Anxiety Disorders
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| Individuals with anxiety disorders use rigid, repetitive, and ineffective behaviors to | Try to control anxiety.
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| Anxiety disorders tend to be | persistent and often disabling
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| Major depression and substance abuse are frequently encountered with | anxiety disorders
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| Anxiety disorders tend to cluster in | families
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| Panic disorders are 2-3x more frequent in | women
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| Generalized anxiety disorder is 2x more frequent in | women
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| Phobias are 2x more frequent in | women
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| Social anxiety disorder is _______in prevelance when comparing women and men. | equal
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| OCD is _______in prevalence when comparing women and men. | equal
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| PTSD is more likely to affect | women
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| Abnormalities of the benzodiazepine receptors leading to the unregulated anxiety levels of a patient is what theory? | GABA benzodiazepine theory
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| Studies suggest that a stress response of the hypothalamus-pituitary-adrenal system is abnormal in these individuals. | Patients with PTSD
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| This person taught that anxiety resulted from the threatened breakthrough of repressed ideas or emotions from the unconscious. | Freud
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| Freud suggested that ego defense mechanisms are used by an individual to | keep anxiety at manageble levels
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| This person felt that anxiety experienced early in life becomes the prototype for that experienced when unpleasant events occur later in life. | Sullivan
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| Behavioral psychologists conceptualize anxiety as a | learned response that can be unlearned
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| Cognitive theorists take the position that anxiety disorders are caused by | distortions in an individual's thinking and perceiving.
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| Panic attacks in Latin Americans and Northern Europeans often involve sensations of | Choking, smothering, numbness, or tingling as well as fear of dying.
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| Blusing, eye contact or body is offensive to others in what culture? | Japanese and Korean cultures
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| Minority groups have a much higher rates of | PTSD
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| List the disorders that are considered anxiety disorders: | Panic disorders, Phobias, OCD, GAD, PTSD, acute stress disorder, anxiety due to substance use, anxiety due to medical condition, and anxiety not otherwise specified.
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| The key feature of panic disorder is | the panic attack
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| This anxiety disorder is characcterized by recurrent unexpected panic attacks, about which the individual is persistently concerned. | Panid Disorder without agoraphobia
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| The sudden onset of extreme apprehansion or fear, usually associated with feelings of impending doom. | panic attack
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| People experiencing _____ may believe that they are losing their minds or tare having a heart attack. | panic attack
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| Palpitations, chest pain, breathing difficulties, nausea, feelings of choking, chills, and hot flashes are physical symptoms of | panic attacks
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| Typically panic attacks occur _______ and not in response to stress. | suddenly
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| Intense, excessive anxiety or fear about being in places or situations from which escape might be difficult or embarassing, or which help might not be abailable if a panic attack occured. | agoraphobia
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| Examples of situations that are commonly avoided by clients with agoraphobia are: | Being alone outside; being alone at home; traveling in a car, bus, or airplane; being on a bridge; ridign in an elevator.
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| Avoiding behaviors can be | debilitating and life constricting.
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| Recurrent episodes of panic attacks, and at least one of the attacks has been followed by 1 month of either persisten concern about having the attacks, worry about aconsequences, or significant change in behavior. | Panic Disorder
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| Irrational fear of an object or situation that persists although the person may recognize it as unreasonable. | Phobia
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| Fear of being along in open or public places where escape might be difficult, may not leave home. | agoraphobia
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| Fear of situations where one might be seen and embarrassed or criticized. | Social phobia
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| Fear of a single object, activity, or situation. | Specific phobia
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| In a person with a phobia, anxiety is severe if the object, situation or activity | cannot be avoided
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| Preoccupation with persisten intrusive thoughts, impulses, or images or repetitive behaviors or mental acts that the person feels driven to perform in order to reduce distress or prevent a dreaded event or situation. | OCD
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| With OCD the person knows the obsessions/compulsions are | excessive and unreasonable
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| This anxiety disorder can caus increased distress and is timeconsuming. | OCD
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| Excessice anxiety or worry more days than not over 6 months and an inability to control the worrying. | GAD
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| GAD is anxiety and worry associated with three or more of the following symptoms: | Restlless or keyed up;easily fatigued;difficulty concentrating, mind goes blank;irritability; muscle tension;sleep disturbance.
