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Texas State - NURS 3360 - Study Guide - Final

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Texas State - NURS 3360 - Study Guide - Final

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background image Psych Test 3 Study Guide-Based on the blueprint by Janene Jefferys and Cari Furst Blueprint category in Purple  Blueprint subcategory in Red  Answer from book and slides in Black Key Points/definitions highlighted Meds in blue Anxiety related disorders Common anxiety disorders and manifestations: Generalized Anxiety Disorder-chronic worrying out of proportion of the 
situation. For some people, the amygdala (the emotional, survival part of the 
brain) overreacts to stimuli and puts the body on overdrive worrying.  This 
hurts memory and thinking abilities
Panic attacks-Uncontrollable panic and fear related to a triggering situation, 
or sometimes just out of the blue.
Agoraphobia-anxiety caused by real or anticipated exposure to a triggering 
situation such as crowds and enclosed spaces
Social anxiety disorder-fear of a social situation OCD-repetition of an action calms the person, the action makes them feel 
o Body dysmorphic-anxiety about perceived flaws, desire to correct  “flaws” repetitively o Hoarding-every item has value, losing the item(s) cause anxiety
o Hair pulling-the action and pain of pulling out hair provides comfort
o Excoriation (skin picking)-scabs all over body
ASD (acute stress disorder)-Anxiety immediately after a traumatic event PTSS (post-traumatic stress syndrome)-Anxiety and stress related to the 
event >1 month after. 
Dissociative disorders-may be type of coping mechanism.  Can be 
dissociative personality (person thinks another person has the anxiety) or 
dissociative amnesia (person forgets being anxious)
Somatic symptom disorders o Illness anxiety-person thinks they are sick all the time
o Conversion –anxiety shuts down brain so body cannot move
General signs and symptoms of anxiety:  ↑HR, ↑RR, sweating, blood to muscles and  heart. Mild-sharpening of awareness and thinking skills, person is more alert Moderate-field of perception narrows, there is selective inattention and 
problem solving is decreased. Person may not hear what you are telling them
Severe-focus on only a few details, may have repetitive behavior, problem 
solving is nonexistent, cannot look beyond the immediate issue
background image General treatment methods:  STAY CALM. Listen to their concerns, no matter how  “inconsequential”. Address the stimuli if possible.  Connect with them by 
therapeutic communication.  Help them calm down by physically modeling de-
stressing techniques (slower breathing, walking).
Bio-Psycho-Social Factors impacting anxiety:  Overreaction of the amygdala,  hypersensitivity of neurons, increased cortisol related to repetition of 
frightening events (e.g. abuse). Poor prefrontal control of fear response or 
feeling unsafe.
Drug Categories and primary Drugs used in treatment of Anxiety: People often self-medicate with alcohol SSRIs are the first line drug for anxiety because of the adverse effects of other 
In early 1900’s, seltzers and barbituates such as Miltown and Equinol were used for 
anxiety. These drugs are lethal in overdose and people develop tolerance to the 
In 1950’s Benzodiazepines were developed. Examples are Valium (short term relief),
Ativan (anxiety disorders), Xanax (for GAD and panic attacks) and Librium. 
Benzodiazepines are GABA potentiators- they increase the inhibitory action of GABA
to calm someone down.
SE: inability to make new memories, poor impulse control, sedation, motor  incoordination, sexual dysfunction, weight gain, cross tolerance with alcohol and 
sedatives, physical dependence
Nursing implications: benzodiazepines interact with many drugs, are  potentiated by alcohol and grapefruit juice. Withdrawal is dangerous, must NOT stop
drug abruptly.
Buspirone (BuSpar)-NOT a benzodiazepine Possibly serotonin agonist, takes a while to take effect (1-3 weeks). Does not  have potential for abuse, is not sedating and does not have cross tolerance with 
sedatives or alcohol
SE: dizziness, nausea, excitement and nervousness SSRI’s or buspirone are often paired with benzodiazepines.  Benzodiazepines 
provide quick relief until SSRIs and buspirone can kick in.  Then the patient is 
weaned off the benzodiazepines.
Nursing Process for Anxiety
background image Assess: patient triggers, current coping skills, physical and mental 
expressions of anxiety, suicide risk, how the patient is feeling
Diagnose: poor decision making, safety risks Plan: what can be done to relieve anxiety, can the patient make decisions, or 
do they need to calm down more
Implement: therapeutic communication, destress techniques, patient 
teaching about triggers and coping mechanisms
Evaluate: patient response, ability to make decisions independently Communication techniques:  Use simple sentences and repeat yourself if necessary.  Ask about what the patient is feeling and help patients identify causes of those 
feelings. Discussion about what they are feeling can help the patient work through 
the feelings.
Bi-polar disorders Bi-polar definitions and manifestations Bi-polar I-more mania, less depression.  Bi-polar II-more depression, less mania Cyclothymia-milder form of bipolar, where mood swings from hypomania to 
mild depression for at least 2 years
Bi-polar NOS-does not fit into above categories Rapid cycling-four or more mood episodes in 12 months. More at risk for 
suicide attempts
Ultra-rapid cycling-mood swing within 1 day. More at risk for suicide attempts Mania- elevated energy, sharp thinking, grandiose plans and perceptions. Fast speech and ideas, poor judgement, high sex drive, aggressive behavior, 
excessive involvement in pleasurable activities (shopping, cleaning, sex). 
Psychotic symptoms of hallucinations or delusions only occur in mania.
  Manic  episode=↑mood (at least three symptoms) for >1 week  Hypomanic- elevated mood and thoughts but less goal directed activity Depression -irritability, no energy, decreased patience, tiredness, no goals Bio-Psycho-Social factors of Bi-polar Bio-possibly a decrease in the Na, K-ATPase activity (the ion pump that keeps 
sodium and potassium at correct levels in the neurons) causes the increased neuron
activity (mania) and decreased neuron activity (depression). Also, brain lesions and 
abnormal activity in neuronal function are common in bipolar patients
Psychosocial-family dynamics, reaction against depression and genetics may all 
play a role in bipolar disorders
Impact of bipolar disorder on daily life

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School: Texas State University
Department: Nursing and Health Science
Course: Psych Mental Hlth
Professor: Janene Jeffery
Term: Spring 2018
Name: Psych Study Guide 3
Description: This study guide has all the key terms, drugs and ideas from the blueprint and lecture content.
Uploaded: 03/27/2018
7 Pages 36 Views 28 Unlocks
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