Mental Health Challenges: Anxiety, Mood Disorders, and Trauma-Informed Care

Flashcards covering key concepts from lecture notes on anxiety disorders, Peplau's levels of anxiety, OCD interventions, PTSD, mood disorders, depression, bipolar classifications, and trauma-informed care.

According to Peplau's levels of anxiety, what are the primary characteristics and behavioral signs of mild anxiety?

Mild anxiety is associated with daily living tensions, leaves the person alert, and increases their perceptual field, which motivates learning, growth, and creativity. Symptoms include restlessness, irritability, impatience, and tension-relieving behaviors like finger tapping or fidgeting.

How does Peplau characterize severe anxiety, and what level of supervision is required?

Severe anxiety causes a significant reduction in the perceptual field where the person focuses on specific details and blocks out the environment. All activity is directed toward relieving anxiety, and the person suffers an inability to process information or make decisions, requiring much direction and direct supervision.

What severe physiological and behavioral manifestations define the panic level of anxiety according to Peplau?

Panic is marked by a sense of terror, dilated pupils, pallor, unintelligible speech or muteness, severe tremors, hallucinations, extreme withdrawal or out-of-control agitation, a disorganized personality, and an inability to function or follow direction.

What is the key physiological distinction between stress and anxiety as described in the lecture notes?

Stress is a direct physical and mental response to an active situation or threat that releases adrenaline. Anxiety is the reaction to stress that persists after the stressor is gone, characterized by apprehension, fear, and feelings of impending doom.

What are the core diagnostic criteria regarding duration and symptom presentation for Generalized Anxiety Disorder (GAD)?

GAD requires worry that is excessive, persistent, and pervasive for more days than not over a period of at least 6 months, focusing on a variety of life events and activities rather than a single specific stressor.

Why are SSRIs and SSNRIs preferred over benzodiazepines as first-line long-term pharmacological therapy for GAD?

Due to the chronic nature of GAD, benzodiazepines are no longer first-line because of the significant risk of addiction and dependence associated with long-term use.

How are obsessions distinguished from compulsions in Obsessive-Compulsive Disorder (OCD)?

Obsessions are unwanted, intrusive, and persistent thoughts, impulses, or images that cause severe anxiety. Compulsions are repetitive, ritualistic behaviors performed specifically to temporarily relieve or prevent the anxiety caused by obsessions.

What harm reduction strategies should nurses apply for a patient with OCD who exhibits severe handwashing rituals?

Nurses should focus on maintaining skin integrity by removing harsh soaps, using tepid water, and providing gentle guidance to gradually influence the frequency of hand washing without abruptly blocking rituals.

Based on the provided brain diagram, what changes occur in the thalamus and prefrontal cortex in PTSD?

In PTSD, the thalamus shows decreased cerebral blood flow, while the prefrontal cortex exhibits decreased gray and white matter density and decreased responsiveness to trauma and emotional stimuli.

How does Acute Stress Disorder differ from PTSD in terms of symptom onset, duration, and clinical features?

Acute Stress Disorder symptoms emerge 2 to 4 days after trauma and last up to 1 month (versus longer in PTSD). ASD also explicitly incorporates dissociative symptoms such as depersonalization and dissociative amnesia.

What are the six emergency nursing care steps when managing a patient experiencing an active panic attack?

1. Stay with the patient.

2. Reassure them you will not leave.

3. Give clear directions.

4. Walk or pace with the patient in a low-stimulation environment.

5. Administer PRN anxiolytic medications.

6. Allow the patient to vent feelings after the attack resolves.

What diagnostic assessment mnemonic is commonly used for Major Depressive Disorder, and what does each letter represent?

SIGECAPS: S - Sleep I - Interest G - Guilt E - Energy C - Concentration A - Appetite P - Psychomotor activity S - Suicidal thoughts

What are the three implementation phases of depression treatment and their respective timeframes?

1. Acute phase (6 to 12 weeks)

2. Continuation phase (4 to 9 months)

3. Maintenance phase (1 year or more)

What clinical manifestations signal Serotonin Syndrome, and what immediate medical interventions are required?

Symptoms include hyperactivity, tachycardia, hyperpyrexia, elevated BP, delirium, seizures, myoclonus, and muscle rigidity. Interventions include removing offending agents, supportive care (cooling blankets, artificial ventilation), and administering serotonin receptor antagonists such as cyproheptadine.

What is the therapeutic blood level range for Lithium carbonate, and at what concentration is it considered toxic?

The therapeutic blood level for Lithium carbonate is $0.6\text{ to }1.2\,\text{mEq/L}$. Toxicity is indicated at levels of $1.5\,\text{mEq/L}$ and above.

What are the main clinical differences between Bipolar I disorder and Bipolar II disorder regarding manic episodes and psychosis?

Bipolar I requires at least one full manic episode lasting at least 1 week, represents a psychiatric emergency, and may include psychosis. Bipolar II requires at least one hypomanic episode lasting at least 4 days, does not involve psychosis, and rarely requires hospitalization.

What are the duration requirements for diagnosing Cyclothymic Disorder in adults compared to children?

Cyclothymic Disorder requires alternating hypomanic symptoms and mild-to-moderate depressive symptoms for at least 2 years in adults and 1 year in children.

According to the ACE study chart, what percentage of the 17,000 participants experienced at least one Adverse Childhood Experience?

64% of participants experienced at least 1 ACE (26% had 1 ACE, 16% had 2 ACEs, 9.5% had 3 ACEs, and 12.4% had 4+ ACEs).

What specific health risks are multiplied for an individual with an Adverse Childhood Experience (ACE) score of 4 or higher?

An ACE score of 4 or higher makes an individual 2 times as likely to smoke, 12 times as likely to attempt suicide, 7 times as likely to suffer from alcoholism, and 10 times as likely to inject street drugs.

In Trauma-Informed Care, how does putting on 'trauma glasses' reframe behaviors categorized as 'resistant' or 'attention seeking'?

'Resistant' behavior is reframed as mistrust due to a history of being hurt or fear of losing progress. 'Attention seeking' behavior is reframed as feeling disconnected, unheard, or alone, and actively searching for connection.