Health and healing week 3

What is anxiety?

An unpleasant feeling of apprehension, uneasiness, uncertainty, or dread from a real or perceived threat.

What is fear?

A reaction to a specific danger.

What is normal anxiety?

Anxiety that is necessary for survival and can occur during everyday life.

How can anxiety disorders affect functioning?

They can interfere with social, occupational, and personal functioning.

What are the four levels of anxiety?

Mild, moderate, severe, and panic.

What characterizes mild anxiety?

Sharp focus, effective problem-solving, and the ability to take in information.

What physical symptoms may occur with mild anxiety?

Restlessness, irritability, finger tapping, fidgeting, and nail biting.

What characterizes moderate anxiety?

A narrowed perceptual field, selective inattention, and reduced learning and problem-solving ability.

What physical symptoms may occur with moderate anxiety?

Pounding heart, increased heart and respiratory rates, shaking, sweating, dry mouth, and stomach pain.

What characterizes severe anxiety?

A greatly reduced perceptual field and an inability to think clearly, learn, or problem-solve.

What physical symptoms may occur with severe anxiety?

Headache, nausea, dizziness, insomnia, trembling, hyperventilation, and a sense of impending doom.

What characterizes panic-level anxiety?

Severely disturbed behaviour, inability to process the environment, and possible loss of contact with reality.

What behaviours may occur during panic?

Pacing, running, shouting, screaming, withdrawal, and erratic or impulsive actions.

What are coping strategies?

Actions or thought processes used to address stress or change one's reaction to it.

What is adaptive coping?

Helpful coping, such as counselling, mindfulness, exercise, relaxation, or breathing exercises.

What is maladaptive coping?

Unhelpful coping, such as avoidance, withdrawal, disengagement, or substance misuse.

Why is nurse self-awareness important when caring for an anxious patient?

Anxiety can be contagious, so nurses need to recognize and manage their own anxiety.

What is panic disorder?

A disorder involving frequent, unexpected panic attacks with sudden intense fear or discomfort.

What are common symptoms of a panic attack?

Intense fear, impending doom, palpitations, chest pain, breathing difficulties, nausea, chills, and hot flashes.

How long do panic attacks typically last?

They are extremely intense, last minutes, and then subside.

What is a phobia?

A persistent, irrational fear of a specific object, activity, or situation that leads to avoidance.

What characterizes a specific phobia?

Intense fear that impairs daily functioning and lasts at least six months.

What is acrophobia?

Fear of heights.

What is agoraphobia?

Fear of open spaces.

What is claustrophobia?

Fear of closed spaces.

What is hematophobia?

Fear of blood.

What is monophobia?

Fear of being alone.

What is mysophobia?

Fear of germs or dirt.

What is social phobia?

Fear of social or performance situations.

What is generalized anxiety disorder (GAD)?

Excessive, ongoing worry that is difficult to control and interferes with daily activities.

What are common symptoms of GAD?

Restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbances.

What is substance-induced anxiety?

Anxiety symptoms that develop during substance use or within a month of discontinuing a substance.

What is anxiety due to a medical condition?

Anxiety that results directly from a medical condition.

What medical conditions can cause symptoms similar to anxiety?

Heart conditions, lung conditions, hyperthyroidism, pulmonary embolism, and cardiac dysrhythmias.

How can nutritional deficiencies contribute to anxiety?

Deficiencies such as low B12 or magnesium may contribute to anxiety-related symptoms.

What is obsessive-compulsive disorder (OCD)?

A disorder involving unwanted, distressing obsessions and repetitive compulsions.

What are obsessions?

Repeated unwanted thoughts, urges, or images that cause distress or anxiety.

What are compulsions?

Repetitive behaviours or mental acts performed to reduce anxiety or prevent something bad from happening.

What is the purpose of a compulsion?

To temporarily reduce anxiety related to an obsession.

What are common obsessions in OCD?

Fear of contamination, harm, losing control, imperfection, and unwanted sexual or religious thoughts.

What are common compulsions in OCD?

Repeated washing, checking, counting, praying, and arranging objects.

What is post-traumatic stress disorder (PTSD)?

A condition that can develop after a traumatic event involving severe emotional distress.

What are the major features of PTSD?

Re-experiencing trauma, avoidance, emotional numbing, and increased arousal.

What is a flashback?

A dissociative experience in which a person relives a traumatic event as though it is happening now.

What are examples of increased arousal in PTSD?

Irritability, sleep difficulties, poor concentration, hypervigilance, and an exaggerated startle response.

What biological factors may contribute to anxiety disorders?

Genetics and changes in neurotransmitters and brain functioning.

What environmental factors may contribute to anxiety disorders?

Trauma, major life events, and learning anxious behaviours from others.

What sociocultural factors may contribute to anxiety disorders?

Family circumstances, culture, religious upbringing, bullying, rejection, trauma, and abuse.

What should be assessed when a patient presents with anxiety?

Physical and neurological health, substance use, anxiety level, suicide risk, and psychosocial stressors.

Why is it important to assess substance use in a patient with anxiety?

Substances, medications, alcohol, nicotine, and caffeine may contribute to symptoms.

What should nurses assess regarding anxiety-related safety?

The patient's potential for self-harm or suicide.

What are nursing interventions for mild to moderate anxiety?

Use open-ended questions, listen, provide a calm presence, and acknowledge the patient's distress.

What are nursing interventions for severe anxiety or panic?

Prioritize safety, meet physical needs, prevent exhaustion, minimize stimulation, and consider PRN or STAT medication as appropriate.

