NURS 661 Exam 2 Full And Revised (Diseases & Disorders) Latest Study Guide Grade A+.

NURS 661 Exam 2 Full And Revised (Diseases & Disorders) Latest Study Guide Grade A+. Nurs661 Study Guide Exam 2 1. Know different types of anxiety disorders and be able to distinguish between them a. panic disorder: neurotransmitters; serotonin, norepinephrine and GABA. Increased sympathetic tone in the peripheral as well as central NS. Post-synaptic serotonin hypersensitivity; local inhibitory GABA transmission to amygdala, midbrain and hypothalamus. p. 392. Anxiogenic effects of yohimbine, exaggerated MHPG cortisol and cardiovascular responses. Panicogens: respiratory panicogens: carbon dioxide, sodium lactate, bicarbonate. psychosocial theories: unsuccessful defense against anxiety-provoking impulses=physiological response. Higher incidence of stressful life events: abuse, separation anxiety first-degree relatives of patients with panic disorder have a four- to eight-fold higher risk for panic disorder than first-degree relatives of other psychiatric patients. From Sadock (2014) p. 393 includes the DSM-V criteria. 1. Recurrent unexpected panic attacks: abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time 4 or more of the follow occur 1. palpitations, pounding heart or elevated HR 2. sweating 3. trembling or shaking 4. sensation of SOB or smothering 5. feelings of choking 6. chest pain or discomfort 7. nausea or abdominal distress 8. dizzy, unsteady, light-headed or faint 9. chills or heat sensation 10. paresthesia (numbness or tingling) 11. derealization (feelings of unreality) or depersonalization (being detached from one’s self) 12. Fear of losing control or going crazy 13. fear of dying 14. Culture specific sx: tinnitus, neck soreness, headache, uncontrollable screaming or crying. shouldn’t count as one of the four sx 2. At least one of the attacks has been followed by 1 mo or more of a. persistent concern or worry about another panic attack or consequences like losing control b. significant maladaptive change in behavior as a results of attack: avoidance of perceived stimulus 3. Disturbance not better explained by another mental disorders: social anxiety, phobia, OCD, separation b. separation anxiety disorder: Bowlby’s theory of anxiety: child’s sense of distress during separation is perceived and experienced as anxiety and is prototype of anxiety. Mother’s ability ot relieve fear is fundamental to attack with child. Tearfulness and/or irritability; emerges and peeks usually around 9-18mo/old, generally disappears by 3rd year . Crying is the primary signal. (Sadock p. 99). P. 1253: with children--highly comorbid with GAD and social anxiety disorder. 30% have all three and 60% having one will have one of the others. 15% of children display intense persistent fear, shyness and social withdrawal when faced with unfamiliar settings and people. Higher than average resting heart rate, higher morning cortisol, low heart rate variability. DSM-V: a level of fear or anxiety regarding separation from parents or primary caregiver which is beyond developmental expectations. At least 3 sx of excessive worry for at least 4 weeks: refusal to attend school, repeated physical complaints (headaches, stomach aches) with anticipated separation, nightmares related to separation. get remained DSM V criteria. DSM-V--DEvelopmentally inappropriate or excessive fear or anxiety concerning separation for those to whom the individual is attacked: p. 191 DSM-V a. 3 of the following: 1. recurrent excessive distress when anticipation or experiencing separation from home or major attachment figures. 2. persistent excessive worry about losing, harm to them, injury, disasters or death to major attachment figures 3. persistent excessive worry about an untoward event to person that will separate them from major attachment figure (MAF): get lost, kidnapped, accident become ill 4. Persistent reluctance nor refusal to go out, away from home, to school, work, elsewhere: fear of separation. 5. persistent excessive fear or reluctance to be alone or without MAF at home or in other settings 6. persistent excessive reluctance to sleep away from home 7. Repeated nightmares about separation 8. repeated physical symptoms when separated from MAF: headaches, stomachaches, N/V b. The fear, anxiety, or avoidance is persistent lasting at least 4 weeks in children and 6 mo in adults c. Causes clinically significant impairment in social academic, occupational, or other important area of functioning c. Not better explained by other mental disorder: austism, delusions, hallucinations, agoraphobia, GAD, having an illness anxiety disorder. . c. Generalized anxiety disorder is characterized by a pattern of frequent, persistent worry and anxiety that is out of proportion to the impact of the event or circumstance that is the focus of the worry. The distinction between generalized anxiety disorder and normal anxiety is emphasized by the use of the word “excessive” in the criteria and by the specification that the symptoms cause significant impairment or distress. DSM-5 diagnostic criteria for generalized anxiety disorder are listed in Table 9.6-2. Has the oldest median age of onset. 1. most often coexists with other mental disorder: usually social or specific phobia, panic d/o or depressed d/o. p. 407 50-75% have another mental disorder. 2. 25 % of anxiety pts have GAD. usually late adolescence/early adult onset, but oldest median age onset. 3. basal ganglia, limbic system, frontal cortex. occipital lobe has the highest concentration of benzo receptors. p. 408 4. DSM-V for GAD 1. Excessive anxiety and worry (apprehensive expectation) more days than not for 6 mo bout a number of events or activities. 2. Difficult to control the worry 3. Anxiety/worry are associated with 3 or more of the following (only 1 sx required in children) 1. restlessness, feeling keyed up or on edge 2. being easily fatigued 3. difficulty concentrating, mind goes blank 4. irritability 5. muscles tension 6. sleep disturbance: falling asleep, staying asleep; or restless, unsatisfying sleep iv. anxiety worry or phys symptoms cause clinically significant distress or impairment: social, occupational, or other areas of function v. Not attributable to substance.