1. Distinguish between anxiety and fear.
o ANXIETY DEFINITION: Dread, apprehension, uneasiness, or excessive nervousness
Expected and considered normal when appropriate to the situation
Should resolve when situation resolves
Emotion, behavioral, conatal, or physical symptoms
At end of life it is at a much higher level
Can serve as a motivation!
o FEAR: is being afraid of being threatened by a clearly defined “something” like a bear
or a dog.
2. Classify the levels of anxiety and behavioral changes related to each level.
o Mild: Something feels “different”
Sensory stimulation increases
Can make the person focus and can be motivational
No direct interventions are needed
o Moderate: Disturbing feeling that something is definitely wrong
Can still solve problems and process information
Issues concentrating and need redirected
Use short simple sentences
1 command at a time
When teaching, make them teach it back to you
o Severe: Trouble thinking and reasoning
Muscles become tighter
Vital signs go crazy
i. High BP
ii. High HR
Restless, irritable, and angry
Cannot pay attention
Pacing is possible, so walk with to keep up
Decrease anxiety to mild or moderate so we can proceed accordingly
i. Focus them in on taking deep breaths
Do not leave them alone (someone needs to be with them at all times)
Take them to a non-stimulating environment
Reassure them that they are safe and anxiety will pass (up to 30 min)
Talking down techniques:
i. Talking to them like a little child and slowly to calm them down
o Panic: She did not say…
3. Design and implement a plan of care for patients with anxiety disorders.
o Combination of medications and therapy: Gold standard
Based on symptoms
If the anxiety is making their breathing worse, then you’d want to treat for the worsened breathing
o Cognitive–behavioral therapy (CBT)
Positive reframing: Turns negative messages into positive messages
Decatastrophizing: Trying to get patients to use a more realistic approach to evaluating a situation
Assertiveness training: Helps patients navigate their intrapersonal relationships
i. The use of “I” statements and more likely to speak for themselves!
ii. Able to communicate for themselves and their own needs
, 4. Differentiate the types of anxiety disorders, including stress-related illness, panic disorder, phobias, social anxiety
disorder, generalized anxiety disorder, selective mutism, and separation anxiety disorder, with analysis of symptoms
and treatments for each.
o Stress-related illness: present or made worse by chronic unresolved stress
Eating disorders
Somatic symptom disorder
o Panic disorder:
Most common!
o Specific phobia: being afraid of specific things
o Social anxiety disorder: also called social phobia and don’t want to be in party or social areas.
Fear of speaking in public
Issues performing in front of others
Excessive fear of embarrassment or poor performance
o Generalized anxiety disorder:
Highest rates of all mental disorders for all kids and adults
Most common in women and those under the age of 45
o Selective mutism: Kids fail to speak in social situations
They’re able to speak, but they wont talk with friends or extended family
They will talk at home
Can be seen in abusive situations esp. if abuser threatens to harm the child’s family if they talk
Occurs due to high level of social anxiety
o Separation anxiety disorder: Excessive anxiety when they are separated from their home, people, or
whoever they are attached to
Some separation anxiety is normal with little kids or toddlers
Once past that childhood developmental stage and then clinically inappropriate
Diagnosed before turning 18, but after that developmental stage
5. Evaluate types of treatments, medication use, and the effectiveness of both for pts with anxiety disorders
o Combination of medications and therapy: Gold standard
Based on symptoms
If the anxiety is making their breathing worse, then you’d want to treat for the worsened breathing
o Cognitive–behavioral therapy (CBT)
Positive reframing: Turns negative messages into positive messages
Decatastrophizing: Trying to get patients to use a more realistic approach to evaluating a situation
Assertiveness training: Helps patients navigate their intrapersonal relationships
i. The use of “I” statements and more likely to speak for themselves!
ii. Able to communicate for themselves and their own needs
6. Organize a teaching plan for patients, families, caregivers, and communities to improve understanding of anxiety and
stress-related disorders.
