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Psychiatric-Mental Health Nursing 8th Edition Videbeck Test Bank, Exams of Nursing

The Christ College of Nursing and Health SciencesNursing

Psychiatric-Mental Health Nursing 8th Edition Videbeck Test Bank Post-traumatic stress disorder (PTSD) a disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or been confronted with a traumatic event such as a natural disaster, combat, or an assault. Four Subcategories of PTSD 1. reexperiencing the trauma through dreams or recurrent and intrusive thoughts 2. avoidance 3. negative cognition or thoughts 4. hyperarousal Manifestations of PTSD - flashbacks - feels a numbing of general responsiveness - persistent signs of increased arousal - losing a sense of connection and control over life Onset of PTSD

Typology: Exams

2024/2025

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Psychiatric-Mental Health Nursing 8th Edition Videbeck Test Bank
Post-traumatic stress disorder (PTSD)
a disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or
been confronted with a traumatic event such as a natural disaster, combat, or an assault.
Four Subcategories of PTSD
1. reexperiencing the trauma through dreams or recurrent and intrusive thoughts
2. avoidance
3. negative cognition or thoughts
4. hyperarousal
Manifestations of PTSD
- flashbacks
- feels a numbing of general responsiveness
- persistent signs of increased arousal
- losing a sense of connection and control over life
Onset of PTSD
3 months or more after trauma
Treatment of PTSD
- Exposure therapy
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Psychiatric-Mental Health Nursing 8th Edition Videbeck Test Bank

Post-traumatic stress disorder (PTSD) a disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or been confronted with a traumatic event such as a natural disaster, combat, or an assault. Four Subcategories of PTSD

  1. reexperiencing the trauma through dreams or recurrent and intrusive thoughts
  2. avoidance
  3. negative cognition or thoughts
  4. hyperarousal Manifestations of PTSD
  • flashbacks
  • feels a numbing of general responsiveness
  • persistent signs of increased arousal
  • losing a sense of connection and control over life Onset of PTSD 3 months or more after trauma Treatment of PTSD
  • Exposure therapy
  • Adaptive disclosure
  • Cognitive processing therapy
  • SSRI
  • SSNRI Dissociation a subconscious defense mechanism where the person allows the mind to forget or remove itself from the painful memory Dissociative disorders
  • have the essential feature of a disruption in the usually integrated functions of consciousness, memory, identity, or environmental perception
  • interferes with the person's relationships, ability to function in daily life, and ability to cope with the realities of the abusive or traumatic event. Dissociative amnesia
  • the client cannot remember important personal information
  • includes a fugue experience Fugue experience the client suddenly moves to a new geographical location with no memory of past events and often the assumption of a new identity Dissociative Identity Disorder
  • a state of apprehension, uncertainty, or fear resulting from the anticipation of a real or imagined event, situation, or circumstance that we think might be threatening
  • stress response from our thoughts results from emotional process Fear
  • feeling afraid of threatened by a clearly identifiable external stimulus that represents dangers to a person
  • stress response from immediate danger
  • occurs when there is stimulus
  • results from cognitive process Stress
  • brought about by external pressure
  • the wear and tear that life causes on the body Physical Symptoms of Anxiety
  • Tachycardia
  • Hot flushes
  • Diaphoresis
  • Needing to go to the toilet (GI Upset) Psychological Symptoms: CNS
  • Tremors; Pricking sensations
  • Tinnitus
  • Dizziness
  • Headache
  • Aching muscles Psychological Symptoms: Cardiovascular
  • Palpitation
  • Chest Discomfort
  • Awareness of Missed Beats Psychological Symptoms: Genitourinary
  • Frequent or urgent micturition
  • failure of erection
  • menstrual discomfort
  • amenorrhea Psychological Symptoms: GI
  • epigastric discomfort
  • excessive wind (due to air swallowing)
  • frequent or loose bowel movements Psychological Symptoms: Sleep Disturbance
  • Insomnia
  • night terrors

