Psych-Nursing Anxiety – Flashcards
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A universal human experience and most basic of emotions; sense of psychological distress
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Anxiety
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a reaction to a specific danger
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Fear
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Normal anxiety is a _______ condition. It can be motivating and drives people to make or survive change (e.g. job interviews, studying for an exam, preparing for a presentation, etc.)
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healthy
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Greater than expected intensity of normal anxiety.
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Abnormal Anxiety
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prevents fulfillment of professional, personal, and social roles
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Abnormal anxiety
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Accompanied by flashbacks, obsessions, or compulsions
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Abnormal anxiety
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curtails daily or social activities
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Abnormal anxiety
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lasts longer than expected given the participating stress.
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Abnormal anxiety
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occurs in normal experience of every day living, allows an individual to perceive reality in sharp focus.
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Mild anxiety
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A person with a _____ level of anxiety: hears and grasps more information, Problem solving more effective.
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mild
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Physical symptoms of ____ _______: slight discomfort, restlessness, irritability, or mild tension relieving behaviors.
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mild anxiety
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increased anxiety where some details excluded
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moderate anxiety
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_________ anxiety: sees and hears less information and may demonstrate selective hearing
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moderate
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physical symptoms of _______ anxiety: tension, pounding heart, increased pulse and respiratory rate, perspiration, and mild somatic symptoms.
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moderate
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most extreme level of anxiety and results in markedly disturbed behavior
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Panic
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_____ may be manifested as pacing, running, shouting, screaming, or withdrawal. May have hallucinations or false sensory perceptions. May be erratic, uncoordinated, or impulsive.
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Panic
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Anxiety disorders are the most ______ form of psychiatric disorder for children and adults.
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common
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In the U.S., approximately __ million adults are affected by anxiety disorders
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40
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__% of youth experience an anxiety disorder
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20
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possible etiology of anxiety disorder that has been passed down to you
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genetic
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etiology; not enough GABA or repeated trauma can alter release of neurotransmission and anatomy of brain; hyperactivity of limbic regions of brain (amygdala)
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neurobiological
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psychological theory; anxiety is learned
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behavioral theories
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psychological theory; anxiety caused by distortions of individuals thoughts and perceptions
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cognitive theories
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Generalized Anxiety Disorder is characterized by chronic and excessive anxiety more days than not for at least __ months
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6
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symptoms of _______ _________ ________: restlessness, fatigue, poor concentration, irritability, tension, sleep disturbance, interferes with daily activity
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Generalized Anxiety Disorder
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a persistent, irrational fear of a specific object, activity, or situation that does not pose a significant danger
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phobia
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excessive fear of being alone or in a public place from which escape may be difficult or help would be unavailable in event of becoming disabled
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agoraphobia
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persistent and irrational fear of and compelling desire to avoid a circumstance or thing other than agoraphobia such as dogs, spiders, heights, storms, water, blood, closed spaces, tunnels, or bridges
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specific phobia
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a persistent irrational fear of and compelling desire to avoid situations in which people may be exposed to strangers or to scrutiny from others
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social phobia
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sudden onset of extreme apprehension or fear, usually associated with feelings of impending doom.
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panic attack
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physical symptoms of ________ _______: chest pain, smothering sensation, choking, breathing difficulty, dizziness, breathing difficulty, dizziness, palpitations, sweating, chills or hot flashes
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panic attacks
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recurrent, unexpected panic attacks that cause affected clients to worry persistently about recurrences or complications
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panic disorder
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panic disorder: Behavior changes in response to the attacks for at least (#) _____
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1 month
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recurrent, intrusive, and persistent ideas, thought, images, or impulses despite efforts to ignore them
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obsessions
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ritualistic behaviors an individual feels compelled to perform in an attempt to reduce anxiety
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compulsions
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person must contain obsessions and/or compulsions
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OCD
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person knows the obsessions/compulsions are excessive and unreasonable
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OCD
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The obsessive/compulsion can cause increased distress and is time consuming (more than 1hr/day)
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OCD
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Acute, chronic, and delayed PTSD. (differ in timing, duration, and degree of impairment)
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Stress disorders
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generally associated with traumatic experiences (war, natural disasters, rape, accidents)
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stress disorders
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occurs within 1 month after exposure to highly traumatic event and usually resolves within 4 weeks
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acute stress disorder
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acute stress disorder usually resolves within __ ______
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4 weeks
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symptoms of ____ _____ ______: dissociation (detached), poor memory of events surrounding trauma
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acute stress disorder
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symptoms of ASD continue more than 1 month and accompanied by functional impairment or stress
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PTSD
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Symptoms of _____: Generalized anxiety, intrusive thoughts or image of trauma, flashbacks, nightmares/sleep disturbances, difficulty concentrating, irritability, avoidance
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PTSD
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duration less than 3 months
