MARYVILLE
NURS 623 EXAM 3 | QUESTIONS WITH
COMPLETE SOLUTIONS | LATEST UPDATE
Anxiety disorder - Most common psych disorder in the US (usually 20-45year olds)
Symptoms manifested in several ways:
•Affective
•Behavioral
•cognitive
•Somatic
More common in women
Thinks to rule out with anxiety - thyroid issues
palpitations
drug use
caffeine
diagnostics for anxiety - blood chemistry
ekg
thyroid function
Symptom criteria for diagnosis of GAD - Excessive anxiety and worry (apprehensive
expectation), occurring more days than not for at least 6 months, about a number of
events or activities (such as work or school performance)
Clinical Presentation of GAD
Excessive anxiety
Hyper vigilant
Headaches
Restlessness
Shakiness
Hyperactive autonomic symptoms
Disrupts life
Symptoms for 6 months or more
Education for GAD - •Avoid alcohol and stimulants
•Symptom recognition
•Symptom interpretation
,Treatment for GAD - Non pharmacologic
•***Cognitive behavior therapy (CBT)
Pharmacology
•Anti-anxiety agents (refer to text for list)
•Acute: alprazolam and diazepam short term
•Long term: SSRIs
•*caution in elderly
Panic disorder - An anxiety disorder marked by unpredictable minutes-long episodes of
intense dread in which a person experiences terror and accompanying chest pain,
choking, or other frightening sensations.
Distinguish between disorder and attack
•Pattern of recurrent episodes
•Sudden onset
•Severe symptoms
Diagnosis: based on clinical symptoms
•Refer to text for symptom criteria
Treatment:
•SSRI/SNRI or TCA
•CBT**
PTSD (Post Traumatic Stress Disorder) - Types PTSD
•Acute: <3 months
•Chronic: >3 months
•Delayed: onset at least 6 months after trauma
Clinical
•Symptoms are apparent for greater than one month
Symptoms:
intrusive, avoidant behaviors, hyper arousal.
education and treatment for PTSD - Pharmacology
-SSRI
-Paroxetine and sertraline
-? prazosin
Non-pharmacological
•CBT and prolonged exposure (PE)
•Critical incident debriefing (CID)
, •Stress inoculation therapy (SIT)
•Image rehearsal therapy (IRT)
•Psychodynamic Therapy
•Family, group, and peer
Major depressive disorder - Characteristics
•Severe negative change
in mood, thinking, and
behavior
•Severity
•With or without suicide idealization
Epidemiology
•5-20% of population
•Adults >65 (30-40%)
•High rate for recurrence
•Women > Men
•8-19% hospitalized
•1 out of 7 suicide
•Co-morbid anxiety, cardiac and diabetes
Differential diagnosis for major mood disorder - Thyroid disorder
•Sleep disorder
•Unrecognized bipolar
•Neurological
•Medications
•Substance use
•Adrenal functioning
Clinical features of Major depressive disorder - The DSM-5 symptom criteria for major
depression state that five (or more) of the following symptoms have been present during
the same 2-week period and represent a change from previous functioning.
At least one of the symptoms is either (1) depressed mood or (2) anhedonia, meaning
loss of interest or pleasure:
• Depressed mood expressed as feelings of sadness or hopelessness. Irritability may be
the primary symptom in adolescents and children.
• Markedly diminished interest (apathy) in most activities.
• Change in appetite.
• Insomnia or hypersomnia.
• Behavioral agitation or retardation.
• Loss of energy.
• Feelings of worthlessness or guilt.
• Loss of concentration.
• Recurrent thoughts of death or suicide.
NURS 623 EXAM 3 | QUESTIONS WITH
COMPLETE SOLUTIONS | LATEST UPDATE
Anxiety disorder - Most common psych disorder in the US (usually 20-45year olds)
Symptoms manifested in several ways:
•Affective
•Behavioral
•cognitive
•Somatic
More common in women
Thinks to rule out with anxiety - thyroid issues
palpitations
drug use
caffeine
diagnostics for anxiety - blood chemistry
ekg
thyroid function
Symptom criteria for diagnosis of GAD - Excessive anxiety and worry (apprehensive
expectation), occurring more days than not for at least 6 months, about a number of
events or activities (such as work or school performance)
Clinical Presentation of GAD
Excessive anxiety
Hyper vigilant
Headaches
Restlessness
Shakiness
Hyperactive autonomic symptoms
Disrupts life
Symptoms for 6 months or more
Education for GAD - •Avoid alcohol and stimulants
•Symptom recognition
•Symptom interpretation
,Treatment for GAD - Non pharmacologic
•***Cognitive behavior therapy (CBT)
Pharmacology
•Anti-anxiety agents (refer to text for list)
•Acute: alprazolam and diazepam short term
•Long term: SSRIs
•*caution in elderly
Panic disorder - An anxiety disorder marked by unpredictable minutes-long episodes of
intense dread in which a person experiences terror and accompanying chest pain,
choking, or other frightening sensations.
Distinguish between disorder and attack
•Pattern of recurrent episodes
•Sudden onset
•Severe symptoms
Diagnosis: based on clinical symptoms
•Refer to text for symptom criteria
Treatment:
•SSRI/SNRI or TCA
•CBT**
PTSD (Post Traumatic Stress Disorder) - Types PTSD
•Acute: <3 months
•Chronic: >3 months
•Delayed: onset at least 6 months after trauma
Clinical
•Symptoms are apparent for greater than one month
Symptoms:
intrusive, avoidant behaviors, hyper arousal.
education and treatment for PTSD - Pharmacology
-SSRI
-Paroxetine and sertraline
-? prazosin
Non-pharmacological
•CBT and prolonged exposure (PE)
•Critical incident debriefing (CID)
, •Stress inoculation therapy (SIT)
•Image rehearsal therapy (IRT)
•Psychodynamic Therapy
•Family, group, and peer
Major depressive disorder - Characteristics
•Severe negative change
in mood, thinking, and
behavior
•Severity
•With or without suicide idealization
Epidemiology
•5-20% of population
•Adults >65 (30-40%)
•High rate for recurrence
•Women > Men
•8-19% hospitalized
•1 out of 7 suicide
•Co-morbid anxiety, cardiac and diabetes
Differential diagnosis for major mood disorder - Thyroid disorder
•Sleep disorder
•Unrecognized bipolar
•Neurological
•Medications
•Substance use
•Adrenal functioning
Clinical features of Major depressive disorder - The DSM-5 symptom criteria for major
depression state that five (or more) of the following symptoms have been present during
the same 2-week period and represent a change from previous functioning.
At least one of the symptoms is either (1) depressed mood or (2) anhedonia, meaning
loss of interest or pleasure:
• Depressed mood expressed as feelings of sadness or hopelessness. Irritability may be
the primary symptom in adolescents and children.
• Markedly diminished interest (apathy) in most activities.
• Change in appetite.
• Insomnia or hypersomnia.
• Behavioral agitation or retardation.
• Loss of energy.
• Feelings of worthlessness or guilt.
• Loss of concentration.
• Recurrent thoughts of death or suicide.