Resistance Stage

  • the flight-or-fight response occurs
  • if the body adapts to the stress, the body responses relax Exhaustion Stage
  • when the body has used up its adaptive energy and can no longer cope with stressors, it breaks down in disease, collapse, or death
  • occurs when the person responds negatively to anxiety and stress
  • body stores are depleted Anxiety Attack an episode of high-degree anxiety accompanied by high-degree response; gradual build-up Panic Attack
  • happens unexpectedly
  • sense of smothering
  • feelings of choking
  • chest pain
  • fear of dying
  • feels of being detached from onself Levels of Anxiety
  1. Mild Anxiety
  2. Moderate Anxiety
  3. Severe Anxiety
  1. Panic Anxiety Mild Anxiety
  • a sensation that something is different and warrants special attention
  • sensory stimulation increases and helps the person act, think, learn, feel, and protect themselves
  • restlessness; fidgeting; GI butterflies; difficulty sleeping; hypersensitivity to noise Moderate Anxiety
  • disturbing feeling that something is definitely wrong
  • person can still process information, solve problems, and learn new things with assistance from others
  • difficulty concentrating independently but can be redirected to the topic
  • increased use of automatisms; muscle tension; diaphoresis; pounding pulse; headache; dry mouth; high voice pitch; faster rate of speech; GI upset; frequent urination Severe Anxiety
  • has trouble thinking and reasoning
  • cannot complete task, solve problems, and learn effectively
  • cries
  • ritualistic behavior
  • severe headache; N/V and diarrhea; trembling; rigid stance; vertigo; pale; tachycardia; chest pain Panic Anxiety
  1. Separation Anxiety Disorder Selective Mutism diagnosed in children when they fail to speak in social situations even though they are able to speak Anxiety disorder due to another medical condition diagnosed when the prominent symptoms of anxiety are judged to result directly from a physiological condition Substance/Medicine-induced anxiety disorder anxiety caused directly by drug abuse, a medication, or exposure to a toxin Separation anxiety disorder excessive anxiety concerning separation from home or from persons the client is attached to Etiology of Anxiety Disorders
  2. Genetic Theories: Family studies; Heritability
  3. Neurochemical Theories: GABA (dysfunctional); Serotonin
  4. Psychodynamic/Psychoanalytic: Freud (Defense Mechanisms); Sullivan and Peplau (Interpersonal Theory); Behavioral Theory Treatment for Anxiety Disorders
  1. Cognitive Behavioral therapy
  • positive reframing
  • decatastrophizing
  • assertiveness training Positive Reframing turning negative messages into positive messages Decatastrophizing involves the therapist's use of questions to more realistically appraise the situation Assertiveness Training helps the person take more control over life situations Panic Disorder composed of discrete episodes of panic attacks, that is, 15-30 minutes of rapid, intense, escalating anxiety in which the person experiences great emotional fear as well as physiological discomfort Treatment of Panic Disorders
  • Cognitive Behavioral therapy
  • Deep breathing and relaxation
  • medications: benzodiazepines; SSRI antidepressants; Tricyclic Antidepressants; Antihypertensives
  • immediate anxiety response
  • recognition that the fear is irrational not required
  • avoidance or extreme distress
  • life-limiting
  • 6 months duration
  • not caused by another disorder Categories of Specific Phobias a. natural environment phobias b. blood-injection phobias c. situational phobias d. animal phobia e. other types of specific phobias natural environment phobias fear of storms, water, heights, or other natural phenomena Astraphobia - fear of thunder and lightning Aquaphobia - fear of water blood-injection phobias fear of seeing one's own or other's blood, traumatic injury, or an invasive medical procedure Dentophobia - fear of the dentist Trypanophobia - fear of injection

situational phobia fear of being in a specific situation such as on a bridge, tunnel, elevator, small room, hospital, or airplane Ablutophobia - fear of washing Claustrophobia - fear of closed spaces animal phobia fear of animals or insects Cynophobia - fear of dogs Ophidiophobia - fear of snakes Entomophobia - fear of insects other types of specific phobias e.g. fear of getting lost while driving Emetophobia - fear of vomiting Globophobia - fear of balloons Coulrophobia - fear of clowns Social Anxiety Disorder (Social Phobia) the person becomes severely anxious to the point of panic or incapacitation when confronting situations involving people

