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| Anxiety is a universal human experience and is the most basic of emotions. It can be defined as a feeling of apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat. |
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| Fear is a reaction to a specific danger, whereas anxiety is a vague sense of dread related to an unspecified or unknown danger. |
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| Normal anxiety is a healthy reaction necessary for survival. It provides the energy needed to carry out the tasks involved in living and striving toward goals. Anxiety motivates people to make and survive change. |
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| which psychologist had a profound role in shaping the specialty of psychiatric mental health nursing. |
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| which anxiety occurs in the normal experience of everyday living, allows an individual to perceive reality in sharp focus? |
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| The person experiencing which level of anxiety sees, hears, and grasps less information and may demonstrate selective inattention |
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| A person with which level of anxiety may focus on one particular detail or many scattered details and have difficulty noticing what is going on in the environment, even when it is pointed out by another. Learning and problem solving are not possible at this level, and the person may be dazed and confused. |
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| what is the most extreme level of anxiety and results in markedly disturbed behavior. |
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| Someone in a state of panic is unable to process what is going on in the environment and may lose touch with reality. The behavior that results may be manifested as pacing, running, shouting, screaming, or withdrawal. Hallucinations, or false sensory perceptions (e.g., seeing people or objects not really there), may be experienced. Physical behavior may become erratic, uncoordinated, and impulsive. |
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| what are automatic coping styles that protect people from anxiety and maintain self-image by blocking feelings, conflicts, and memories? |
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| what defence mechanism is used to make up for perceived deficiencies and cover up shortcomings related to these deficiencies to protect the conscious mind from recognizing them. |
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| which defense mechanism is the unconscious transformation of anxiety into a physical symptom with no organic cause. Often the symptom functions to gain attention or as an excuse. |
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| what defense mechanism involves escaping unpleasant, anxiety-causing thoughts, feelings, wishes, or needs by ignoring their existence. |
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| which defense mechanism is a process in which events are analyzed based on remote, cold facts and without passion, rather than incorporating feeling and emotion into the processing. |
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| which defense mechanism is attributing to oneself the characteristics of another person or group. This may be done consciously or unconsciously. |
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| which defense mechanism t is the transference of emotions associated with a particular person, object, or situation to another nonthreatening person, object, or situation. |
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| which defense mechanism is a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. It may result in a separation between feeling and thought. This can also manifest itself in compartmentalizing uncomfortable or unpleasant aspects of oneself? |
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| which defense mechanism is when unacceptable feelings or behaviors are controlled and kept out of awareness by developing the opposite behavior or emotion. |
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| which defense mechanism is reverting to an earlier, more primitive and childlike pattern of behavior that may or may not have been previously exhibited. |
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| which defense mechanism is the process by which the outside world is incorporated or absorbed into a person's view of the self. |
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| which defense mechanism refers to the unconscious rejection of emotionally unacceptable features and attributing them to other people, objects, or situations. You can remember this defense through the childhood retort of “What you say is what you are.” |
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| which defense mechanism consists of justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller as well as the listener. |
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| which defense mechanism is a first-line psychological defense against anxiety. It is the temporary or long-term exclusion of unpleasant or unwanted experiences, emotions, or ideas from conscious awareness. This happens at an unconscious level. |
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| which defense mechanism is the inability to integrate the positive and negative qualities of oneself or others into a cohesive image. Aspects of the self and of others tend to alternate between opposite poles; for example, either good, loving, worthy, and nurturing, or bad, hateful, destructive, rejecting, and worthless. |
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| which defense mechanism is an unconscious process of substituting mature, constructive, and socially acceptable activity for immature, destructive, and unacceptable impulses. Often these impulses are sexual or aggressive. |
