RNSG2213/RNSG 2213 Mental Health Nursing Review
for Exam 2 Level 3 (Answered) Latest Version. Graded
A+.
How are anticonvulsants used in the treatment of anxiety? – ANS Usually used in
adjunct to other medications, help relieve the symptoms of anxiety
Valporic acid, gabapentin (neurontin
How are antidepressants used to treat anxiety? - ANSFirst line treatment for anxiety
disorders, secondary benefit of treating co-occurring depressive disorders. SSRIs and
SNRIs preferred over TCAs as they have less side effects
•SSRIs: celexa (citalopram) Lexapro (escitalopram) Prozac (fluoxetine) paxil
(paroxetine) zoloft (sertraline)
•SNRIs: cymbalta (duloxetine) and Effexor (venlafaxine)
•tricyclics: anafranil (clomipramine): for OCD
How are beta blockers used in the treatment of anxiety? – ANS Used for panic
disorders and social anxiety. Decreases heart rate, contractility and blood pressure to
relieve physical symptoms of anxiety
Propranolol (Inderal)
How are beta-blockers used in the treatment of anxiety? – ANS Blocks the hormones
epinephrine/adrenaline. Decrease heart rate, contractility and blood pressure to
decrease somatic feelings of anxiety.
Propranolol (Inderal) and atenolol (Tenormin)
How do biochemical factors effect depression? – ANS Biochemical factors: changes in
the neurotransmitters and the limbic system, hypothalamus, prefrontal cortex,
hippocampus and amygdala. Low serotonin and norepinephrine, and dysfunction in
glutamate, dopamine, GABA and acetylcholine.
*PET scan reveals a less active brain
How do genetics effect depression? – ANS interact with environmental factors, first
degree family members are 2-4 times more likely to develop. Increased risk for
comorbidity (substance abuse) increased risk for occurrence and earlier onset
How do hormone effect depression? – ANS Many depressed patients have increased
levels of cortisol caused by chronic stress
,*depressed individuals display hyperactivity in HPA axis
How do stressful life events effect depression? - ANSEarly life experiences such as
harsh/abusive parenting can make a person more psychologically sensitive to rejection
and stress.
Implications: social separations, job loss, loss of self esteem, death of someone
important, extreme poverty
How is generalized anxiety disorder diagnosed? - ANSAn individuals symptoms must
persist for most days during a 6 month period and have at least three of the following
symptoms:
•restlessness
•fatigue
•poor concentration
•irritability
•muscle tension
•sleep disturbances
How should you communicate someone who is experiencing mild to moderate anxiety?
- ANS•be simple, direct and calm
•identify the persons anxiety and assess it "you look upset"
•encourage the patient to talk about feelings and concerns, use nonverbal language to
demonstrate interest
•focus on the patients concerns, do not introduce irrelevant topics and do ask clarifying
questions "I'm not sure what you mean, can you give me an example?"
•help identify thoughts or feelings before the onset of anxiety and encourage problem
solving. The person may need assistance with this.
•explore behaviors that have worked to relieve anxiety in the past and provide outlets for
dissipating excess energy (walking, exercising)
How you should you communicate with someone with severe to panic levels of anxiety?
- ANS•maintain a calm manner and ALWAYS remain with the person (prevent feelings
of abandonment)
•use clear and simply statements in a low-pitched, slow voice. You may need to repeat
yourself
•move to a quieter environment, decrease stimuli
•reinforce reality if distortions occur, focus on the now and what's happening in the
environment
•safety is an overall goal, attend to physical needs when necessary (warmth,
elimination, pain relief, family contact)
•provide opportunities for movement and exercise (walk/pace with them) but set
physical limits for safety "you may not hit anyone here. If you can't control yourself, we
will help you." Be firm and authoritative.