Insomnia

  • dissatisfaction with sleep quality and quantity
  • difficulty falling asleep, maintaining sleep, and/or early-morning wakening with an inability to return to sleep Subtypes of Insomnia Disorder
  1. Inadequate Sleep Hygiene
  2. Psychophysiological insomnia
  3. paradoxical insomnia
  4. idiopathic insomnia
  5. insomnia due to a mental disorder, medical condition, or drug/substance Inadequate Sleep Hygiene
  • engaging in behaviors not conducive to sleep or interfering directly with sleep
  • consuming caffeine or nicotine before bedtime; excessive emotional or physical stimulation just prior to bedtime; daytime naps; wide variations of day sleep-wake routines Psychophysiological Insomnia
  • conditioned arousal associated with the thought of sleep
  • associated with stress and anxiety
  • excessive worry about sleep problems; trying too hard to sleep; rumination; increased muscle tension Paradoxical Insomnia
  • when the person thinks they are awake or are not sleeping even though brain wave activity is consistent with normal sleep
  • due to ruminative worrying that continues into sleep but causes the individual to believe they are awake Idiopathic Insomnia
  • a lifelong inability to obtain adequate sleep
  • a neurologic deficit in the sleep-wake cycle
  • chronic and lifelong Hypersomnolence Disorder
  • excessive sleepiness for at least 1 month that involves either prolonged sleep episodes or daily daytime sleeping that causes significant distress or impairment in functioning
  • major sleep episodes may be 8-12 hours long and there is difficulty in waking up Narcolepsy
  • chronic excessive sleepiness characterized by repeated, irresistible sleep attacks Obstructive Sleep Apnea
  • repeated episodes of upper airway obstruction
  • common in obese individuals Central Sleep Apnea
  • episodic cessation of ventilation without airway obstruction

Parasomnia characterized by abnormal behavioral or psychological events associated with sleep, specific sleep stages, or sleep-wake transition Parasomnia Disorders

  1. Nightmare Disorder
  2. Sleep Terror Disorder
  3. Sleepwalking Disorder
  4. Sleep Disorders related to another mental disorder
  5. Sleep Disorder due to a general medical condition
  6. Substance-induced sleep disorder Nightmare Disorder repeated occurrence of frightening dreams that lead to waking from sleep Sleep Terror Disorder
  • repeated occurrence of abrupt awakenings from sleep associated with a panicky screams or cry
  • have no memory of the dream Sleepwalking Disorder repeated episodes of complex motor behavior initiated during sleep

Treatment Modalities for Sleep Disorders

  1. Pharmacologic
  2. Complementary Therapies
  3. Psychosocial Intervention Pharmacologic Treatment for Sleep Disorders
  4. Benzodiazepines
  • Flurazepam (Dalmane)
  • Temazepam (Restoril)
  1. Non-Benzodiazepines
  • Zolpidem (Ambien)
  • Zaleplon (Sonata)
  1. Antidepressants
  • Trazodone (Desyrel) - increases stage III and IV
  • Nefazodone (Serzone)
  1. Anticonvulsants
  • restless leg syndrome
  • Gabapentin (Neurontin) Complementary Disorders for Sleep Disorders
  • agents derived from dietary supplement Melatonin and plants (valerian and kava-kava)
  • foods like turkey, potatoes, and warm milk
  • have tryptophan (found in milk) that promotes sleep and rest Psychosocial Interventions for Sleep Disorders