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NURS 353 TEST 3 SLIDES WITH CORRECT ANSWERS 1 00%
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what is anxiety? - ANSWER apprehension, uneasiness, uncertainty, or dread from a real or perceived threat
what is fear? - ANSWER reaction to specific danger
what is mild anxiety like? - ANSWER everyday problem solving leverage, grasp information more effectively
what is moderate anxiety like? - ANSWER selective inattention, clear thinking hampered, problem solving not optimal, SNS symptoms begin
what is severe anxiety like? - ANSWER perceptual field greatly reduced, difficulty concentrating on environment, confused and automatic behavior, somatic symptoms increase
what is panic? - ANSWER markedly disturbed behavior, running, shouting, screaming, pacing, unable to process reality, impulsivity
what are defense mechanisms? - ANSWER automatic coping styles, protect people from anxiety, maintain self-image by blocking feelings/conflicts/memories, can be adaptive or maladaptive
what is an adaptive coping mechanism? - ANSWER lowers anxiety for the acceptable achievement of goals
what is maladaptive coping mechanisms? - ANSWER overuse of immature defenses
what is separation anxiety? - ANSWER developmentally inappropriate levels of concern over being away from a significant other
what are specific phobias? - ANSWER persistent irrational fear of a specific thing that leads to a desire for avoidance
what is social anxiety? - ANSWER severe anxiety/fear provoked by exposure to a social or performance situation
what is panic disorder? - ANSWER panic attacks- abrupt surge of intense fear or intense discomfort that reaches peak within minutes, not gradual at all, unpredictable
what are signs of a panic attack? - ANSWER palpitations, SOB, chest pain, nausea, fear of losing control, impending doom feeling, trembling, shaking, pounding HR
what is agoraphobia? - ANSWER excessive anxiety/fear about situations that may be difficult or embarrassing, to the point where they wont leave home
what is generalized anxiety? - ANSWER excessive worry that lasts for months
what is selective mutism? - ANSWER not able to speak when exposed to triggers
how do we assess anxiety? - ANSWER rule out other causes, determine source, determine level, assess for self-harm, complete psychosocial assessment
what should we look for with anxiety? - ANSWER coping skills
what do we do if a pt is having a panic attack? - ANSWER do not leave them, sit with them
what is trichotillomania? - ANSWER hair pulling disorder
what is excoriation? - ANSWER skin picking disorder
what are risk factors for OCD? - ANSWER child abuse and trauma, post infectious autoimmune disorder, genetics, comorbidities
what are some nursing diagnoses with OCD? - ANSWER anxiety, impaired skin integrity, disturbed body image, risk for self destructive behavior, risk for impaired socialization, difficulty coping, low self esteem
what do we do for excoriation or trichotillomania? - ANSWER cover hands with mitts if needed
what are some meds for OCD? - ANSWER SSRIs, clomipramine (TCA), venlafaxine (SNRI), some antipsychotics
what are some surgeries for OCD? - ANSWER gamma knife (lesions to disconnect overactive circuits), deep brain stimulation
what is depression? - ANSWER sadness, emptiness, irritability, somatic concerns, and impairment of thinking, impact a persons ability to function
what is disruptive mood dysregulation? - ANSWER disorder in children adolescents, temper tantrums way out of proportion to the situation at least 3 times a week and in at least 2 settings
what are some signs of DMD? - ANSWER bad hygiene, give them positive reinforcement, flat affect, anergia
how do we manage DMD? - ANSWER symptomatic meds, CBT, parent training, facial expression recognition training
what is persistent depressive disorder (dysthymia)? - ANSWER depressive feelings for most of the day through majority of days, for at least 2 years in adults and 1 year in kids/adolescents and present other symptoms
what are signs of persistent depressive? - ANSWER decreases appetite or overeating, insomnia or hypersomnia, low energy, poor self esteem, difficulty thinking, hopelessness
what is premenstrual dysphoric? - ANSWER symptom clusters in the last week before the onset of a womans period, symptoms disappear or significantly decrease with onsent of menstruation
what are signs of premenstrual dysphoric? - ANSWER mood swings, irritability, depression, anxiety, feeling overwhelmed, difficulty concentrating
what is post partum depression? - ANSWER feelings of sadness and inadequacy weeks after giving birth, can come with psychosis, fear of harming child
what can we do to help with post partum depression? - ANSWER nurture mom/baby attachment, nannies
what is major depressive disorder? - ANSWER 5 or more signs in 2 week- 6 mo, plus at least depressed mood or anhedonia
what are signs of MDD? - ANSWER weight and appetite changes, sleep disturbances, fatigue, worthlessness/guilt, loss of ability to concentrate, recurrent thoughts of death, psychomotor agitation (slow movement)
when do we especially look for suicide risk? - ANSWER when a pt suddenly seems happier or giving away things
what does exercise increase? - ANSWER serotonin
what is somatization? - ANSWER the expression of psychological stress through physical symptoms
what is somatic symptom disorder? - ANSWER caused by emotional distress, excessive thoughts/anxiety/behaviors around symptoms or health concerns, no significant physical findings and medical diagnosis, suffering is authentic, high level of functional impairment
what are the two kinds of somatic symptom disorder? - ANSWER care seeking and avoidant
what can we do for somatic symptom? - ANSWER develop therapeutic relationship, help find triggers, provide consistent reassurance, support, encourage healthy lifestyle, run the tests, avoid unnecessary/repetitive diagnostics, hypnotherapy, CBT with meds
what is illness anxiety disorder? - ANSWER fear and preoccupation with having or acquiring a serious illness for at least 6 mo, self scanning, no symptoms or mild, may be care seeking or avoidant
what can we do for illness anxiety? - ANSWER antidepressants, ECT, CBT, develop therapeutic relationship, do not dismiss concerns, get rid of internet knowledge, encourage socialization
what is conversion disorder? - ANSWER neuro symptoms in the absence of a neuro diagnosis, deficits in voluntary motor or sensory functions
what are some signs of conversion dis? - ANSWER paralysis, blindness, movement/gait disorders, numbness, paresthesia, loss of vision or hearing, epileptic resemblance episodes
how do we care for conversion pts? - ANSWER therapeutic relationship, avoid direct confrontation but do not play into it rule things out, reassurance and support, encourage socialization, coping mechanisms
how can we treat conversion? - ANSWER body oriented psycho therapy, DBT, psychodrama, PT
what are nursing diagnoses with somatic disorders? - ANSWER difficulty coping, anxiety, risk for loneliness, powerlessness, hopelessness, chronic low self esteem, impaired socialization, pain, impaired family process, risk for suicide
what is factitious disorder? - ANSWER deliberately and dramatically fabricate symptoms or self inflicted injuries, assume sick role, compulsivity, conscious of actions, may be physical or psychiatric
what are the two kinds of factitious disorder? - ANSWER imposed on self, imposed on others
what can we do for factitious? - ANSWER assess but avoid running unnecessary tests, CBT
what is malingering? - ANSWER consciously faking a disorder in order to attain a specific gain (insurance fraud, prescription meds, avoidance of prison or military)
What are disassociative disorders? - ANSWER disruption in psychological functioning, dissociation and reexperiencing trauma
what is the defense mechanism for dissociative disorders? - ANSWER unconscious protection