What other interventions can help manage anxiety?

Teach coping skills, provide education, refer to support groups, and reinforce the patient's strengths.

What medications may be used for anxiety disorders?

Antidepressants, benzodiazepines, beta blockers, anticonvulsants, and antihistamines.

Why are benzodiazepines generally used short term?

They act quickly but can cause dependence.

What should be evaluated when reviewing progress in anxiety treatment?

Safety, anxiety level, symptom recognition, coping skills, self-care, relationships, and usual roles.

What is depression?

A mood disorder that can significantly affect daily functioning, relationships, work, and school.

What is a major depressive disorder (MDD) episode associated with?

Depressed mood or loss of interest or pleasure, along with other symptoms that impair functioning.

What is anhedonia?

Loss of the ability to experience pleasure.

What are common symptoms of major depressive disorder?

Depressed mood, loss of interest, weight changes, sleep changes, fatigue, guilt, poor concentration, and suicidal thoughts.

What physical symptoms may occur with depression?

Headaches, back pain, weakness, appetite changes, constipation, dehydration, and changes in sexual interest.

What are the diagnostic symptom requirements for MDD in the PowerPoint?

Five or more symptoms during the same two-week period, including depressed mood or loss of interest or pleasure, with significant distress or impairment.

What must be considered before diagnosing MDD?

Whether symptoms are due to a substance or medical condition and whether manic episodes are present.

What are risk factors for depression?

Female gender, childhood trauma, stressful life events, family history, neuroticism, other disorders, and chronic medical conditions.

What psychiatric disorders may co-occur with depression?

Schizophrenia, substance use disorders, eating disorders, anxiety disorders, and personality disorders.

What biological factors may contribute to depression?

Genetics, neurotransmitter dysregulation, hormonal changes, and HPA-axis hyperactivity.

Which neurotransmitters are associated with depression in the PowerPoint?

Serotonin, norepinephrine, and dopamine.

What role does serotonin play?

It contributes to mood regulation and several bodily functions, including sleep and digestion.

What role does norepinephrine play?

It helps maintain alertness and focus.

What role does dopamine play?

It contributes to pleasure, satisfaction, motivation, memory, mood, and movement.

What should be assessed when a patient has depression?

Risk of harm, medical and neurological conditions, substance use, psychiatric history, past treatment, triggers, and support systems.

What areas should be assessed in the mental status assessment of a depressed patient?

Affect, thought processes, mood, feelings, cognition, behaviour, communication, spirituality, insight, judgment, suicidal thoughts, and relationships.

What are common physiological assessment findings in depression?

Changes in appetite and weight, sleep disturbances, reduced sexual interest, poor hygiene, constipation, dehydration, and physical complaints.

What are the three phases of depression treatment and recovery?

Acute, continuation, and maintenance.

What is the acute phase of depression treatment?

Usually 6–12 weeks, focused on reducing symptoms and restoring functioning.

What is the continuation phase of depression treatment?

Usually 4–9 months, focused on preventing relapse.

What is the maintenance phase of depression treatment?

One year or longer, focused on preventing recurrence.

What is the recovery model?

An approach that emphasizes hope, personal strengths, partnership, and patient-defined goals.

What is cognitive behavioural therapy (CBT)?

Therapy that addresses connections between thoughts, feelings, and behaviours and teaches people to reframe negative thinking.

What is interpersonal psychotherapy (IPT)?

Therapy that focuses on dysfunctional interpersonal relationships that contribute to or maintain depression.

What treatments may be used for depression?

CBT, psychotherapy, interpersonal therapy, group therapy, light therapy, lifestyle changes, antidepressants, and ECT.

When may hospitalization be needed for depression?

When functioning is severely impaired or the patient is suicidal.

What is electroconvulsive therapy (ECT)?

A treatment that induces a brief seizure under general anesthesia and muscle relaxation.

What are possible side effects of ECT?

Temporary confusion and memory impairment.

When may ECT be indicated?

Acute suicidality, psychotic features, catatonia, severe agitation or stupor, poor medication response, or life-threatening refusal of food or fluids.

What consent is required for ECT according to the PowerPoint?

Consent is required, with new consent signed for each course of treatment.

What are the main classes of antidepressants?

SSRIs, norepinephrine reuptake inhibitors, SNRIs, atypical antidepressants, tricyclic antidepressants, and MAOIs.

What are SSRIs?

Selective serotonin reuptake inhibitors that block neuronal reuptake of serotonin.

Why are SSRIs commonly recommended?

They are a recommended first-line treatment and have a lower incidence of anticholinergic side effects and less cardiotoxicity than some alternatives.

Why is close suicide assessment important when starting antidepressants?

Energy may increase before mood improves, potentially giving the patient more ability to act on suicidal plans.

What is serotonin syndrome?

A potentially life-threatening reaction involving excessive serotonin activity.

What are symptoms of serotonin syndrome?

Restlessness, tachycardia, fever, high blood pressure, altered mental status, mood changes, seizures, muscle rigidity, and gastrointestinal symptoms.

What are key interventions for serotonin syndrome listed in the PowerPoint?

Remove offending agents and initiate appropriate symptomatic treatment and supportive care.

What should be monitored when evaluating depression treatment?

Suicidal ideation, sleep, hygiene, self-esteem, social interaction, mood, and outlook on life.

What is an important medication safety consideration for a suicidal patient?

Ensure the patient swallows medication; if treated in the community, the PowerPoint recommends no more than a one-week medication supply.