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| which defense mechanism is the conscious denial of a disturbing situation or feeling. For example, Jessica has been studying for the state board examination for a week solid. She says, “I won't worry about paying my rent until after my exam tomorrow.” |
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| which defense mechanism is most commonly seen in children. It is when a person makes up for an act or communication. |
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| Name 4 disorders included under the umbrella of "anxiety disorder" |
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• Panic disorders
• Phobias
• Obsessive-compulsive disorder
• Generalized anxiety disorder
• Posttraumatic stress disorder
• Acute stress disorder
• Substance-induced anxiety disorder
• Anxiety due to medical conditions
• Anxiety disorder not otherwise specified |
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| the sudden onset of extreme apprehension or fear, usually associated with feelings of impending doom. The feelings of terror present during a panic attack are so severe that normal function is suspended, the perceptual field is severely limited, and misinterpretation of reality may occur. |
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| a persistent, irrational fear of a specific object, activity, or situation that leads to a desire for avoidance, or actual avoidance, of the object, activity, or situation |
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Definition
| also called social anxiety disorder (SAD), is characterized by severe anxiety or fear provoked by exposure to a social or a performance situation (e.g., fear of saying something that sounds foolish in public, not being able to answer questions in a classroom, eating in public, performing on stage |
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| defined as thoughts, impulses, or images that persist and recur, so that they cannot be dismissed from the mind. Obsessions often seem senseless to the individual who experiences them (ego-dystonic), and their presence causes severe anxiety. |
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Definition
| ritualistic behaviors an individual feels driven to perform in an attempt to reduce anxiety. Performing the compulsive act temporarily reduces high levels of anxiety. |
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| what is Generalized anxiety disorder (GAD) |
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Definition
| Generalized anxiety disorder (GAD) is characterized by excessive anxiety or worry about numerous things, lasting for 6 months or longer |
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Term
| what is Posttraumatic stress disorder (PTSD) |
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Definition
| is characterized by persistent reexperiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others, to which the individual responded with intense fear, helplessness, or horror |
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| what is Acute stress disorder |
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Definition
| Acute stress disorder occurs within 1 month after exposure to a highly traumatic event, such as those listed in the section on PTSD. To be diagnosed with acute stress disorder, the individual must display at least three dissociative symptoms either during or after the traumatic event, including a subjective sense of numbing, detachment, or absence of emotional responsiveness; a reduction in awareness of surroundings; derealization (a sense of unreality related to the environment); depersonalization (experience of a sense of unreality or self-estrangement); or dissociative amnesia (loss of memory) |
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| what are the most common form of psychiatric disorders in the United States |
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| anxiety disorders affect about what percentage of the population 18 and up? |
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| about 75% of people with anxiety disorders have their first episode at what age? |
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| describe the GABA benzodiazepine theory. |
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| Benzodiazepine receptors are linked to a receptor that inhibits the activity of the neurotransmitter GABA. The release of GABA slows neural transmission, which has a calming effect. Binding of benzodiazepine medications to benzodiazepine receptors facilitates the action of GABA (Sadock & Sadock, 2008). This theory proposes that abnormalities of the benzodiazepine receptors may lead to unregulated anxiety levels. |
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| describe the Psychodynamic theories about the development of anxiety disorders |
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Definition
| They center on the idea that unconscious childhood conflicts are the basis for symptom development. Sigmund Freud suggested that anxiety results from the threatened breakthrough of repressed ideas or emotions from the unconscious into consciousness. Freud also suggested that ego defense mechanisms are used by the individual to keep anxiety at manageable levels |
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| which psychologist believed that anxiety is linked to the emotional distress caused when early needs go unmet or disapproval is experienced (interpersonal theory). He also suggested that anxiety is “contagious,” being transmitted to the infant from the mother or caregiver. Thus the anxiety experienced early in life becomes the prototype for anxiety experienced when unpleasant events occur later in life. |
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| describe Behavioral theories |
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Definition
| Behavioral theories suggest that anxiety is a learned response to specific environmental stimuli (classical conditioning). |
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| what is a popular tool in measuring anxiety |
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Definition
| The Hamilton Rating Scale for Anxiety |