7. Examine the cause(s) behind anxiety disorders, somatic symptom illnesses, factitious disorders, and malingering.
ANXIETY DISORDER:
o Stress-related illness: present or made worse by chronic unresolved stress
Eating disorders
Somatic symptom disorder
o Agoraphobia: When people will not leave the house
o Panic disorder:
Most common!
o Specific phobia: being afraid of specific things
o ANXIETY DEFINITION: Dread, apprehension, uneasiness, or excessive nervousness
Expected and considered normal when appropriate to the situation
Should resolve when situation resolves
Emotion, behavioral, conatal, or physical symptoms
At end of life it is at a much higher level
Can serve as a motivation!
o FEAR: is being afraid of being threatened by a clearly defined “something” like a bear
or a dog.
2. Classify the levels of anxiety and behavioral changes related to each level.
o Mild: Something feels “different”
Sensory stimulation increases
Can make the person focus and can be motivational
No direct interventions are needed
o Moderate: Disturbing feeling that something is definitely wrong
Can still solve problems and process information
Issues concentrating and need redirected
Use short simple sentences
1 command at a time
When teaching, make them teach it back to you
o Severe: Trouble thinking and reasoning
Muscles become tighter
Vital signs go crazy
i. High BP
ii. High HR
Restless, irritable, and angry
Cannot pay attention
Pacing is possible, so walk with to keep up
Decrease anxiety to mild or moderate so we can proceed accordingly
i. Focus them in on taking deep breaths
Do not leave them alone (someone needs to be with them at all times)
Take them to a non-stimulating environment
Reassure them that they are safe and anxiety will pass (up to 30 min)
Talking down techniques:
i. Talking to them like a little child and slowly to calm them down
o Panic: She did not say…
3. Design and implement a plan of care for patients with anxiety disorders.
o Combination of medications and therapy: Gold standard
Based on symptoms
If the anxiety is making their breathing worse, then you’d want to treat for the worsened breathing
o Cognitive–behavioral therapy (CBT)
Positive reframing: Turns negative messages into positive messages
Decatastrophizing: Trying to get patients to use a more realistic approach to evaluating a situation
Assertiveness training: Helps patients navigate their intrapersonal relationships
i. The use of “I” statements and more likely to speak for themselves!
ii. Able to communicate for themselves and their own needs
, 4. Differentiate the types of anxiety disorders, including stress-related illness, panic disorder, phobias, social anxiety
disorder, generalized anxiety disorder, selective mutism, and separation anxiety disorder, with analysis of symptoms
and treatments for each.
o Stress-related illness: present or made worse by chronic unresolved stress
Eating disorders
Somatic symptom disorder
o Panic disorder:
Most common!
o Specific phobia: being afraid of specific things
o Social anxiety disorder: also called social phobia and don’t want to be in party or social areas.
Fear of speaking in public
Issues performing in front of others
Excessive fear of embarrassment or poor performance
o Generalized anxiety disorder:
Highest rates of all mental disorders for all kids and adults
Most common in women and those under the age of 45
o Selective mutism: Kids fail to speak in social situations
They’re able to speak, but they wont talk with friends or extended family
They will talk at home
Can be seen in abusive situations esp. if abuser threatens to harm the child’s family if they talk
Occurs due to high level of social anxiety
o Separation anxiety disorder: Excessive anxiety when they are separated from their home, people, or
whoever they are attached to
Some separation anxiety is normal with little kids or toddlers
Once past that childhood developmental stage and then clinically inappropriate
Diagnosed before turning 18, but after that developmental stage
5. Evaluate types of treatments, medication use, and the effectiveness of both for pts with anxiety disorders
o Combination of medications and therapy: Gold standard
Based on symptoms
If the anxiety is making their breathing worse, then you’d want to treat for the worsened breathing
o Cognitive–behavioral therapy (CBT)
Positive reframing: Turns negative messages into positive messages
Decatastrophizing: Trying to get patients to use a more realistic approach to evaluating a situation
Assertiveness training: Helps patients navigate their intrapersonal relationships
i. The use of “I” statements and more likely to speak for themselves!
ii. Able to communicate for themselves and their own needs
6. Organize a teaching plan for patients, families, caregivers, and communities to improve understanding of anxiety and
stress-related disorders.
7. Examine the cause(s) behind anxiety disorders, somatic symptom illnesses, factitious disorders, and malingering.
ANXIETY DISORDER:
o Stress-related illness: present or made worse by chronic unresolved stress
Eating disorders
Somatic symptom disorder
o Agoraphobia: When people will not leave the house
o Panic disorder:
Most common!
o Specific phobia: being afraid of specific things
