Podcast
Questions and Answers
A patient exhibiting hypervigilance and aggression following a traumatic event would MOST immediately benefit from interventions focused on:
A patient exhibiting hypervigilance and aggression following a traumatic event would MOST immediately benefit from interventions focused on:
- Correcting distorted thoughts through CBT.
- Using EMDR to process traumatic memories.
- Establishing a structured and safe environment. (correct)
- Administering SSRIs, like paroxetine, as a first-line treatment.
Which nursing intervention would be MOST appropriate for a patient experiencing detachment from reality and reporting feeling like they are observing themselves from outside their body?
Which nursing intervention would be MOST appropriate for a patient experiencing detachment from reality and reporting feeling like they are observing themselves from outside their body?
- Somatic Therapy techniques, such as grounding exercises (correct)
- Administering clonidine to reduce hypervigilance
- Prolonged Exposure Therapy
- Cognitive-Behavioral Therapy (CBT)
A patient with PTSD is prescribed prazosin. The nurse should include which information in the patient's education regarding this medication?
A patient with PTSD is prescribed prazosin. The nurse should include which information in the patient's education regarding this medication?
- Prazosin helps reduce daytime anxiety.
- Prazosin enhances concentration and focus.
- Prazosin can help alleviate PTSD-related nightmares. (correct)
- Prazosin is a first-line treatment for depression.
Which medication requires cautious monitoring for potential interactions and dietary restrictions due to the risk of hypertensive crisis?
Which medication requires cautious monitoring for potential interactions and dietary restrictions due to the risk of hypertensive crisis?
A patient undergoing EMDR therapy reports feeling overwhelmed and highly anxious. Which nursing action is MOST appropriate?
A patient undergoing EMDR therapy reports feeling overwhelmed and highly anxious. Which nursing action is MOST appropriate?
Which outcome indicates effective nursing care for a patient with a trauma disorder?
Which outcome indicates effective nursing care for a patient with a trauma disorder?
A patient with a history of trauma is consistently late for therapy appointments and appears disengaged during sessions. Which approach is MOST appropriate for the nurse to take?
A patient with a history of trauma is consistently late for therapy appointments and appears disengaged during sessions. Which approach is MOST appropriate for the nurse to take?
During a group therapy session, a patient with PTSD becomes visibly distressed and begins to dissociate. Which of the following nursing interventions is MOST appropriate?
During a group therapy session, a patient with PTSD becomes visibly distressed and begins to dissociate. Which of the following nursing interventions is MOST appropriate?
A patient diagnosed with a dissociative disorder reports gaps in their memory and difficulty recalling personal information. Which therapy MOST directly addresses these symptoms?
A patient diagnosed with a dissociative disorder reports gaps in their memory and difficulty recalling personal information. Which therapy MOST directly addresses these symptoms?
Which of the following assessment findings is MOST indicative of a dissociative disorder rather than PTSD?
Which of the following assessment findings is MOST indicative of a dissociative disorder rather than PTSD?
A client consistently transforms feelings of anger towards their supervisor into an eagerness to volunteer for extra shifts. Which defense mechanism is the client employing?
A client consistently transforms feelings of anger towards their supervisor into an eagerness to volunteer for extra shifts. Which defense mechanism is the client employing?
A veteran who witnessed intense combat avoids thinking or talking about the experience. While this helps them manage day-to-day, it also prevents them from seeking needed therapy. Which defense mechanism is MOST likely being used, and is it adaptive or maladaptive in this scenario?
A veteran who witnessed intense combat avoids thinking or talking about the experience. While this helps them manage day-to-day, it also prevents them from seeking needed therapy. Which defense mechanism is MOST likely being used, and is it adaptive or maladaptive in this scenario?
A nurse is teaching a client about cognitive reframing. Which statement indicates the client understands the technique?
A nurse is teaching a client about cognitive reframing. Which statement indicates the client understands the technique?
Which scenario BEST exemplifies the use of the defense mechanism of projection?
Which scenario BEST exemplifies the use of the defense mechanism of projection?
A normally calm and collected individual begins to speak in a childish voice and demands attention after receiving bad news. Which defense mechanism is MOST likely being used?
