Professional Documents
Culture Documents
Chanter13:AnxietyandStressRelatedIllness
l. Anxiety?
Belravioral,ernotiona :.,.
l" cogrritive .,.lhvsiologicrespotrses'
b. Resistancestage-bloodto areas
heart beats fasterandlrarderto circulatehighll'oxlgenatedandhighl--
rnourisheo
bloodtu the muscleto defend
c. Exhaustionphase-continual
3. AutonomicNervousSYstem?
ltespottses
to fcar and anxietr
4. Levels of Anxiet-v?
a.Mild anxiet-v- sensationthatincreaseandhelpsperson focus attentiotr to
learn" solve
problems,think.act. feel andprotectthemselves.Positivebecauscit allorvs
the
persolrto learn nerv belravior and solve problenls
b.ModerateAnxiety'-ield narrorved task."flrepersoncan still
perceptualf to irnrnediate
processinfonnation. solve problemsandlearn rrerv tlringsrv/ assistance
from
others.
tnalllcr
6. Short-termanxiety?
Can be treated with anxiolvtic medications. Mostof tlresedrugs are
benzoc{iazepirres.
'uvlrichhavea potentialfor abuseand dependencr. Theidealuse is no longer
tlran 4-6
rvks.Side effects for Anxiolr,ticare drorvsiness.
sedalion.poorcoordinationand impairecl
Inemoryor cloudeclsensorium.Teachclientthatit does not
treatrvhatcausedtheanxietv
bLrt"iusttheslmptoms,benzodiazepines
makesonealcoholdrink lrave the effect of three
drinksso client shouldn'tdrink
7.Typesof Anxiety disorders?
a.. Posttraurnatic stt'essdisordertPf SD) tl.Specilicphobia'
b. Socialphobia e. OUD
c.GeneralizeclAnxietl,disorder(GAD) t. Acste stressdisortler
Agoraphobiarv/orry/o panic disorder-- ("fearof thernarketplace"or 1'ealof
bcitts
Sg.
anxietl'about
mighttre clifficult or helprnightbe unavailable. PrirnaryCiain-tlre
relief of
anxict-\achicvcdbr perforrnirrg behavior ingir.
h.Panicdisorder-at leastonentontlr of
recurrcntlrncxpectedpzrnicaltacks(sttddcrronsel
of feelirrgof irnpendingdoorn)thatcausesconstantconcern.I5-i0 rninsof
ra;lid.intense.cscalatinganxietl'wi1hcmotionalfcar and phvsiological
isconrtbrt;palpitation.srvcating.trernors.SOB.scnseof sullbcalion. clrcst
pain.... ... ....Treatment: behavior deep brcathing and
coguitive techniques.
rclaxationan duredications asRenzodiazepine.
andhlpcrtc:tts
8.DefenseMechanisms?
Cognitive distortions that a personuses unconsciously to maintain a
senseof lreing in
controlof a situation. to lessendiscomfoft and to deal rv/ stress
b.Dqql4{Lt}plfjz"UlC-uscolcluestionsto
morerealisticallrappraisethr'question(cg.
What's tlrc uorsc thal canhappcn'.)
Or isthat likelr"l)
a.History-scekstreattnentafter sevet'al
panicattacks.fhinkstlrer,arcgoingcrazr o
havinga heart attack. flrev cannotidentil\trigger
b.(ieneralAppearanceand motor Behavior- increasespcechrate. pitclr and
volr.rme.
dil'fictrltl'sittingattdAutomatisms (autornatic. rnaurrcrisrrr
unconscious (eg.
tapping finger..iingling kevsor twistirrg liair)
and<Jerealization tlrattlrings
real)
d.ThoughtProcessesandConfent-believcdthevilre d1ing.
lostngcolrfrolor"going
insarre."suicicleand thoughts are disorganizecl
e.Sensoriumand Intellectual Processes-c'onfrrsecl
and clisoriented
{. Judgment issuspcndcd(clientcan run out into a specding car) and
Insight pnll afier
the client is cducate-d
aboutpanicdisorcler
12.Interventionsfor PanicDisorder?