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acute PTSD
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duration 3 months or more
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chronic PTSD
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onset of symptoms at least 6 months after stress
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delayed PTSD
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develop with use or within 1 month of stopping use of substance
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substance induced anxiety
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anxiety due to a _______ _________: result of a medical condition (heart condition or thyroid)
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medical condition
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does not inhibit problem but does not meet criteria for a disorder
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Anxiety D/O NOS
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essential to determine whether the anxiety is secondary to another source (medical condition) or primary problem as anxiety disorder
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treatment
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based on theory of recognizing thoughts that produce and maintain anxiety and use techniques to alter those thoughts
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Cognitive-behavioral therapy
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conditioning technique by which client learns to replace gradually a panic response with a relaxation response (progressively confront an object of fear in small steps)
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systematic desensitization
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involves exposure to feared object or situation..flooding...person is exposed to anxiety provoking stimulus as long as 1 to 2 hours
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exposure treatment
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SSRIs; pharmacologic method of treatment
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antidepressant
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SNRIs; pharmacologic method of treatment
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antidepressant
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Tricyclics; pharmacologic method of treatment
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antidepressant
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MAOIs; pharmacologic method of treatment
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antidepressant
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benzos; pharmacologic method of treatment
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antianxiety drugs
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nonbenzos (nonaddictive); pharmacologic method of treatment
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antianxiety drugs
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________ _______ of treatment: antihistamines
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pharmacologic method
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________ _______ of treatment: B-blockers
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pharmacologic method
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________ _______ of treatment: anticonvulsants
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pharmacologic method
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Citalopram (Celexa)
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SSRI
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Escitalopram (Lexapro)
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SSRI
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Fluoxetine (Prozac)
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SSRI
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Fluvoxamine (Luvox)
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SSRI
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Paroxetine (Paxil)
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SSRI
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Sertraline (Zoloft)
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SSRI
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Vilazadone (Viibryd)
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SSRI
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Duloxetine (Cymbalta)
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SNRI
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Venlafaxine (Effexor)
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SNRI
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amitriptyline (Elavil)
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Tricyclic antidepressant
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clomipramine (anafranil)
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Tricyclic antidepressant
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desipramine (norpramin)
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Tricyclic antidepressant
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doxepin (Adapin, Sinequan)
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Tricyclic antidepressant
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imipramine (Tofranil)
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Tricyclic antidepressant
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Norttriptyline (Aventyl, Pamelor)
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Tricyclic antidepressant
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Phenelzine (Nardil)
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MAOI
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Tranylcypromine (Parnate)
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MAOI
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alaprazolam (Xanax)
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benzo
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chlordiazepoxide (librium)
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benzo
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clonasepam (Klonopin)
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benzo
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diazepam (Valium)
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benzo
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lorazepam (Ativan)
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benzo
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Oxazepam (Serax)
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benzo
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Buspirone (Buspar)
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nonbenzo
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hydroxyzine hydrochloride (Atarax)
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antihistamine
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hydroxyzine pamoate (Visatril)
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antihistamine
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atentolol (Tenormin)
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beta blockers
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Proranolol (Inderal)
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beta blockers
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carbamazepine (Tegretol)
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anticonvulsant
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carbamazepine (Neurontin)
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anticonvulsant
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Valporic acid (Depakote)
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anticonvulsant
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Ex) Anxiety, Ineffective coping, social isolation, disturbed thought process, post-trauma syndrome, insomnia, fatigue, self-care defecit
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anxiety nursing diagnoses
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Mild to Moderate Anxiety: Reducing anxiety level and preventing escalation to more distressing level can be aided by providing a calm ________, recognizing the anxious person's distress, and being willing to _________
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presence, listen
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Severe to Panic Levels: Person with severe to panic levels of anxiety may be _______ to solve problems and may have a poor grasp of what is happening in the environment.
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unable
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Nursing interventions may include: ______ needs (fluids, rest), ______ environment, and possibly use of medications
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physical, quiet
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Interventions : Promotion of ____ _____activities: Nutrition and fluid intake, personal hygiene and grooming, elimination, sleep
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self-care
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counseling, Milieu therapy , promotion of self-care, pharmacologic methods
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Interventions
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herbal and complementary therapy (Ex. Kava Kava, Valerian Root)
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integrative therapy
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Problems that occur with psychotropic herbs include their _____ side effects and herb-drug interactions
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toxic