A normally calm and collected individual begins to speak in a childish voice and demands attention after receiving bad news. Which defense mechanism is MOST likely being used?
A client who is experiencing intense anxiety is encouraged to start a journal. The nurse explains that this activity is MOST likely to help the client in what way?
A client who is experiencing intense anxiety is encouraged to start a journal. The nurse explains that this activity is MOST likely to help the client in what way?
A client reports feeling detached from their body, as if they're watching themselves from outside. This is significantly impairing their ability to function. Which condition is MOST likely indicated by this symptom?
A client reports feeling detached from their body, as if they're watching themselves from outside. This is significantly impairing their ability to function. Which condition is MOST likely indicated by this symptom?
Which individual is MOST likely to be diagnosed with Acute Stress Disorder (ASD)?
Which individual is MOST likely to be diagnosed with Acute Stress Disorder (ASD)?
Exposure to Adverse Childhood Experiences (ACEs) increases the risk for developing trauma-related disorders due to their impact on:
Exposure to Adverse Childhood Experiences (ACEs) increases the risk for developing trauma-related disorders due to their impact on:
A client with anxiety is learning relaxation techniques. Which statement indicates an understanding of the purpose of these techniques?
A client with anxiety is learning relaxation techniques. Which statement indicates an understanding of the purpose of these techniques?
A patient with PTSD reports persistent nightmares and difficulty sleeping. Which medication would the nurse anticipate being prescribed to specifically target these symptoms?
A patient with PTSD reports persistent nightmares and difficulty sleeping. Which medication would the nurse anticipate being prescribed to specifically target these symptoms?
A patient undergoing prolonged exposure therapy becomes highly distressed and requests to stop the session. What is the MOST appropriate nursing intervention?
A patient undergoing prolonged exposure therapy becomes highly distressed and requests to stop the session. What is the MOST appropriate nursing intervention?
A patient with a dissociative disorder is having difficulty recalling significant personal information. Which therapeutic approach should the nurse expect to be MOST beneficial?
A patient with a dissociative disorder is having difficulty recalling significant personal information. Which therapeutic approach should the nurse expect to be MOST beneficial?
Which nursing intervention is MOST important when establishing a therapeutic relationship with a patient who has a history of trauma?
Which nursing intervention is MOST important when establishing a therapeutic relationship with a patient who has a history of trauma?
A patient taking amitriptyline for PTSD reports experiencing dry mouth, constipation, and blurred vision. What is the priority nursing intervention?
A patient taking amitriptyline for PTSD reports experiencing dry mouth, constipation, and blurred vision. What is the priority nursing intervention?
A patient undergoing EMDR therapy reports feeling overwhelmed and unable to concentrate between sessions. Which of the following nursing interventions is MOST appropriate?
A patient undergoing EMDR therapy reports feeling overwhelmed and unable to concentrate between sessions. Which of the following nursing interventions is MOST appropriate?
A patient with a history of childhood trauma presents with increased anxiety and hypervigilance. Which of the following nursing interventions is MOST appropriate initially?
A patient with a history of childhood trauma presents with increased anxiety and hypervigilance. Which of the following nursing interventions is MOST appropriate initially?
A patient diagnosed with Dissociative Identity Disorder (DID) is experiencing significant distress as one alter is self-harming. What is the MOST appropriate immediate nursing intervention?
A patient diagnosed with Dissociative Identity Disorder (DID) is experiencing significant distress as one alter is self-harming. What is the MOST appropriate immediate nursing intervention?
A patient reports feeling detached from their body and surroundings following a traumatic event. Which nursing intervention is MOST appropriate to implement?
A patient reports feeling detached from their body and surroundings following a traumatic event. Which nursing intervention is MOST appropriate to implement?
A patient with PTSD is prescribed Phenelzine. What dietary education is MOST critical for the nurse to provide?
A patient with PTSD is prescribed Phenelzine. What dietary education is MOST critical for the nurse to provide?
A client reports experiencing persistent and excessive worry about various aspects of their life, including work, health, and finances, accompanied by fatigue and muscle tension. Which anxiety disorder is MOST likely indicated by these symptoms?