a'
promotingsafetlandcomfort:useasoothing.calmvoiceandgivebriefdirectionto
assuresafety
cotnmunicationteclrniques'
guidedimagery(imaginea safe place) and
c. ManagingAnxietv:relaxatioirtecSniques.
prog.essiverelaxation(personprogressivelytightens.holds.andthenrelaxes
musciegrollpsthroughrhl'thmicbreathing)
d. providingCliJntanclfamilyeducation-
clientshouldunderstandthattherapiesand
drugsc1on,tCUREtlredisorderbutaremethodsto helptherncontrolandmanage
it. Encourageclientto exerciseregularlyto
metabolizeadrenalin.reducespanic
reactionsandf productionof endorphins
13.Phobias?
f'earof a spccificob.iectora socialsitualiontltatcaltses
lllogical.ilrtense.persistent
ettremc-clistressanclinterfercsrv/ rrorrrral
functioning.LJsualll'doncltresttltf,rornpast
that
negatiyeexperiences.
attdirrational'
14.Thethreecategoriesof phobias?
a.Agoraphobia
b. SpecificPhobia
l. Naturalenvironment(storms)
z blood-irr.iection
Phobias
3.Sitr,rational on a bridgc-....)
phobia(hcingin clcvator.
+.AnimalPlrobia
social
phobia.
15.Treatmentfor phobias?
*belravioral
desensitization-cxposcsthe client OR
Flootling-a rapid clcsensilization tlrevcorrfront
rvlrere tlrcphobicolr.joct(pictLrrcor
actual ob.ject) r-rrttil anxictr
in no lttttger procluc:e
16.OCD?
Recurrent.persistent, thoughts. images. or impulses
intrusiveandunr.vanted that cause
rnarked anxiety and interferes w/ interpersonal. social or occupational
function.
Compulsionis ritualistic or repetitive behaviors or menlal acts that a
personcarries out
continuousll,in an attemtrrt to neutralize anxietl . It diagnosedrvhen it
interf'eresw/ person
functioning. The client understands thatritualsare unusual ancl
unreasonable
ritunl
butciifficLtltl. or pa1ing
attentiontvhen obsessions arestrong
20.Interventionfor OCD?
a.Use therapeutic communication-dicussingfeelings and managitrg anxiety
b. Teachrelaxationand behavioral techniques
c.Completinga daily routine- client initially ma1' needadditionaltime to
allor.v for
rituals; don't internrptor ternpt to stop rituals because
anxiety'escalate
4
-'dramatically.Overallthe client has to be rvillingto change.
21.GeneralizedAnxiety Disorder(GAD)?
6 months ol'persistenl anclexsessivewona ancl anxietr. Feerls highh
anxiotrs at leasl
50% of the lirnt:firr6 rnonthsor morc. Pcrsonhas three or
rnoresvlnptorrs:ulreasirress.
irritabilitl'.rnuscletension.fatigue.clifficultl'thinking and sleep
alteration. ElTective
treatmentsare Buspirone (Buspar)anclSSRIatrlidepressants
23.Treatmentandinterventions?
a.groupor individual thrrrap)in thc cornmunitr to addrcss crpclicncc.
b.cogrtitir,'ebehavioraltherapv andsubsequent
to deal rv/ thoughls feelingandbclirvior
ol-tratrnra srrrvivors
ancl abuse
c.reassociationlbl dissclciatit-rr
d. Paxil ancl Zolofl usecl to trcrat P'fSD successfrillv
24. Applicationof the nursing process (assessment)?
a. Background- reveal history of abuse or trauma
b.General Appearance and motor Behavior- appearshvperalertand react to
evell
small environmental noises lv/ a staflle response. anxiolrsor agitated
and
diffi culty sitting sti ||
c. Mood and Aff'ect- frighten look or scared or agitated and hostile
dependingon the
experience
d.Thoughtprocessand content- may repoft hallucinations voices in their
and buzzing
lreads,self-destructive and suicidal ideation
thoughts.
irnagc
arnrresia.
cletacllrrent
29.Date rape(acquaintancerape)?
