MIDTERM ASSIGNMENT#1 I.

DEFINE THE FOLLOWING: ANXIETY- a vague feeling of dread or apprehension; it is a response to external or internal stimuli that can have behavioral, emotional, cognitive and physical symptoms. FEAR- feeling afraid or threatened by a clearly identifiable, external stimulus that represents danger to the person. STRESS- the wear and tear that life causes on the body. OBSESSIONS- recurrent, persistent, intrusive, and unwanted thoughts, images or impulses that cause marked anxiety and interfere with interpersonal, social or occupational function. ANXIOLYTIC DRUGS- used to treat anxiety and anxiety disorders, insomnia, OCD, depression, posttraumatic, stress disorder and alcohol withdrawal. ANXIETY DISORDERS- a group of conditions that share a key feature of excessive anxiety, with ensuring behavioral, emotional, cognitive and physiologic responses. II. HOW IS NORMAL ANXIETY DIFFERENTIATED FROM ABNORMAL ANXIETY
Everyone feels anxiety at some point in their lives. Whether it's a case of nerves over giving a speech or panicky feelings before taking a test in college, anxiety is a normal emotion. Many people, however, suffer from an anxiety disorder which makes these feelings much more common in their lives. Abnormal anxiety interferes with daily living and may cause you to avoid certain situations because you are too upset or nervous about them. Learning the difference between normal and abnormal anxiety is the first step toward overcoming your fears.

III.

IDENTIFY LEVELS OF ANXIETY & DESCRIBE AS TO PHYSICAL/BEHAVIORAL COGNITIVE & EMOTIONAL SYMPTOMS: ANXIETY LEVEL MILD PSYCHOLOGICAL RESPONSES Wide perceptual field Sharpened Senses Increased motivation Effective problem solving Increased learning ability Irritability MODERATE Perceptual field narrowed to immediate task Selectively attentive Cannot connect thoughts or events independently Increased use of automatisms Muscle tension Diaphoresis Pounding pulse Headache Dry mouth High voice pitch Faster rate of speech PHYSIOLOGIC RESPONSES Restlessness Fidgeting GI butterflies Difficulty Sleeping Hypersensitivity to noise.

GI upset Frequent Urination SEVERE Perceptual field reduced to one Severe headache detail or scattered details Nausea, vomiting, and diarrhea Cannot complete tasks Trembling Cannot solve problems or learn Rigid stance effectively Vertigo Behavior geared toward anxiety relief and is usually Pale ineffective Tachycardia Doesnt respond to redirection Chest pain Feels awe, dread or horror Cries Ritualistic behavior PANIC Perceptual field reduced to focus on self Cannot process any environmental stimuli May bolt and run OR Totally immobile and mute Dilated pupils Increased blood pressure and

Distorted perceptions Loss of rational thought Doesnt recognize potential danger Cant communicate verbally Possible delusions and hallucination May be suicidal

pulse Flight, Fight or Freeze

The four levels of anxiety are mild anxiety (helps people learn, grow and change.) moderate anxiety (increases focus on the alarm; learning is still possible) severe anxiety (greatly decreases cognitive function, increases preparation for physical responses, increase space needs.) and panic (fight, flight, or freeze response; no learning is possible, the person is attempting to free him or herself from the discomfort of this high stage of anxiety.
IV.

WHAT FEATURES ARE COMMON TO ANXIETY DISORDERS. Avoidance Anxious Thinking Intolerance of Uncertainty Need for control

 Safety Behaviors and Rituals

WHAT FEATURES ARE UNIQUE TO EACH? Agoraphobia Panic Disorder Social Phobia Obsessive-Compulsive Disorder Generalized Anxiety Disorder Acute Stress Disorder

Posttraumatic stress disorder

VI.

DISCUSS THE NEUROBIOLOGIC UNDERPININGS OF THE ANXIETY DISORDERS.

Anxiety disorders are diagnosed when anxiety no longer functions as a signal of danger or a motivation for needed change but becomes chronic and permeates major portions of the persons life, resulting in maladaptive behaviors and emotional disability. Anxiety disorders have many manifestations but anxiety is the key feature of each. Types of anxiety disorders include the following: Agoraphobia with or without panic disorder, panic disorder, specific phobia, social phobia, OCD, Generalized anxiety disorder (GAD), Acute stress disorder, Posttraumatic stress disorder.

Anxiety disorders have the highest prevalence rates of all mental disorders in the United States. Nearly one in four adults in the United States is affected, and the magnitude of anxiety disorders in young people is similar. Anxiety disorders are more prevalent in women, people younger than age 45 years, people who are divorced or separated and people of lower economic status. The exception of OCD, which is equally prevalent in men and women but is more common among boys than girls.
VII. DISCUSS

BIOPSYCHOSOCIAL TREATMENT APPROACHES USED FOR PATIENTS WITH ANXIETY DISORDERS.

Treatment for anxiety disorders usually involves medication and therapy. Cognitive behavioral therapy is used successfully to treat anxiety disorders. Positive reframing means turning negative messages into positive messages. The therapist teaches the person to create positive messages for use during panic episodes. Decatastrophizing involves the therapists use of questions to more realistically appraise the situation. Assertiveness training helps the person take more control over life situations. Techniques help the person take more control over life situations. Techniques help the person negotiate interpersonal situations and foster self assurance. They involve using I statements to identify feelings and to communicate concerns or needs to others. VIII. GIVE NURSING INTERVENTIONS USED IN PATIENT WITH ANXIETY DISORDERS. -Remain with the client at all times when levels of anxiety are high (severe or panic). -Move the client to a quiet area with minimal or decreased stimuli such as small room or seclusion area. -Remain calm in your approach to the client.

-Use short, simple and clear statements. -Avoid asking or forcing the client to make choices. -PRN medications may be indicated for high levels of anxiety, delusions ,disorganized thoughts and so forth. -Be aware of your own feelings and level of discomfort. -Encourage the clients participation in relaxation exercises such as deep breathing, progressive muscle relaxation, meditation and imagining being in a quiet, peaceful place. -Teach the client to use relaxation techniques independently. -Help the client see that mild anxiety can be a positive catalyst for change and does not need to be avoided.