Term
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Definition
| painful uneasiness of mind due to an impending or anticipated threat. |
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Term
| psychodynamic theoretical framework |
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Definition
| inability of the ego to resolve a conflict between the id and the superego. Person may resort to many kinds of unconscious mechanisms to solve the conflict; neurotic symptoms in an effort to defend against this neurotic responses (pg.18). |
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Term
| cognitive theoretical framework |
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Definition
| their perceptions and their thought processes that evokes this kind of response. |
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Term
| behavioral theoretical framework |
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Definition
| understand anxiety coming from a learned process or learned response. People become conditioned to learned to respond this way. It is not just this one event anymore; people learn to generalize to other events or “all of life” essentially. When you ask someone what they are anxious about they start to say everything. |
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Term
| biological theoretical framework |
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Definition
| neurotransmitters are involved; fight or flight response/general adaptation syndrome; many medications may make someone feel anxious. Drinking too much caffeine may cause anxiety. |
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Term
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Definition
| ne you think of most often; when people are at highest level of anxiety; many symptoms; cannot focus (pg.564) palpitations, pounding heart, sweating, trembling, shaky, SOB, feeling like they are choking, nauseas, abdominal stress, dizzy, fear of dying or losing control, chills and hot flashes |
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Term
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Definition
| more common form of an anxiety disorder; most ppl have a certain level of OCD (it doesn’t debilitate them) to have diagnosis of OCD you have to meet certain criteria (pg. 5..) |
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Term
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Definition
(pg. 574) this stress is out of the range of out of the ordinary experiences ex: sexual experiences; trauma; environmental disasters; accidents ect. Symptoms: anger (an emotional response) flashbacks; dissociation (go somewhere in their mind where they know it is safe, somewhere where they can forget about what happened); nightmares. Taking care of them: (pg.581) you need to be non-threatening and matter of fact, be consistent in order to develop trust, stay with them during their flashback, try to ground them and help them feel safe. Get an accurate history only when they are ready. Acknowledge and validate that the patient went through this trauma and these feelings. Try to come up with some ways of coping and management. Goal is to help them incorporate this into the person that they are and to move on to go on with their lives. Also identify maladaptive coping mechanisms that they have.
-“soldier’s heart” (civil war) shell shock (WWI), battle fatigue (WWII); post-Vietnam syndrome (After Vietnam). When people have had repeated stressors (PTSD) it effects the brain. Destruction of cells to the hippocampus in the brain. Up to 7% reduction in the left hippocampus was found. Shrinkage of 26% in left hippocampus and 22% reduction in right hippocampus in those who were in Vietnam. |
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Term
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Definition
| sometimes confused with schizophrenia (psychotic disorder) with DID; dissociative identity disorder (anxiety disorder) has atleast two more distinct personalities, sometimes they live separate lives, dissociative amnesia ect. inability to recall that the two identities exist. |
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Term
| conversion disorder (somatoform disorder) |
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Definition
people convert their anxiety into a physical problem; typically they are very extensive (ex: they cannot see; cannot walk; have pseudoseizures)
hypochondriasis- diagnostic material; preoccupation and fear of developing a disease. |
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Term
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Definition
| tx for anxiety: Buspar (no addictive potential) very useful in generalized anxiety disorders; very effective for people who need to be taking for a long time. |
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Term
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Definition
| (valium, Ativan ect) used for behaviors, withdrawal, sedation, neuromuscular disorder (want muscles to relax), sleep disorders, seizure disorders. Powerful potentaitors of GABA (helps relax them) they also cause selective CNS depression (good for sleep ect) MANY SIDE EFFECTS: tolerance (they need more and more to get the same effect); paradoxical reaction (instead of helping them relax it makes them very anxious); people can become very dependent on it (give small doses? But if you were to stop taking it then you through withdrawal); have very low overdose potential (you would have to take quite a lot to have a lethal effect; unless combined with alcohol and/or other medications) NURSING INTERVENTIONS: not for long-term use; should not be mixed with alcohol, really need to check the doses with elderly and children. When people are taken off of them they should be tapered slowly. |
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Term
| goals for pt's with anxiety |
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Definition
| help people deal with the feelings, decrease level of anxiety, promote self-reliance, and problem solve. Find social support for this person. How can you help these people cope in constructive ways. |
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Term
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Definition
| in anxiety disorders norepinephrine is thought to be.... |
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Term
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Definition
| in anxiety disorders epinephrine is thought to be... |
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Term
| decreased (allowing for increased cellurlar excitability) |
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Definition
| In anxiety disorders GABA is thought to be... |
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Term
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Definition
| unwanted, intrusive, persistent ideas, thoughts, impulses, or images that cause marked anxiety or distress. The most common ones include repeated thoughts about contamination, repeated doubts, a need to have tings in a particular order, aggressive or horrific impulses, and sexual imagery |
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Term
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Definition
