | Definition: The therapeutic use of the client’s immediate environment to advance client goals. Example: The ER nurse elects to move the client struggling with severe anxiety away from the nurse’s station and resuscitation area to reduce stimuli. |
| Strategy: Anticipatory guidance | Definition: Educational and counseling practice that proactively addresses possible future changes and challenges in relation to a client’s health status. Example: educates the client on possible adverse effects of an antidepressant |
| Strategy: Anti-stigma messaging | Definition: A consistent pattern of communication that aspires to correct misinformation & challenge negative attitudes/beliefs about mental illness. Example: The nurse earnestly & constructively corrects a family member’s about the client’s anxiety |
| Strategy: Triggers | Definition: Identify what causes the psychological or physiological response of anxiety toward client self-management. Example: The nurse assists the client in determining the cause of worry and how they are responding. |
| Strategy: Self-management | Definition: Encouragement and education to utilize techniques and strategies to reduce anxiety for the client. Example: The nurse educates the client to use mindfulness, deep breathing, or other techniques to reduce anxiety and increase relaxation. |
| Strategy: Support | Definition: Direct client to individuals or groups for support and socialization. Example: The nurse provides information regarding community support groups for individuals who have experienced trauma. |
| Psychotherapy: | a talk therapy focused on the client’s specific anxiety |
| Cognitive behavioral therapy (CBT): | a type of psychotherapy directed at how the client thinks, behaves, and reacts to causes and the feeling of anxiety |
| Cognitive therapy: | similar to CBT, it is focused on identifying the cause of anxiety and eliminating thoughts that are distorted or unhelpful regarding anxiety or stressors |
| Exposure therapy: | the client is exposed to the underlying cause of anxiety that they are avoiding, such as driving in traffic or riding in an elevator, to gradually become more comfortable with the activity |
| Support groups: | groups focusing on sharing and achieving goals related to anxiety management |
| Complementary-integrative approaches: | relieving anxiety in specific situations, such as during a medical procedure—practices include relaxation techniques (deep breathing, guided imagery, progressive body relaxation), hypnosis, massage therapy, mindfulness meditation, and music |
| Lifestyle management: | helping the client make better choices, including nutritional strategies (healthy diet), exercise, and avoiding excessive caffeine or substance use |
| Anxiety-related disorders are frequently treated with | anxiolytics (benzodiazepines), SSRI (selective serotonin reuptake inhibitor) antidepressants, and SNRI (serotonin and norepinephrine reuptake inhibitor) antidepressant. SSRIs and SNRIs are essential medications used to treat OCD and related disorders. |
| Meehl's Diathesis-Stress Model | several vulnerability genes that appear to be associated with an increased risk for developing mental illness. The dynamic interaction between genetic and environmental variables determines the potential for developing a mental illness. |
| risk factors for developing manifestations of obsessive-compulsive disorder? | genetic predisposition for developing obsessive-compulsive disorder. |
| The cortico-striato-thalamo-cortical circuit is associated with | manifestations such as worry, apprehension, and obsession. |
| A reflex arc is a neural pathway that controls | reflexes and not obsessive-compulsive symptoms. |
| The hypothalamic pituitary adrenal axis is associated with those symptoms associated with | trauma response |
| The amygdala-centered circuit is associated with manifestations such as | fear, panic, and phobia. |
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