Anxiety, Mood, and Cognitive Disorders: Nursing and Treatment Overview

What is a crisis?

A temporary period of difficulty in which normal coping mechanisms fail and anxiety increases.

What are the four levels of anxiety?

Mild, Moderate, Severe, and Panic.

What occurs during Mild Anxiety?

Awareness increases and learning is enhanced.

What occurs during Moderate Anxiety?

Perception begins to narrow and concentration decreases.

What occurs during Severe Anxiety?

Perception is greatly reduced and problem-solving becomes difficult.

What occurs during Panic-Level Anxiety?

The person cannot process information, may lose touch with reality, and cannot function effectively.

What is the nurse's priority during panic-level anxiety?

Remain with the patient and ensure safety.

What is GAD (Generalized Anxiety Disorder)?

Chronic, unrealistic, excessive anxiety and worry lasting at least 6 months.

What are common symptoms of GAD?

Excessive worry, fatigue, insomnia, muscle tension, and poor concentration.

How is GAD treated?

SSRIs, SNRIs, anxiolytics, and therapy.

How do you know anxiety treatment is effective?

The patient reports decreased anxiety and improved daily functioning.

How are beta-blockers used to treat anxiety?

They reduce physical symptoms such as tremors, sweating, and rapid heart rate.

What is a phobia?

A persistent, irrational fear that leads to avoidance behavior.

What is agoraphobia?

Fear of being in open or public places where escape may be difficult.

What is social phobia?

Fear of embarrassment, criticism, or negative evaluation by others.

How are phobias treated?

Therapy, gradual exposure, CBT, and medications when needed.

What is PTSD?

A trauma-related disorder involving re-experiencing a traumatic event through flashbacks, nightmares, and hypervigilance.

What is a hallmark symptom of PTSD?

Re-experiencing the traumatic event.

How is PTSD treated?

CBT, PE, EMDR, group therapy, family therapy, and SSRIs.

What is PE (Prolonged Exposure Therapy)?

A therapy that repeatedly exposes the patient to trauma-related memories in a safe environment.

What is EMDR?

A therapy that helps patients process traumatic memories.

What is OCD?

A disorder involving obsessions and compulsions driven by anxiety.

What is the root problem in OCD?

Anxiety.

What is an obsession?

An intrusive, unwanted thought that causes distress.

What is a compulsion?

A repetitive behavior performed to reduce anxiety.

How is OCD treated?

SSRIs and therapy.

What is Somatic Symptom Disorder?

Multiple physical symptoms that cannot be medically explained and cause distress.

What is Illness Anxiety Disorder?

Preoccupation with having a serious illness despite little evidence of disease.

What is another name for Illness Anxiety Disorder?

Hypochondriasis.

What is Factitious Disorder?

Intentionally producing symptoms to ********************.

What is another name for severe Factitious Disorder?

Munchausen Syndrome.

What is Conversion Disorder?

Psychological stress that presents as neurological symptoms without a medical cause.

What does SSRI stand for?

Selective Serotonin Reuptake Inhibitor.

What SSRIs were emphasized in class?

Citalopram, Escitalopram, Fluoxetine, Paroxetine, and Sertraline.

What are common side effects of SSRIs?

Nausea, headache, insomnia, sexual dysfunction, and weight changes.

What is Serotonin Syndrome?

A potentially life-threatening condition caused by excessive serotonin.

What are symptoms of Serotonin Syndrome?

Agitation, confusion, fever, sweating, tremors, and hyperreflexia.

What is delirium?

An acute and usually reversible disturbance in attention and awareness.

What is dementia?

A progressive decline in memory and cognitive functioning.

What is the biggest difference between delirium and dementia?

Delirium is sudden; dementia is gradual.

Which condition is usually reversible: delirium or dementia?

Delirium.

Which condition develops over hours to days?

Delirium.

Which condition develops over months to years?

Dementia.

What is the nurse's first priority when delirium is suspected?

Identify and treat the underlying cause.

What are common causes of delirium?

Infection, hypoxia, medications, withdrawal, and electrolyte imbalances.

What are priority nursing interventions for delirium?

Safety, reorientation, hydration, and reducing stimuli.

What is the priority nursing concern for dementia?

Safety.

How can safety be maintained in dementia?

Fall precautions, wandering precautions, supervision, and adequate lighting.

What is Alzheimer's Disease?

The most common type of dementia characterized by progressive cognitive decline.

What are early symptoms of Alzheimer's Disease?

Memory loss, misplacing items, and word-finding difficulty.

What are moderate-stage symptoms of Alzheimer's Disease?

Confusion, wandering, agitation, sundowning, and confabulation.

What are late-stage symptoms of Alzheimer's Disease?

Incontinence, inability to communicate, swallowing difficulty, and total dependence.

What is aphasia?

Loss of language ability.

What is apraxia?

Inability to perform learned purposeful movements.

What is confabulation?

Filling memory gaps with fabricated stories.

What medications are used to treat Alzheimer's Disease?

Donepezil, Rivastigmine, and Memantine.

What is Lewy Body Dementia?

A form of dementia characterized by visual hallucinations and Parkinson-like symptoms.

What symptom helps distinguish Lewy Body Dementia from Alzheimer's Disease?

Visual hallucinations.

Why must antipsychotics be used cautiously in Lewy Body Dementia?

Patients are highly sensitive to them.

What is CBT?

A therapy that helps patients identify and change negative thought patterns.

What are common symptoms of depression?

Sadness, hopelessness, fatigue, sleep changes, appetite changes, and loss of interest.

What is anhedonia?

Loss of interest or pleasure in activities.

What is MDD?

Depression lasting at least 2 weeks with impaired functioning.

What are the diagnostic criteria for MDD?

Depressed mood or loss of interest for at least 2 weeks with impaired functioning.

What causes depression?

Genetic, biological, psychological, and environmental factors.

How is MDD treated?

Antidepressants, CBT, psychotherapy, and sometimes ECT.

What is PDD?

Chronic depression lasting at least 2 years.

How is PDD treated?

Antidepressants and psychotherapy.

What is PMDD?

A severe mood disorder related to the menstrual cycle.

How is PMDD treated?

SSRIs and lifestyle modifications.

How is light therapy used for depression?

The patient sits near a light box daily.

How long is light therapy usually used each day?

About 30 minutes daily.

What precautions should be taken with antidepressants?

Monitor for suicidal thoughts, especially when starting treatment.

Should antidepressants be stopped abruptly?

No.

What is the most important assessment for a patient with depression?

Suicide assessment.

What is the strongest predictor of future suicide?

A previous suicide attempt.

What should always be assessed in a suicidal patient?

Thoughts, plan, means, and intent.

What level of observation is required for active suicidal intent?

One-to-one observation.

What are suicide precautions?

Removing harmful objects, close observation, and maintaining safety.

What are common suicide risk factors?

Previous attempts, depression, isolation, substance abuse, chronic illness, and access to firearms.

Does asking about suicide increase suicide risk?

No.

What is therapeutic communication?

Communication that helps patients explore feelings and concerns.

What type of question is most therapeutic?

Open-ended questions.

What is an example of therapeutic communication?

"Tell me more about that."

What is an example of nontherapeutic communication?

"Everything will be okay."

What is the most important rule for mental health NCLEX questions?

Safety first.