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Anxiety
PN 141 final
Question | Answer |
---|---|
what are the three types | mild, moderate, severe/ panic |
mild: charecteristics of it | useful, mativational, focus on tasks |
mod: charecteristics of it | often considered the optimal level for learning to take place, physical s/s are present but not troubling to the individual |
severe/ panic: charecteristics of it | inability to think clearly or solve problems, misperception of surrounding events (they jump off buildings, running, or striking out), freezing up |
PTSD: what is it | cluster of s/s experienced following a distressing event (rape, murder, fire, war, car accident, shooting at school) |
PTSD: s/s | intense fear, helplessness, horror, experiencing the event over and over, sleeplessness, startle effect |
anxiety is a normal response to what | stress |
what is anxiety | a feeling of uneasiness and ativation of the ANS in response to vague, nonspecific threat |
when is it a disorder | when anxiety becomes overwhelming, when it impairs the person's ability to function at home, school, or work, and affects relationships with other ppl |
where in the brain does anxiety appear to origonate | the limbic system |
during anxiety there is an increase in blood flow where in the brain | limbic system, and cerebral cortex |
experience can teach pple different ways how to handle ______________- | stress |
if a person focuses her or his thoughts on stressful events, will they be more or less anxious | more |
does intelligence put ppl at a higher risk for anxiety | yes |
what is the feeling of dysphoria | uncomfortable and distressed |
usually a persons feeling when fearful is ___ ___ _______ with real danger | out of proportion |
s/s of the sympathetic stimulation | increased HR, increased BP, dilated pupils, cool skin, piloerection, decreased GI motility |
what is piloerection | hair standing on end |
anxiety and fear cause the same phsyiological response of the stimulation ______ system | the sympathetic |
what are the four levels of anxiety | mild, moderate, severe, panic |
mild; subjective effects | perceptual fields widens slightly. increased ability to see realtionships among data |
mild: observable behavior | alert, more perceptive, able to recognize anxiety, promotes motivation and growth |
moderate: subjective effects | perceptual field narrows slightly, concetrates on immediate focus, ignoring peripheral stimuli, can change attention if directed, good for learning |
moderate: observable behavior | able to sustain attention on a focal point. inattentive to stimuli outside this focus. may talk faster. VS begin to increase (except temp). able to recognize and express anxiety |
severe: subjective effects | perceptual field is greatly reduced, doen't notice external events. unable to redirect focus even with outside direction |
severe:observable behavior | attention is focused on a small part of a specific area. assumption made may be erroneous due to incomplete perception. may be unaware of anxiety. VS increasing. coping/relief measures used, misperception of surronding events |
panic: subjective effects | percetion is reduced to a detail. perception is disorted. May jum p from one detail to another as in flight of ideas. Experienced as a threat to survival. affected person feals dread and terror |
panic: observable behavior | feelins of unreality, confusion, terror, self- abosrobtion, may be expressed with violence to self or others. loss of control. may include pacing or running. automatic coping/releif behaviors used. can result in auxaustion |
a panic attack is charecterized by what | an episode of intense fear or discomfort |
s/s of a panic attack | sweating, pounding ht, trembling/shaking, SOB, feeling of choking, chest pain, N, abd. distress, feeling dizzy, unsteady, derealization, going crazy, fear of dying, paresthesias, chills |
mood neurotransmitters: serotonin: what happens to sleep when it is too high | they are sleepy |
mood neurotransmitters: serotonin: what happens to sleep when it is too low | they have insomnia |
mood neurotransmitters: serotonin: what is it associated with | sleep cycle, depression, carb cravings, PMS, mood balance |
mood neurotransmitters: serotonin: what happens to mood balance when it is too low | depression |
mood neurotransmitters: serotonin: what happens to mood balance when it is too high | anxiety |
mood neurotransmitters: dopamine: what is it associated with | focus, attention, memory, motivation drive, mood addictive disorders |