•assess need for medications (benzodiazepines)
, If a client with a history of anxiety disorders presents with symptoms. What is the priority
intervention? - ANSPerform a physical exam to determine the cause of the clients
systems
*physical problems should be ruled out before determining a psychological cause for a
clients symptoms
What are acting-out behaviors? - ANSaddressing of emotional conflict or stressors by
actions rather than reflecting. A person may lash out in anger verbally or physically to
distract themselves from thoughts or feelings and feel less vulnerable or helpless (a
man tearing up every patient file in a cabinet after he was turned down for a promotion)
What are antihistamines used in the treatment of anxiety? - ANSUsed in the short term
for mild to moderate anxiety, safe to use in adolescents. Non addictive and have a
sedating effect.
Benadryl (diphenhydramine) vistaril (hydroxyzine pamoate) atarax (hydroxyzine
chloride)
SE: dizziness, headache, sedation, dry mouth
What are atypical antidepressants? - ANSbupropion (Wellbutrin) (Zyban):
norepinephrine-dopamine reuptake inhibitor. Can also be used for smoking cessation.
Caution in patients with seizures
trazodone (Desyrel): serotonin antagonist-reuptake inhibitor. Useful for insomnia. Can
cause priapism.
mirtazapine (Remeron): tetracyclic antidepressant. Increases noradrenaline and
serotonin.
What are behaviors that indicate a higher suicide risk? - ANSIsolation, refusal to eat
meals, crying, inability to sleep, expressions of hopelessness, agitation, impulsivity and
aggressiveness
What are benzodiazepines used for the treatment of anxiety? - ANSEnhance the
actions of GABA receptors, producing a depressing/calming effect. Has a rapid onset,
only used for short term management
Ativan (lorazepam) Valium (diazepam) Xanax (alprazolam) Librium (chlordiazepoxide)
SE: sedation, ataxia, decreased cognitive function
What are bipolar spectrum disorders? - ANSBrain disorders that cause unusual shifts in
mood, energy, judgement and the ability to carry out daily tasks. It is a flaw in chemistry,
not character. Characterized by periods of mania or hypomania
for Exam 2 Level 3 (Answered) Latest Version. Graded
A+.
How are anticonvulsants used in the treatment of anxiety? – ANS Usually used in
adjunct to other medications, help relieve the symptoms of anxiety
Valporic acid, gabapentin (neurontin
How are antidepressants used to treat anxiety? - ANSFirst line treatment for anxiety
disorders, secondary benefit of treating co-occurring depressive disorders. SSRIs and
SNRIs preferred over TCAs as they have less side effects
•SSRIs: celexa (citalopram) Lexapro (escitalopram) Prozac (fluoxetine) paxil
(paroxetine) zoloft (sertraline)
•SNRIs: cymbalta (duloxetine) and Effexor (venlafaxine)
•tricyclics: anafranil (clomipramine): for OCD
How are beta blockers used in the treatment of anxiety? – ANS Used for panic
disorders and social anxiety. Decreases heart rate, contractility and blood pressure to
relieve physical symptoms of anxiety
Propranolol (Inderal)
How are beta-blockers used in the treatment of anxiety? – ANS Blocks the hormones
epinephrine/adrenaline. Decrease heart rate, contractility and blood pressure to
decrease somatic feelings of anxiety.
Propranolol (Inderal) and atenolol (Tenormin)
How do biochemical factors effect depression? – ANS Biochemical factors: changes in
the neurotransmitters and the limbic system, hypothalamus, prefrontal cortex,
hippocampus and amygdala. Low serotonin and norepinephrine, and dysfunction in
glutamate, dopamine, GABA and acetylcholine.
*PET scan reveals a less active brain
How do genetics effect depression? – ANS interact with environmental factors, first
degree family members are 2-4 times more likely to develop. Increased risk for
comorbidity (substance abuse) increased risk for occurrence and earlier onset
How do hormone effect depression? – ANS Many depressed patients have increased
levels of cortisol caused by chronic stress
,*depressed individuals display hyperactivity in HPA axis
How do stressful life events effect depression? - ANSEarly life experiences such as
harsh/abusive parenting can make a person more psychologically sensitive to rejection
and stress.