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| With this anxiety disorder, anxiety or worry or hysical symptoms cause siginificant impairment in social, occupational or other areas of important functioning. | GAD
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| _______ without a history of panic disorder occurs only rarely, and it occurs early in the clients history. | agoraphobia
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| Specific phobias are common and usually do not cause much difficulty because | People can contrive to avoid the feared object.
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| A ritualistic behavior that in individual feels driven to perform in an attempt to reduce anxiety. | compulsion
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| Common obsessions and compulsions are: | Doubt, need to check; sexual imagery or ideation; need for order; violence;germs or dirt.
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| What are the symptoms a person with GAD may exhibit? | Restlessness, fatigue, poor concentration, irritability, tension, sleep disturbance.
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| Examples of worries typical in GAD are: | Inadequacy in interpersonal relationships, job responsibilities, finances, health of family members, household chores, and lateness for appointments.
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| In GAD, decision making is | difficult, owing to poor concentration and dread of making a mistake.
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| Nurses need to teach clients with GAD that there are | effective psychotherapy treatments for this disorder.
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| This disorder is characterized by repeated reexperiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others. | PTSD
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| PTSD symptoms often begin _____ after the trauma. | 3 months
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| Dissociative experiences during which the event is relived and the person behaves as though he or she is experiencing the event at that time. | flashbacks
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| The major features of PTSD are: | Persistant reexperiencing of the trauma, perisitant avoidance of stimuli associated with the trauma, experience of persistent numbness of general responsiveness, persistent symptoms of increased arousal.
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| Difficulty with interpersonal, social, or occupational relationships nearly always accompanies | PTSD
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| This anxiety disorder occurs within 1 month after exposure to a highly traumatic event. | Acute Stress Disorder
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| Acute stress disorder resolves within | 4 weeks
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| This anxiety disorder is characterized by symptoms of anxiety, panic attacks, obsessions, and compulsions that develop with the use of a substance or within a month of stopping use of the substance. | Substance-Induced Anxiety Disorder
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| Chronic PTSD has a duration of ________ or longer. | 3 months
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| Acute stress disorder is no due to | drug/medication or medical condition.
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| Acute stress disorder occurs within _____ of the traumatic event. | 4 weeks
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| In this anxiety disorder, the individual's symptoms of anxiety are a direct physiological result of a medical condition, such as hyperthyroidism, pulmonary embolism, or cardiac dysrhythmias. | Anxiety due to medical condition
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| This anxiety disorder is a diagnosis used for disorders in which anxiety or phobic aboidance predominates but the symptoms do not meet full diagnostic criteria for a specific anxiety disorder. | Anxiety Disorder Not Otherwise Specified
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| People with anxiety disorders rarely need ______ unless they are suicidal or have compulsions causing injury. | hospitalization
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| The main symptoms of anxiety disorders are: | panic attacks, excessive anxiety, severe reactions to stress or trauma, phobias, obsessions, and compulsions.
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| What defense is used by a patient who has a phobia? | displacement
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| What defense is used by a patient who has a compulsion? | undoing
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| What defenses are used by a patient who has an obsession? | reaction-formation and intellectualization
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| What defenses are used by a patient who has PTSD? | Isolation and repression
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| Basic level psychiatric mental health nurses use ________ to assist clients with anxiety disorders to reduce anxiety, enhance coping and communication skills, and intervene in crises. | counseling
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| Advanced nurses use treatment approaches that include: | Cognitive or cognitive behavioral therapy, relaxation training, and the behavioral techniques of modeling, systematic desensitization, flooding, and response prevention.
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| If a patient with anxiety does have to be hospitalized, what features of atherapeutic mileu can be especcially helpful to the patient? | Structure of the daily routine, providing daily activities to promote sharing and cooperation, provide therapeutic interactions, including client in decisions about his or her own care.
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| What self-care activities are most likely to be affected with an anxiety disorder? | Nutrition and fluid intake, personal hygiene and grooming, elimination, and sleep.