A client reports experiencing persistent and excessive worry about various aspects of their life, including work, health, and finances, accompanied by fatigue and muscle tension. Which anxiety disorder is MOST likely indicated by these symptoms?
A patient who experienced a car accident three weeks ago is exhibiting symptoms such as flashbacks, nightmares, and hypervigilance. Which condition is MOST likely indicated?
A patient who experienced a car accident three weeks ago is exhibiting symptoms such as flashbacks, nightmares, and hypervigilance. Which condition is MOST likely indicated?
A client who was recently fired from their job is experiencing significant sadness, anxiety, and social withdrawal. Which condition is MOST likely indicated?
A client who was recently fired from their job is experiencing significant sadness, anxiety, and social withdrawal. Which condition is MOST likely indicated?
Which of the following scenarios BEST exemplifies the defense mechanism of repression?
Which of the following scenarios BEST exemplifies the defense mechanism of repression?
A client experiences sudden and intense episodes of fear, accompanied by a rapid heartbeat, chest pain, and shortness of breath. The client reports feeling a sense of impending doom during these episodes. Which condition is MOST likely indicated?
A client experiences sudden and intense episodes of fear, accompanied by a rapid heartbeat, chest pain, and shortness of breath. The client reports feeling a sense of impending doom during these episodes. Which condition is MOST likely indicated?
An individual avoids social gatherings and public speaking engagements due to an intense fear of being judged or embarrassed. Which condition is MOST likely indicated?
An individual avoids social gatherings and public speaking engagements due to an intense fear of being judged or embarrassed. Which condition is MOST likely indicated?
A person refuses to seek medical treatment despite experiencing concerning symptoms, stating that they are fine and the symptoms will go away on their own. Which defense mechanism is MOST likely being used?
A person refuses to seek medical treatment despite experiencing concerning symptoms, stating that they are fine and the symptoms will go away on their own. Which defense mechanism is MOST likely being used?
An individual reports feeling intense fear and anxiety when exposed to heights, leading to avoidance behaviors. The individual recognizes that this fear is excessive but cannot control it. Which condition is MOST likely indicated?
An individual reports feeling intense fear and anxiety when exposed to heights, leading to avoidance behaviors. The individual recognizes that this fear is excessive but cannot control it. Which condition is MOST likely indicated?
A person avoids using public transportation, going to crowded places, or being in open spaces due to a fear of not being able to escape if they experience overwhelming anxiety or a panic attack. Which condition is MOST likely indicated?
A person avoids using public transportation, going to crowded places, or being in open spaces due to a fear of not being able to escape if they experience overwhelming anxiety or a panic attack. Which condition is MOST likely indicated?
Which factor increases the risk of developing an anxiety disorder?
Which factor increases the risk of developing an anxiety disorder?
A client who consistently blames their spouse for their own shortcomings is MOST likely utilizing which defense mechanism?
A client who consistently blames their spouse for their own shortcomings is MOST likely utilizing which defense mechanism?
A teenager who is struggling with feelings of anger begins attending kickboxing classes three times a week. This is an example of which defense mechanism?
A teenager who is struggling with feelings of anger begins attending kickboxing classes three times a week. This is an example of which defense mechanism?
A patient who is prescribed lorazepam for acute anxiety is preparing for discharge. Which instruction is MOST important for the nurse to emphasize?
A patient who is prescribed lorazepam for acute anxiety is preparing for discharge. Which instruction is MOST important for the nurse to emphasize?
During an unusually stressful period at work, an adult patient finds themself biting their nails constantly, something they had stopped doing in childhood. Which defense mechanism is MOST likely being demonstrated?
During an unusually stressful period at work, an adult patient finds themself biting their nails constantly, something they had stopped doing in childhood. Which defense mechanism is MOST likely being demonstrated?
Which nursing intervention is MOST appropriate when a patient reports feeling anxious and overwhelmed?
Which nursing intervention is MOST appropriate when a patient reports feeling anxious and overwhelmed?
A patient preparing for a stressful medical procedure develops a detailed schedule for the day, researches every aspect of the procedure, and organizes their tasks meticulously. Which coping style are they MOST likely using?
