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NSG 411: EXAM 2
mild anxiety
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•Associated with the tension of everyday life
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moderate anxiety
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moderate anxiety
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severe anxiety
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•Marked by a significant reduction in the perceptual field
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panic |
•Associated with dread, terror, and the person feeling it is unable to perform things even with direction
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coping mechanisms for mild anxiety
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—Include crying, sleeping, eating, yawning, laughing, cursing, physical exercise, daydreaming
—Oral behavior, e.g., smoking and drinking, can be other means of coping with mild anxiety
—People may protect themselves by assuming comfortable roles, limiting close relationships to those with similar values
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coping mechanisms cont.
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—Moderate, severe, and panic levels of anxiety pose greater ego threats and coping requires more energy
—Problem- or task-focused coping involves:
¡Attack, withdrawal, or compromise
—Emotion- or ego-focused coping involves:
¡Defense mechanisms
÷First line of psychic defense
÷Used to cope successfully with mild and moderate levels of anxiety
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defense mechanism
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—Protect from feelings of inadequacy and worthlessness
—Prevent awareness of anxiety
—Extreme use distorts reality, interferes with interpersonal relationships, limits ability to work
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withdrawel |
—Retreat from anxiety-provoking experiences
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acting out:
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—discharge of anxiety through aggressive behavior
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psychosomatization
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—Visceral or physiologic expression of anxiety
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avoidance |
—Management of anxiety-laden experience through evasive behaviors
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problem solving
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—Systematic method for addressing difficult situations
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anxiety disorders:
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—Group of conditions in which affected clients experience persistent anxiety that cannot be dismissed
—Coping mechanisms are ineffective
—Anxiety interferes with ADL’s
—Feelings that the core of their personalities are being threatened when no actual danger exists
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anxiety disorders ex:
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—Generalized Anxiety Disorder (GAD)
—Phobic Disorders
—Panic Attacks
—Panic Disorder
—Obsessive Compulsive Disorder (OCD)
—Stress Disorder
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generalized anxiety disorder
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—Excessive anxiety and worry at least 6 months
—Encompassing many aspects of the person’s life
—Anxiety and worry associated with at least 3:
÷Restlessness or feeling keyed up
÷Being easily fatigued
÷Difficulty concentrating
÷Irritability
÷Muscle tension
÷Sleep disturbances
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GAD interventions
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—Psychotherapy
—Stress management
—Meditation
—Exercise
—Avoid caffeine, stimulants
—Pharmacologic therapy
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phobic disorders
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—Persistent, irrational fear attached to an object or situation
—Phobias are always anticipated and never expected
—Exposure to the phobic stimulus provokes anxiety
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types of phobic disorders
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agoraphobia
specific phobia
social phobia
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agoraphobia |
÷Fear of being alone or in a public place from which escape would be difficult
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specific phobia
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÷Persistent, irrational fear of & compelling desire to avoid a circumstance or thing
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social phobia
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÷Persistent, irrational fear to avoid situations when exposed to strangers or scrutiny from others
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panic attacks
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—Discrete period of intense fear or discomfort without any real accompanying danger
—Accompanied by at least 4 of 13 somatic or cognitive symptoms
¢Palpitations
¢Sweating
¢Trembling or shaking
¢Sensations of SOB or smothering
¢Feelings of choking
¢CP
¢Nausea or ABD distress
¢Dizzy, unsteady, lightheaded, or faint
¢De-realization
¢Fear of losing control or going crazy
¢Fear of dying
¢Numbness or tingling
¢Chills or hot flashes
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panic disorders
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—Not only a panic attack but recurrent unexpected panic attacks
—At least one of the attacks has been followed by at least 1 month of 1 or more:
÷Persistent concern about more attacks
÷Worry about the consequences of the attack
÷A significant change in behavior related to the attacks
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OCD |
—Either obsessions or compulsions
—Cause marked distress, are time consuming, or significantly interfere with the person’s daily routine, occupational, academic, functional, or usual social activities
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stress disorders
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PTSD
ASD
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ptsd |
Exposure to a traumatic event
¢Experience, witnessed, or was confronted with an event that involved actual threatening death or serious injury
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ASD |
÷Occurs within the first month of exposure to extreme trauma
•Combat, rape, physical assault, near death experience, or witnessing a murder
¢Symptoms begin during or shortly after the event
¢Usually resolves within 2-28 days after exposure
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panic attack treatment CBT:
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¡Use cognitive restructuring to reframe catastrophic thinking
¡Educate about the disorder
¡Teach breathing techniques
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GAD treatment: CBT
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¡Relaxation techniques, stress management, biofeedback
¡Use cognitive interventions to reframe catastrophic thinking
¡Assist client with problem-solving
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OCD: CBT: TX
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¡Desensitize client to feared situations
¡Educate about the disorder
¡Teach relaxation techniques
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ASD-CBT-TX
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¡Assist the client to find a support group
¡Engage in therapeutic dialogues with the client
¡Teach problem-solving
¡Teach relaxation techniques
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spec. phobia-CBT- TX
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¡Desensitize client to feared situations
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social phobia CBT- TX
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¡Challenge negative beliefs
¡Teach realistic appraisal of social situations
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PTSD- CBT- TX
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¡Encourage client to attend group therapy
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