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| What are the 3 outcomes of the The Hamilton Rating Scale for Anxiety point score? |
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Definition
14-17 = mild anxiety
18-24 = moderate anxiety
25-30 = severe anxiety |
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| Anxiety Self-Control, Anxiety Level, Stress Level, Coping, Social Interaction Skills, and Symptom Control... are all examples of what? |
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Definition
| NOC-recommended outcomes related to anxiety |
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| A person experiencing which level of anxiety is unable to solve problems and may have a poor grasp of what is happening in the environment. Unproductive relief behaviors may take over, and the person may not be in control of his or her actions. |
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Definition
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| what is the first line medical treatment for anxiety? What other drugs are used, though less often? |
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Definition
| SSRI/SNRI antidepressants are primary. Tricyclic antidepressants, benzos, MAOIs are also used. |
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Term
| what herbal supplement is used as an herbal sedative with antianxiety effects. |
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Definition
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Term
| Kava kava is known to dramatically inhibit what? |
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Definition
| a liver enzyme (P450) necessary for the metabolism of many medications. This inhibition could result in liver failure, especially when taken along with alcohol or other medications such as central nervous system depressants (antianxiety agents fall into this category). |
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Term
| what herbal supplement is used as an herbal sedative with antianxiety effects. |
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Definition
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Term
| Kava kava is known to dramatically inhibit what? |
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Definition
| a liver enzyme (P450) necessary for the metabolism of many medications. This inhibition could result in liver failure, especially when taken along with alcohol or other medications such as central nervous system depressants (antianxiety agents fall into this category). |
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1. Since learning that he will have a trial pass to a new group home tomorrow, Bill's usual behavior has changed. He has started to pace rapidly, has become very distracted, and is breathing rapidly. He has trouble focusing on anything other than the group home issue and complains that he suddenly feels very nauseated. Which initial nursing response is most appropriate for Bill's level of anxiety?
1. “You seem anxious. Would you like to talk about how you are feeling?”
2. “If you do not calm down, I will have to give you prn medicine to calm you.”
3. “Bill, slow down. Listen to me. You are safe. Take a nice, deep breath…”
4. “We can delay the visit to the group home if that would help you calm down.” |
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2. A patient, who seems to be angry when his family again fails to visit as promised, tells the nurse that he is fine and that the visit wasn't important to him anyway. When the nurse suggests that perhaps he might be disappointed or even a little angry that the family has again let him down, the patient responds that it is his family that is angry, not him, or else they would have visited. What defense mechanism(s) is this patient using to deal with his feelings? Select all that apply.
1. Rationalization
2. Introjection
3. Projection
4. Regression
5. Denial
6. Dissociation |
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3. John, a construction worker, is on duty when a wall under construction suddenly falls, crushing a number of co-workers. Shaken initially, he seems to be coping well with the tragedy but later begins to experience tremors, nightmares, and periods during which he feels numb or detached from his environment. He finds himself frequently thinking about the tragedy and feeling guilty that he was spared while many others died. Which statement about this situation is most accurate?
1. John is experiencing posttraumatic stress disorder (PTSD) and requires therapy.
2. John has acute stress disorder and should be treated with antianxiety medications.
3. John is experiencing anxiety and grief and should be monitored for PTSD symptoms.
4. John is experiencing mild anxiety and a normal grief reaction; no intervention is needed. |
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4. A variety of medications are used in the treatment of severe anxiety disorders. Which class of medication used to treat anxiety is potentially addictive?
1. Benzodiazepines
2. Selective serotonin reuptake inhibitors (SSRIs)
3. Beta-blockers
4. Antihistamines
5. Buspirone |
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5. An older adult in the outpatient internal medicine clinic complains of feeling a sense of dread and fearfulness without apparent cause. It has been growing steadily worse and is to the point where it is interfering with the patient's sleep and volunteer work. After a brief interview and cursory physical exam, the APRN diagnoses the patient with generalized anxiety disorder and suggests a referral to the mental health clinic. Which response(s) by the clinic nurse would be appropriate? Select all that apply.
1. Complete a neurological history and neurological examination.
2. Examine the patient's extremities for edema, and listen to her lungs.
3. Observe the patient's respirations, and obtain a pulse oximetry reading.
4. Review the patient's current medications, and observe the patient's gait.
5. Suggest that a battery of blood tests, including a CBC, be ordered and reviewed.
6. Ask the APRN to review the nurse's findings before ordering the referral. |
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