A patient preparing for a stressful medical procedure develops a detailed schedule for the day, researches every aspect of the procedure, and organizes their tasks meticulously. Which coping style are they MOST likely using?
A patient with chronic anxiety is learning Cognitive Behavioral Therapy (CBT). Which statement indicates an understanding of the primary goal of CBT?
A patient with chronic anxiety is learning Cognitive Behavioral Therapy (CBT). Which statement indicates an understanding of the primary goal of CBT?
Which of the following is the MOST important component of creating a safe environment (milieu therapy) for a patient with a trauma history?
Which of the following is the MOST important component of creating a safe environment (milieu therapy) for a patient with a trauma history?
Following a traumatic event, a patient reports feeling irritable, restless, and having difficulty concentrating. Besides pharmacological interventions, which non-pharmacological intervention should the nurse recommend FIRST?
Following a traumatic event, a patient reports feeling irritable, restless, and having difficulty concentrating. Besides pharmacological interventions, which non-pharmacological intervention should the nurse recommend FIRST?
A patient consistently reacts to minor stressors with exaggerated emotional responses and frequently seeks reassurance from others. Which coping style is MOST likely contributing to this pattern?
A patient consistently reacts to minor stressors with exaggerated emotional responses and frequently seeks reassurance from others. Which coping style is MOST likely contributing to this pattern?
A client with a history of childhood trauma consistently volunteers for additional shifts at work to avoid thinking about a painful memory. Which defense mechanism is MOST likely being used, and is it adaptive or maladaptive in this situation?
A client with a history of childhood trauma consistently volunteers for additional shifts at work to avoid thinking about a painful memory. Which defense mechanism is MOST likely being used, and is it adaptive or maladaptive in this situation?
During a crisis, an individual who manages stress by directing intense focus and energy into community volunteering is demonstrating which defense mechanism?
During a crisis, an individual who manages stress by directing intense focus and energy into community volunteering is demonstrating which defense mechanism?
A patient is diagnosed with a specific phobia after experiencing extreme distress when encountering spiders. Which therapeutic approach is MOST likely to be used to address this phobia?
A patient is diagnosed with a specific phobia after experiencing extreme distress when encountering spiders. Which therapeutic approach is MOST likely to be used to address this phobia?
What is the PRIMARY difference between Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) in terms of diagnostic criteria?
What is the PRIMARY difference between Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) in terms of diagnostic criteria?
A patient is experiencing flashbacks, nightmares, and severe anxiety after witnessing a car accident. Which intervention should the nurse prioritize?
A patient is experiencing flashbacks, nightmares, and severe anxiety after witnessing a car accident. Which intervention should the nurse prioritize?
Which statement accurately reflects the relationship between stress, anxiety, and defense mechanisms?
Which statement accurately reflects the relationship between stress, anxiety, and defense mechanisms?
A client undergoing cognitive reframing is attempting to manage anxiety. Which statement indicates that the therapy is effective?
A client undergoing cognitive reframing is attempting to manage anxiety. Which statement indicates that the therapy is effective?
An adult client consistently throws temper tantrums when they do not get their way. Which defense mechanism is MOST likely being employed?
An adult client consistently throws temper tantrums when they do not get their way. Which defense mechanism is MOST likely being employed?
A client with Dissociative Identity Disorder (DID) presents with markedly different behaviors, emotional responses, and self-perceptions depending on the situation. What is the MOST appropriate initial nursing intervention?
A client with Dissociative Identity Disorder (DID) presents with markedly different behaviors, emotional responses, and self-perceptions depending on the situation. What is the MOST appropriate initial nursing intervention?
Which of the following biological factors is the MOST significant contributor to the development of trauma-related disorders following exposure to Adverse Childhood Experiences (ACEs)?
Which of the following biological factors is the MOST significant contributor to the development of trauma-related disorders following exposure to Adverse Childhood Experiences (ACEs)?
A patient displaying persistent avoidance behaviors following a traumatic event finds temporary relief in these actions, but their overall anxiety increases long-term. Which aspect of the anxiety cycle does this exemplify?
A patient displaying persistent avoidance behaviors following a traumatic event finds temporary relief in these actions, but their overall anxiety increases long-term. Which aspect of the anxiety cycle does this exemplify?