Ma\ occttr on a f irst clate,otta ridelrorne frrim a part\'.or
rvlrentlrctrvopeoplehave
knurvncach othcr lbr sornetime.
31.Treatmentand intervention?
Signstrseclto educateabor"rtdate rape antl ale( rvornenlo the
clraracteristics rvhcr
gf rnerr
arelikell'tocotnntitdatingviolenccltlroservhoexpressnesativitiesatrotrt,u
vornerr.
rnaking
expressingangerandusingintirnidation.
Therapv and;rrophylactictreatment{i'rr
sexltaltransmittedcliseasesuchasChlarnidiaor gonorrhea areofT'erecl.
lt takes I I'r or
morefor survivors of rape to regain previoLrs levclof fi.rnctionilrg.
32.CommunityViolence?
Few people responsiblehavebeendiagnosedrv/a ps-
vchiatricdisorder:conductdisorder.
s
Chapter15:MoodDisorder
33.Mooddisorders(affectivedisorders)?
Pervasivealterationsirrertrotionsthatarernanifcstedby depressiotr.tnania
or bcltlt.
agitation!prolactinlervels
to enlarge in lvotnen andtenderin tr:ell
or
guilt.difficultvconcentrating.or making decisions. or recurrentthoughtsof
deatlr
or surcidal ideation.plansor attempts.
J involvernent activities
excessiveinvolverneut activitiesw/ potential
in pleasure-seeking 1orpainfirl
consequences
andpoor.judgment
36.Hypomania?
Irlevated.expansivc.or irritablc rrrood lastirrg4 clars incluriing llrrec
or above svmptoms
37.Bipolar I disorder?
One or more manic or mixecl episodes Lrsually' accompaniedb1" ma.ior
depressive
episodes
38.Bipolar II disorder?
Onc'or ntorc ttra"ior episode b1 at lcastorrehr'pornaniccpisocle
deirrcssive accomparried
39.Related disorders?
a. Dysthymic disorder- least 2 ;-earsof clepressed
mood for morc davs than not lv/ sorne
additional.less severe s)nrptoms and do not meet tlre criteria for a
major
depressive
b. MonoamineOxidaselnhibitors(rr,rol)-usedinfiequerrtlldrre to
potentialsidc
el'lbctsantl interaction rv/nLlrncrousclrugs,esp. ll1'pcrtensive crisis
resull rvhcrr
ingestedt1'ratninc-containing svrxptoms
foodsand fluid or other meclicatit'rn...
arc occipital lrcadache. NV" clrills.slvcatilrg. nuchal
lrvperterrsiorr. r'estlessrrc'ss.
rigiditl^ dilated ptrpils.fcv'er. l'hiscarrleacl
tneclication. clectrodcs
unilateral (lessnrenx,rllrss bul nrorc proccrlulcs
Monitored
elcctroencepltalogram reccivesa slrofl-acting anc$lrelfulalxg5cje
(t,r.r;).Client
-relaxant/paralrtic
. r'rrsclseontr.ctions)
f. Psy'chotlrerapy-
interpersonaltherapy focus on difficr]lties in relationships.
Behavioraltherap,v focus on irnproving social skills. Cognitivetherapy
focus
on hor,v thepersonthinksabout the self. otlrersandthe future and
interprets their
experiences
of the hands
balance [:rncclurage
theday to prortlote sleeping at niglrt
45.Treatmentfor Bipolar?
Lifetimeregimenof medications of antimanic agent(lithium)or
anticonvulsant
medicationsuseclas a rnood stabilizers.
46.Lithium?