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| Weighing anxiety disorder clients frequently is a useful tool for assessing | nutrition
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| Why might maintenanc of skin integrity become a problem for a client with an anxiety disorder? | Excessive washing of the skin.
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| Patients with GAD, PTSD, and acute stress disorder often experience sleep disturbances from | nightmares
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| These intervention include the use of simple relaxation exercises and administration of medications. | Psychobiological Interventions
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| What medications are the first line treatment for anxiety disorders? | SSRI's (antidepressants)
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| Why are SSRI's preferable to the tricyclic antidepressants (TCA's)? | Because they have a more rapid onset of action and fewer problematic side effects.
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| Why are MAOI's reserved for treatment-resistant conditions? | Because of the risk of life-threatening hypertensive crisis if the client does not gollow dietary restrictions (tyramine).
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| Antidepressants have the secondary benefit of treating | comorvid depressive disorders in clients
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| When antidepressant therapy is started, why is it important to start with low doses of SSRI's? | Because of the activating effect, which temporarily increases anxiety symptoms.
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| What may use of an antidepressant do in a client with co-occuring bipolar disorder? | It may cause a manic episode which will require the addition of mood stabilizers or even antipsychotic agents.
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| Use of MAOI's is contraindicated clients with comorbid substance abuse because | There is a risk of hypertensive crisis with the use of stimulant drugs.
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| These drugs are often used to treat the somatic and psychological symptoms of anxiety disorders. | anxiolytic drugs
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| Why are benzodiazepines the most common form of anxiolytic drugs used? | Because they have a quick onset of action.
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| What are the side effects of benzodiazepine? | Sedation, ataxia, and decreased cognitive function,.
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| An alternative anxiolytic drug that does not cause dependence is | Buspirone
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| How long does it take for Buspirone to reach its full effects? | 2-4 weeks
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| What anxiolyic drug would be used for long term treatment? | Buspirone
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| Aside from antidepressants and anyiolytics what are the other classes of medications that may be used to treat anxiety disorders? | Beta blockers, antihistamines, and anticonvulsants.
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| _______ have shown some benefit in management of GAD, SAD, and comorbid depression with SAD or panic disorder. | anticonvulsants
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| Because benzodiazepine is discouraged for patients with comorbid substance dependence, _____ are a safe nonaddictive alternative. | antihistamines
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| Problems that can occur with the use of psychotropic herbs include: | Toxic side effects and herb drug interactions
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| Inhibition of GABA may cause | increased anxiety
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| Among the suggested effective treatments for panic disorder is participation in ______ ______ therapy to gain mastery over panic episodes. | cognitive-behavioral
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| Assisting a client to increase his or her personal judgment of self-worth. | self esteem enhancement
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| The age of onset of most anxiety disorders is | before 40 years
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| Studies of clients with posttraumatic stress disorder suggest that the stress response of what is considered abnormal? | Hypothalamus-pituitary-adrenal system
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| A recurrent, persistent thought or impulse. | obsession
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| Fear and impending doom is a symptom associated with | panic attacks
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| Working with a client to help the client view an occurrence in a more positive light is called | cognitive restructuring
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| The primary purpose of performing a physical examination before beginning treatment for any anxiety disorder is | to determine if the anxiety is of primary or secondary origin
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| The treatment for secondary anxiety is | treatment of the underlying cause.
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| Inability to leave one's home because of avoidance of severe anxiety suggests the anxiety disorder of | panic attacks with agoraphobia
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| Panic attacks in Latin American individuals often involve | fear of dying
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| The nurse caring for a client with a panic attack might anticipate that the psychiatrist would order a stat dose of | a short-acting benzodiazepine
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| The physician orders lorazepam 1 mg po qid for 1 week for a client with generalized anxiety disorder. What should the nurse caution the patient to limit intake of? | caffeine
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| Anxiety disorders often interfere with the usual _________ of clients | role performance
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| Sleep disturbances is a potential problem that should be investigated for a client with | severe obsessive-compulsive disorder
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| What therapeutic intervention can the nurse independently use with a client with anxiety disorder? | modeling
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