mood neurotransmitters: norepinephrine and epinephrine : what is it associated with | energy, drive, anxiety, focus, metabolism, mood |
mood neurotransmitters: GABA: what is it associated with | inhibitory neurotransmitter that is often refferred to as "nature's valium" helps us clam down and relax |
what type of anxiety (mild, mod or severe) is the most optimal one for learning | moderate |
PTSD: when was it first recognized | in war vets after vietnam |
PTSD: what is it | a cluster of s/s following a traumatic event (rape, murder, fire, war, car accident, shooting at school) it is debilitating following extreme traumatic stressers |
PTSD: what is th person's response to the event (s/s of PTSD) | intense fear, helplessness, or horror, persistent reexpierience of the event, avoidence of stimuli associated with the trauma, numbing of general responsivemness, startle response, increased arousal |
PTSD: what happens to a person when they are in a situation that reminds them of the traumatic event | they feel distressed (so they avoid those situations) |
PTSD: ppl normal develop it within ________ months of the traumatic event | 3 months |
PTSD: what are risk factors | severity of traumatic event, duration of trauma, proximity of individuals exposure |
coping with anxiety: pple do what to adapt to stress | they use coping behaviors |
coping with anxiety: coping can be eathier ______ or ________ | adaptive (healthy/ positive resolution) or maladaptive (unhealthy) |
meds: instead of using meds ppl are better off how | if they can develop the tools to solve their own problems with out using drugs to solve them (especially for ppl with low level anxiety/ poor coping skills) |
what is the best approach to anxiety tx | to promote adaptive coping skills |
meds: what are the three classes of anxiolytics | benzodiasepines, nonbenzodiasepines, SSRIs |
meds: benzodiasepines- action | CNS depressants, they potentiate the effect of GABA (it is an inhibitory neurotransmitter- GABA makes the neuron less responsive to excitatory neurotransmitters) |
meds: benzodiasepines- names | Alprazolam (xanax), chlordiazepoxide (librium), diazepam (valium), lorazepam (ativan) |
meds: -benzodiasepines- what two can be given iv for quick action | valium and ativan |
meds: nonbenzodiasepines- action | it differs from benzodiasepines b/c it binds to different brain sites in the body (idffeerent than the GABA effect, but works in the same way) |
meds: nonbenzodiasepines names | Buspirone hydrochloride (Buspar) |
meds: SSRIs- what does it stand for; action | selective serotonin reuptake inhibitor; it selectively blocks and balances the levels of serotonin to achieve mood stabilization |
meds: SSRIs- is it given in high or low dosing for anxiety | HIGH** |
meds: SSRIs: names | fluoxetine (prozac), sertraline (zoloft), paroxetine (paxil), fluvoxamine (luvox), citalopram (celexa), excitalopram (lexapro) |
meds: common side effects of anxiolytics: | mild drowsiness, sedation, depression, lethargy, confusion, * hypotension*, |
meds: nonbenzodiasepines: buspar - what is a common side effect | dry mouth |
meds: after how long can anxiolytics become addictive | within 4-6 weeks |
meds: guidlines for stopping med; what happens if med is stopped abruptly | never stop abruptly, taper off in 4-8 weeks under MD guidance; pt goes through withdrawal and back into anxiety |
meds: how long does anxiolytics have to be taken before therapeutic effects can be seen | 1-4 weeks |
meds: what are some drug to drug interactions | ETOH, analgesics, antidepressants, antipsychotics, digoxin |
meds: why shouldn't meds be mixed with ETOH | can increase CNS depression |
meds: why shouldn't meds be mixed with digoxin | it can increase risk for dig toxicity |
meds: why is pt at risk for hypotension | b/c meds (especially benzos) can cause hypotension and increase risk for falls |
meds: benzodiasepines- s/s of withdrawal | increased anxiety, concentration difficulty, tremor, sensory disturances, |
meds: buspar-does it cause dependance, withdrawal, or interact to ETOH etc | no |
meds: benzodiasepines- what is doing for older adults; | smallest dose, slowly increase dose to reach therapeutic effect; med is excreted more slowly causing prolonged drug effect and can increase adverse reactions or toxicity |
meds: what should therapeutic response be to anyanxiolytic | less anxiety |
why is pt at risk for self harm | b/c they may injure self when anxious |