A patient diagnosed with PTSD is struggling with hyperarousal symptoms. Besides medication, which non-pharmacological intervention would be MOST appropriate to implement initially?
A patient diagnosed with PTSD is struggling with hyperarousal symptoms. Besides medication, which non-pharmacological intervention would be MOST appropriate to implement initially?
A patient is prescribed an SSRI for the treatment of PTSD. What explanation regarding the medication's expected effects is most accurate?
A patient is prescribed an SSRI for the treatment of PTSD. What explanation regarding the medication's expected effects is most accurate?
In prolonged exposure therapy, a patient becomes highly distressed when recounting a traumatic event. Which modification to the intervention is MOST appropriate?
In prolonged exposure therapy, a patient becomes highly distressed when recounting a traumatic event. Which modification to the intervention is MOST appropriate?
A patient with Dissociative Identity Disorder (DID) is experiencing distress due to the actions of one of their alters. Which nursing intervention is MOST appropriate?
A patient with Dissociative Identity Disorder (DID) is experiencing distress due to the actions of one of their alters. Which nursing intervention is MOST appropriate?
Which statement indicates the need for further education regarding trauma-informed care?
Which statement indicates the need for further education regarding trauma-informed care?
Why might a patient with a trauma history find it difficult to maintain a consistent sleep schedule?
Why might a patient with a trauma history find it difficult to maintain a consistent sleep schedule?
A patient experiencing symptoms of a trauma disorder reports feeling detached from their emotions and surroundings. Which type of therapy should the nurse expect to be prescribed to address this symptom specifically?
A patient experiencing symptoms of a trauma disorder reports feeling detached from their emotions and surroundings. Which type of therapy should the nurse expect to be prescribed to address this symptom specifically?
What is the most important initial nursing intervention when working with a patient newly diagnosed with a dissociative disorder?
What is the most important initial nursing intervention when working with a patient newly diagnosed with a dissociative disorder?
A patient avoids discussing a specific traumatic event but instead focuses on minor, unrelated issues. What is the MOST appropriate interpretation?
A patient avoids discussing a specific traumatic event but instead focuses on minor, unrelated issues. What is the MOST appropriate interpretation?
Flashcards
Stress
Stress
The body's response to environmental demands, triggering anxiety; can be adaptive or maladaptive.
Defense Mechanisms
Defense Mechanisms
Unconscious mental strategies used to reduce anxiety.
Altruism
Altruism
Managing stress by helping others.
Sublimation
Sublimation
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Suppression
Suppression
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Cognitive Reframing
Cognitive Reframing
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Separation Anxiety Disorder
Separation Anxiety Disorder
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Specific Phobias
Specific Phobias
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Acute Stress Disorder (ASD)
Acute Stress Disorder (ASD)
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Depersonalization/ Derealization Disorder
Depersonalization/ Derealization Disorder
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Intrusive Symptoms (Trauma)
Intrusive Symptoms (Trauma)
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Mood & Cognitive Alterations (Trauma)
Mood & Cognitive Alterations (Trauma)
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Behavioral Manifestations (Trauma)
Behavioral Manifestations (Trauma)
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Dissociative Disorder Symptoms
Dissociative Disorder Symptoms
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Trauma-Informed Care
Trauma-Informed Care
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CBT (Cognitive-Behavioral Therapy)
CBT (Cognitive-Behavioral Therapy)
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Prolonged Exposure Therapy
Prolonged Exposure Therapy
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EMDR (Eye Movement Desensitization and Reprocessing)
EMDR (Eye Movement Desensitization and Reprocessing)
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Somatic Therapy
Somatic Therapy
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SSRIs (for Trauma)
SSRIs (for Trauma)
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Memory Loss (Dissociative)
Memory Loss (Dissociative)
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Detachment from Reality
Detachment from Reality
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Shifting Identities (DID)
Shifting Identities (DID)
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Structured Routines
Structured Routines
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Hypnotherapy
Hypnotherapy
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SSRIs
SSRIs
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SNRIs
SNRIs
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Beta Blockers (for trauma)
Beta Blockers (for trauma)
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Prazosin
Prazosin
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Repression
Repression
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Regression
Regression
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Displacement
Displacement