| Unwanted repetitive behavior patterns or mental acts (ex: praying, counting, repeating words silently) that are intended to reduce anxiety, not to provide pleasure gratification. They may be performed in response to an obsession or in a stereotyped fashion. |
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Term
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Definition
| depress subcortical levels of the CNS, particularly the limbic system and reticular formation. (EXCEPT BUSPIRONE) |
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Term
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Definition
| These drugs ultimately work to increase the concentratiojn of norepinephrine, serotonin, and/or dopamine in the body. This is accomplished in the brain by blocking the reuptake of these neurotransmitters by the neurons |
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Term
| psychoanalytic (depression) |
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Definition
| comes from anger turned inward. |
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Term
| interpersonal theoretical framework (depression) |
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Definition
| people have conflicts with each other and very often those interpersonal conflicts cause people to have these symptoms. |
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Term
| cognitive theoretical framework (depression) |
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Definition
| this is the perception that causes the people to respond the way they do. |
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Term
| behavior theoretical framework (depression) |
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Definition
| Seligman’s Learned Helplessness (he says that people often start out feeling helpless and then that feeling of helplessness broads out to many aspects of their life); Hopelessness Theory (then other theorist came out and said it is not just helplessness it is hopelessness too; it is not just one part of their life it tends to take over every aspect of their lives and they feel like they are never going to get over this, it will never get better). |
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Term
| biological theoretical framework (depression) |
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Definition
| Neurotransmitter deficit (dopamine and norepinephrine), neuroendocrine factors (hormones; sex and thyroid hormones, cortisol); limbic system deficit (could be chemical it could be a tumor); circadian rhythm alterations; genetic transmission (heredity plays a part); kindling theory (process in which the brain becomes increasingly sensitive to stress and eventually begins to show abnormal activity all the time. Lithium blocks the early stages of kindling. Anticonvulsants act at later stages of kindling.) |
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Term
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Definition
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Term
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Definition
| see periods of hypo-manic phase, but now full swing. |
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Term
| clinical/unipolar/major depression |
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Definition
| flat facial expression, increased or decreased appetite; slowing down of their movements; sad/tired; anhedonia (no pleasure in things); possible delusions and hallucinations; suicidal ideations/suicidal; they are so depressed that they may not have the energy to carry out the plan (give medications and then they may gain the energy to follow through) feel the worst in the morning; hopelessness and worthlessness. |
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Term
| Seasonal Affective Disorder (SAD) |
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Definition
| usually develops in the fall/winter, decrease in sunlight. It usually lasts till the spring time and the change in the amount of sunlight seen. (pg. 551) Sit in front of a window and the light (2-3 hours a day) Helps to be on an antidepressant at the same time. Seen a lot in Alaska and a lot of the northern states (including Minnesota). |
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Term
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Definition
| never get to the really highs or really lows; they do seem to be bipolar. |
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Term
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Definition
| low grade depression. They have many of the symptoms. Difference is they are not as severe; they can still go to work/school, very sad person, but they still carry on. They would say they feel the best in the morning and as the day goes on its all downhill. |
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Term
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Definition
| it’s a different kind of depression; you do not often see this in the hospital because people aren’t usually admitted with these sort of characteristics. They seem down quite a bit, they are over-tired, over-eat, and are over-sensitive. |
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Term
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Definition
| this occurs because of the major changes in the hormones, it is very common, and treatable with an antidepressant for a period of time. More likely to have PPD in next child if you had it with previous. |
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Term
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Definition
| combination of clinical depression and dysthymia. |
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Term
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Definition
| making a lot of phone calls, saying their goodbyes, giving things away. These may be harder to notice. |
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Term
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Definition
| they look really sad, say things like their families would be better off if they were dead |
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Term
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Definition
| hypothyroidism, many interactions with other medications, not to be used during pregnancy, normal sodium intake needs, increased fluid needs (2-3 liters/day), assess for therapeutic levels vs. toxic levels, causes of increased Li levels. |
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Term
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Definition
| serotonin syndrome if used with SSRIs, dietary consideration to prevent hypertensive crisis: reduce tyramine (see text for food restrictions) for one week before initiating and two weeks after discontinuing, evaluate OTC meds |
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Term
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Definition
| minor stage of withdrawal |
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Term
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Definition
| major stage of withdrawal |
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Term
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Definition
| seizures in alcohol withdrawal |
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Term
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Definition
| delirium tremens in alcohol withdrawal |
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