Implications: social separations, job loss, loss of self esteem, death of someone
important, extreme poverty
How is generalized anxiety disorder diagnosed? - ANSAn individuals symptoms must
persist for most days during a 6 month period and have at least three of the following
symptoms:
•restlessness
•fatigue
•poor concentration
•irritability
•muscle tension
•sleep disturbances
How should you communicate someone who is experiencing mild to moderate anxiety?
- ANS•be simple, direct and calm
•identify the persons anxiety and assess it "you look upset"
•encourage the patient to talk about feelings and concerns, use nonverbal language to
demonstrate interest
•focus on the patients concerns, do not introduce irrelevant topics and do ask clarifying
questions "I'm not sure what you mean, can you give me an example?"
•help identify thoughts or feelings before the onset of anxiety and encourage problem
solving. The person may need assistance with this.
•explore behaviors that have worked to relieve anxiety in the past and provide outlets for
dissipating excess energy (walking, exercising)
How you should you communicate with someone with severe to panic levels of anxiety?
- ANS•maintain a calm manner and ALWAYS remain with the person (prevent feelings
of abandonment)
•use clear and simply statements in a low-pitched, slow voice. You may need to repeat
yourself
•move to a quieter environment, decrease stimuli
•reinforce reality if distortions occur, focus on the now and what's happening in the
environment
•safety is an overall goal, attend to physical needs when necessary (warmth,
elimination, pain relief, family contact)
•provide opportunities for movement and exercise (walk/pace with them) but set
physical limits for safety "you may not hit anyone here. If you can't control yourself, we
will help you." Be firm and authoritative.
•assess need for medications (benzodiazepines)
, If a client with a history of anxiety disorders presents with symptoms. What is the priority
intervention? - ANSPerform a physical exam to determine the cause of the clients
systems
*physical problems should be ruled out before determining a psychological cause for a
clients symptoms
What are acting-out behaviors? - ANSaddressing of emotional conflict or stressors by
actions rather than reflecting. A person may lash out in anger verbally or physically to
distract themselves from thoughts or feelings and feel less vulnerable or helpless (a
man tearing up every patient file in a cabinet after he was turned down for a promotion)
What are antihistamines used in the treatment of anxiety? - ANSUsed in the short term
for mild to moderate anxiety, safe to use in adolescents. Non addictive and have a
sedating effect.
Benadryl (diphenhydramine) vistaril (hydroxyzine pamoate) atarax (hydroxyzine
chloride)
SE: dizziness, headache, sedation, dry mouth
What are atypical antidepressants? - ANSbupropion (Wellbutrin) (Zyban):
norepinephrine-dopamine reuptake inhibitor. Can also be used for smoking cessation.
Caution in patients with seizures
trazodone (Desyrel): serotonin antagonist-reuptake inhibitor. Useful for insomnia. Can
cause priapism.
mirtazapine (Remeron): tetracyclic antidepressant. Increases noradrenaline and
serotonin.
What are behaviors that indicate a higher suicide risk? - ANSIsolation, refusal to eat
meals, crying, inability to sleep, expressions of hopelessness, agitation, impulsivity and
aggressiveness
What are benzodiazepines used for the treatment of anxiety? - ANSEnhance the
actions of GABA receptors, producing a depressing/calming effect. Has a rapid onset,
only used for short term management
Ativan (lorazepam) Valium (diazepam) Xanax (alprazolam) Librium (chlordiazepoxide)
SE: sedation, ataxia, decreased cognitive function
What are bipolar spectrum disorders? - ANSBrain disorders that cause unusual shifts in
mood, energy, judgement and the ability to carry out daily tasks. It is a flaw in chemistry,
not character. Characterized by periods of mania or hypomania