A salt corrtainecl Il cotnpelcs sites
irr the lruman bodr. 75% thelapeutic. lbr salt rcrcepttrrs
and afl'E:cts ions attd glucosc Pcakisl0 rniri 1o 4 hrs.It
rv/cornprorniscd or urinarl
retentionor lolv salt clictsor diuretics.
49.Suicide?
The intentional act of killing oneself.
50.Suicidal ideation?
'l'hirrkirrg
51.Riskybehaviors?
A few giveno warning sign thel'.iust placethcrnselves situations
in riskl or dangerous
52.Lethality assessment?
l.il<clihoocl ittingsLricide
of conrrn
fl h \
' \
f I )
ttear futttt'c A./
57.Mourning?
Outrvard expression of grief.e.g.givinga funeral. rvake
58.Types oflosses?
a.ph1'siologic
loss(c.gamputati<xr)
oi prrhlic
andcorrfiilencc
62.DisenfranchisedGrief?
(lrief'ovcra lossthat is rtol or cannol be acknon'ledged nrorrrncd or /
z:\.
openlr,'. prrbliclr
srrlrportccl
sociallr,.
, +'
\
b.the loss itsclIis not recognizec[ or scen associallv sigrrificanl: eg.
Prcrratrl
)
death. itboftiott. dcathof a pct \/
lu
andchronicgriel
b. adequatesituationalsupport....assess
proviclesllppoft.....tt"tunf
internetresourcesareavailableto lrelpclientfincl
to grievingprocess
information.supportgrollpsandactivitiesrelated
copedrv/ significant
c.adequatecoping.....compareandcontrastrva}s in wlrichthe1"
lossin t6* purt and Lelpingthemrevieu,strengtlrsandrenerva sense of
personal
power.Encouragethemto careforthemselves"volunteerandchurchor other
activitiescanrenewfeelirrgsof self-rvortlr
68.Assessmentof grieving?
lnvolvesobservil[ all dirnensious response:tlrinking 1c.grritrrcl"
feelings
t-rf lrutnatr
lrorvperson is acting rtrclravi.ral).
b0d1's reactiotr
valuesairdbelie{.srspir-irrrirr).
icn*rri.ral).
1plrrsiologic1
69.Anger?
to a real or perceivedprovocationand can
A strong.uncomfortable.emotionalresponse
resLrltfrom flrustration.hurt or beirrgafraid.Positiveif expressed
asserlively.resultingin
resolvingconflicts.solveproblemsandmake decision. AngeractivatestheFight-
orflight
response.Negativedeniesit. suppress inappropriatel-v-.
it or if expressecl resulting
in plrr.'sicalor emotionalproblemsor interferesw/ relationships.
70.Hostility?
Al(A Vcrbal aggrcssiorr....ernotion verhalabuse^ violatiotl
tlrlouglr lack of coopcration.
o1'rulesor llorrns. belralior.lts dottc to irrtinriclate ctnotionalhartn
or threatenirrg or cattse
to another alftl cifn lead to plrl,sical aggt'essi0n tirllacksorrn
lrcrsrxt. ol'
ltr()pcrt\)
7l . Complicationof suppressing or denying anger?
Migraines headaches, ulcers, CAD andemotionalproblems(depression
72.Catharsis?
by engaging [rLrt
Explessingarrger in aggressive. saf'eactivities.e.g.hitting a punching
bag or y,elling.Ilorvever.tlris increase
ratherlhanalleviatearrgeratrclntaybe
contraintlicatcd.
75.Acting out?
Immature defense mechanismlrow the personsdealrvithemotionalconflicts or
stressors
through action rather than through reflectionor feelings
76.Treatment?
Aggressionfocusesonthe underlving problenror psrchiatricdiagnosis.Lithium
has
been effective in treating aggressir.e client. Carbamazcpinc used to
treat aggression
associaterv/dementia,psvchosisandpersonalitldisorders.
lt
ph.vsicalaggression.
lu