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Reaction Formation
Reaction Formation
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Denial
Denial
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Rationalization
Rationalization
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Projection
Projection
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Agoraphobia
Agoraphobia
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Social Anxiety Disorder
Social Anxiety Disorder
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Adjustment Disorder
Adjustment Disorder
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Panic Disorder
Panic Disorder
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Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder (GAD)
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Posttraumatic Stress Disorder (PTSD)
Posttraumatic Stress Disorder (PTSD)
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Dissociative Amnesia
Dissociative Amnesia
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Dissociative Fugue
Dissociative Fugue
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Dissociative Identity Disorder
Dissociative Identity Disorder
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Adverse Childhood Experiences (ACEs)
Adverse Childhood Experiences (ACEs)
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Definition of Anxiety
Definition of Anxiety
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Emotional Symptoms of Anxiety
Emotional Symptoms of Anxiety
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Cognitive Symptoms of Anxiety
Cognitive Symptoms of Anxiety
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Physical Symptoms of Anxiety
Physical Symptoms of Anxiety
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Anxiety as a Disorder
Anxiety as a Disorder
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Anxiety Cycle Trigger
Anxiety Cycle Trigger
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Negative Thoughts in Anxiety
Negative Thoughts in Anxiety
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Physical Symptoms in Anxiety Cycle
Physical Symptoms in Anxiety Cycle
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Avoidance in Anxiety
Avoidance in Anxiety
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Reinforcement from Avoidance
Reinforcement from Avoidance
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Genetic Predisposition (Anxiety)
Genetic Predisposition (Anxiety)
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Early Life Trauma (Anxiety)
Early Life Trauma (Anxiety)
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Chronic Stressors (Anxiety)
Chronic Stressors (Anxiety)
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Medical Conditions (Anxiety)
Medical Conditions (Anxiety)
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Substance Use (Anxiety)
Substance Use (Anxiety)
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Panic Attack
Panic Attack
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Social Anxiety
Social Anxiety
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Phobias
Phobias
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PTSD Symptoms
PTSD Symptoms
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Displacement (Defense Mechanism)
Displacement (Defense Mechanism)
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Projection (Defense Mechanism)
Projection (Defense Mechanism)
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Sublimation (Defense Mechanism)
Sublimation (Defense Mechanism)
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Regression (Defense Mechanism)
Regression (Defense Mechanism)
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Open-Ended Questions
Open-Ended Questions
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Validating Feelings
Validating Feelings
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Addressing the stressor directly to reduce its impact.
Addressing the stressor directly to reduce its impact.
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Emotion-Focused Coping
Emotion-Focused Coping
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Study Notes
- Stress arises as the body's response to environmental demands.
- The brain's natural response to demands is stress.
- Stress can lead to anxiety
- Prolonged stress can cause maladaptive responses.
Defense Mechanisms
- Unconscious strategies used to manage anxiety.
- Adaptive (healthy) or maladaptive (unhealthy) depending on their use.
- Altruism: Managing stress by helping others.
- Sublimation: Redirecting impulses into productive activities.
- Suppression: Voluntarily avoiding distressing thoughts.
- Repression: Unconsciously blocking distressing thoughts.
- Regression: Reverting to childish behaviors.
- Displacement: Redirecting emotions onto a safer target.
- Reaction Formation: Behaving opposite to true feelings.
- Denial: Refusing to accept reality.
- Rationalization: Justifying inappropriate behavior.
- Projection: Attributing one's own thoughts to someone else.
Nursing Care: Stress Management Techniques
- Cognitive Reframing: Restructuring negative thoughts into positive ones.
- Relaxation Techniques: Meditation, guided imagery, deep breathing.
- Journal Writing: Identifying stressors and coping plans.
Anxiety Disorders
- Separation Anxiety Disorder: Fear of separation from an attachment figure.
- Specific Phobias: Irrational fear of objects or situations.
- Agoraphobia: Fear of open spaces or crowds.
- Social Anxiety Disorder: Fear of social interactions.
- Panic Disorder: Recurrent panic attacks.
- Generalized Anxiety Disorder (GAD): Chronic, excessive worry.
Trauma- and Stressor-Related Disorders
- Acute Stress Disorder (ASD): Anxiety and detachment lasting 3 days to 1 month after trauma.
- Posttraumatic Stress Disorder (PTSD): Prolonged symptoms lasting more than 1 month.
- Adjustment Disorder: Stress reaction causing mood changes, but less severe than PTSD.
Dissociative Disorders
- Depersonalization/Derealization Disorder: Feeling detached from oneself or surroundings.
- Dissociative Amnesia: Memory loss related to trauma.
- Dissociative Fugue: Wandering away with identity confusion.
- Dissociative Identity Disorder: Presence of multiple personalities.
Risk Factors for Trauma Disorders
- Adverse Childhood Experiences (ACEs) leading to emotional distress.
- Repeated exposure to trauma (military, abuse, violence).
- Lack of social support during stressful experiences.
ASD & PTSD Symptoms
- Intrusive symptoms: Flashbacks, nightmares, avoidance.
- Mood & cognitive alterations: Depression, guilt, negative beliefs.
- Behavioral manifestations: Aggression, hypervigilance, sleep disturbances.
Dissociative Disorder Symptoms
- Memory loss or difficulty recalling personal details.
- Detachment from reality, feeling as if observing oneself.
- Shifting identities (DID - multiple personality disorder).
Nursing Care & Interventions
- Trauma-Informed Care: Acknowledge trauma, ensure safety, provide structured routines.
- CBT (Cognitive-Behavioral Therapy): Correcting distorted thoughts.
- Prolonged Exposure Therapy: Gradual exposure to trauma-related stimuli.
- EMDR (Eye Movement Desensitization and Reprocessing): Using guided eye movements to process trauma.
- Somatic Therapy: Techniques like grounding exercises to reduce dissociation.
- Hypnotherapy: Used for dissociative disorders.
Medications for Trauma Disorders
- SSRIs (First-line treatment): Paroxetine, Sertraline, Fluoxetine.
- SNRIs: Venlafaxine.
- TCAs: Amitriptyline, Imipramine.
- MAOIs: Phenelzine.
- Beta Blockers: Propranolol for hyperarousal symptoms.
- Prazosin: Helps with PTSD-related nightmares.
- Clonidine: Reduces hypervigilance.
Nursing Evaluation of Treatment Effectiveness
- Reduced anxiety and fear
- Improved sleep and concentration
- Increased ability to perform daily activities
- Better coping mechanisms
Understanding Anxiety
- Anxiety is a natural response to stress but becomes a disorder when excessive and persistent.
- Includes emotional, cognitive, and physical symptoms.
- Emotional Symptoms: Excessive worry, fear, irritability.
- Cognitive Symptoms: Difficulty concentrating, racing thoughts, anticipating worst-case scenarios.
- Physical Symptoms: Increased heart rate, sweating, dizziness, muscle tension, GI issues.
- Symptoms become excessive, persistent, and interfere with daily life when anxiety becomes a disorder.
- The level of fear is disproportionate to the actual threat when anxiety becomes a disorder.
- Symptoms last for six months or more when anxiety becomes a disorder.
The Anxiety Cycle
- Trigger: Stressful event or thought.
- Negative Thoughts: I can't handle this.
- Physical Symptoms: Rapid heartbeat, dizziness.
- Avoidance: Staying away from stressors.
- Reinforcement: Avoidance reduces discomfort temporarily but increases long-term anxiety.
Common Risk Factors for Anxiety Disorders
- Genetic predisposition: Family history of anxiety increases risk.
- Early life trauma: Childhood abuse, neglect, loss of a parent.
- Chronic stressors: Financial instability, work stress, relationship conflicts.
- Medical conditions: Hyperthyroidism, heart disease.
- Substance use: Alcohol, caffeine, drugs.
Types of Anxiety Disorders
- Generalized Anxiety Disorder (GAD): Persistent, excessive worry about multiple aspects of life (work, health, finances); symptoms include fatigue, restlessness, muscle tension, irritability, trouble concentrating.
- Panic Disorder: Sudden, intense episodes of fear (panic attacks); symptoms include rapid heartbeat, chest pain, shortness of breath, dizziness, feeling of impending doom.
- Social Anxiety Disorder: Fear of social situations due to embarrassment or judgment; symptoms include sweating, nausea, trembling, difficulty speaking in social settings.
- Phobias: Intense fear of a specific object or situation; symptoms include panic, avoidance behaviors, distress when exposed to the feared object.
- Agoraphobia: Fear of being in places where escape is difficult; common locations avoided include crowds, public transportation, open spaces.
Trauma & Stress-Related Disorders
- Post-Traumatic Stress Disorder (PTSD): Develops after exposure to a traumatic event (war, assault, natural disaster); symptoms include flashbacks, nightmares, hypervigilance, emotional numbness; avoidance behaviors include avoiding people, places, or reminders of trauma.
- Acute Stress Disorder (ASD): Similar to PTSD but occurs within one month of trauma; if symptoms persist longer than one month, it may develop into PTSD.
- Adjustment Disorder: Emotional or behavioral reaction to a stressful event (divorce, job loss); symptoms include sadness, hopelessness, anxiety, social withdrawal.
Defense Mechanisms
- Denial: Refusing to accept reality (e.g., A person diagnosed with cancer refuses to believe they are sick).
- Repression: Unconsciously blocking painful memories (e.g., A survivor of childhood abuse cannot recall the events).
- Displacement: Redirecting emotions to a safer target (e.g., A man angry at his boss yells at his wife instead).
- Projection: Attributing one's thoughts/feelings to others (e.g., A person who dislikes their coworker believes the coworker hates them).
- Reaction Formation: Acting opposite to one's feelings (e.g., A person who dislikes their child becomes overly protective).
- Rationalization: Making excuses to justify behavior (e.g., A student blames a bad grade on the teacher rather than lack of studying).
- Sublimation: Channeling negative emotions into positive outlets (e.g., A person with aggression issues takes up boxing).
- Regression: Reverting to childlike behavior (e.g., An adult throws a tantrum after hearing bad news).
Nursing Interventions for Anxiety & Trauma
- Therapeutic Communication Techniques: Use open-ended questions (“Can you tell me what's worrying you the most?”); Validate feelings (“I understand that this is very stressful for you”); Encourage expression of emotions (“It's okay to feel this way. Let's talk about it”).
- Creating a Safe Environment (Milieu Therapy): Minimize triggers in the environment; Provide a structured and calm setting; Encourage relaxation techniques like deep breathing.
- Cognitive Behavioral Therapy (CBT): Goal: Change negative thought patterns that fuel anxiety; Example technique: If a patient believes “I will fail my test," encourage them to replace it with “I have studied well and will do my best.”
- Pharmacologic Interventions: SSRIs (Selective Serotonin Reuptake Inhibitors): First-line treatment for anxiety (Examples: Sertraline, Fluoxetine); Benzodiazepines: Used for acute anxiety episodes (Examples: Lorazepam, Alprazolam); Risk: Dependency with long-term use.
Coping Strategies
- Problem-Focused Coping: Addressing the issue directly (e.g., making a study plan for an exam).
- Emotion-Focused Coping: Managing emotional distress (e.g., talking to a friend, deep breathing).
- Avoidance Coping: Ignoring the problem (e.g., procrastinating instead of studying).
Stress Reduction Techniques
- Techniques for Stress Alleviation: Mind-to-body approaches: Meditation, yoga, deep breathing; Relaxation response: Opposite of stress response (lowers heart rate, improves focus).
- Practices to Promote Mental Well-being: Biofeedback: Learning to control bodily functions like heart rate; Deep breathing: Activates relaxation response; Guided imagery: Visualizing calming scenes to reduce stress; Mindfulness meditation: Staying present to prevent anxious thoughts.
Seclusion & Restraint Considerations
- Only used when absolutely necessary for patient or staff safety.
- Requires a provider's order and ongoing reassessment.
- Criteria for removal: Signs of de-escalation, improved self-control.
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Description
Learn about stress, anxiety, and defense mechanisms. Defense mechanisms are unconscious strategies to manage anxiety, and their use can be adaptive or maladaptive. Explore common defense mechanisms such as altruism, sublimation, and denial.
