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NURS 661 Exam 1 Maryville Mega Deck – Q&A
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NURS 661 Exam 1 Maryville Mega Deck – Q&ARespiratory Panicogens: ✔️Ans -carbon dioxide, sodium lactate, bicarbonate.
Psychosocial theories r/t panic disorder: ✔️Ans -unsuccessful defense against
anxiety-provoking impulses = physiological response.
Higher incidence of stressful life events: abuse, & separation anxiety.
Panic disorder & the brain ✔️Ans -neurotransmitters; serotonin,
norepinephrine and GABA.
Increased sympathetic tone in the PNS including CNS.
Post-synaptic serotonin hypersensitivity; local inhibitory GABA transmission
to amygdala, midbrain and hypothalamus.
Anxiogenic effects of yohimbine, exaggerated MHPG cortisol and
cardiovascular responses.
first-degree relatives of patients with panic disorder ✔️Ans -have a four- to
eight-fold higher risk for panic disorder than first-degree relatives of other
psychiatric patients.
Recurrent unexpected panic attacks: abrupt surge of intense fear or intense
discomfort that reaches a peak within minutes and during which time 4 or
more of the follow occur ✔️Ans -Palpitations, pounding heart or elevated HR
Sweating
Trembling or shaking
Sensation of SOB or smothering
Feelings of choking
Chest pain or discomfort
Nausea or abdominal distress
Dizzy, unsteady, light-headed or faint
Chills or heat sensation
Paresthesia (numbness or tingling)
Derealization (feelings of unreality) or depersonalization (being detached
from one's self)
,Fear of losing control or going crazy
Fear of dying
Culture specific: tinnitus, neck soreness, headache, uncontrollable screaming
or crying. shouldn't count as one of the four
At least one of the panic attacks has been followed by 1 mo or more of the
following: ✔️Ans -Persistent concern or worry about another panic attack or
consequences like losing control
Significant maladaptive change in behavior as a results of attack: avoidance of
perceived stimulus
Disturbance not better explained by another mental disorders: social anxiety,
phobia, OCD, separation
Separation anxiety disorder:
Bowlby's theory of anxiety: ✔️Ans -child's sense of distress during separation
is perceived and experienced as anxiety and is prototype of anxiety. Mother's
ability to relieve fear is fundamental to attack with child.
Tearfulness and/or irritability; emerges and peeks usually around 9-18 mo
old, generally disappears by 3rd year . Crying is the primary signal.
Separation anxiety disorder:
symptoms ✔️Ans -Higher than average resting heart rate, higher morning
cortisol, low heart rate variability.
Separation anxiety disorder:
with children- ✔️Ans -highly comorbid with GAD and social anxiety disorder.
30% have all three
60% having one will have one of the others.
,15% of children display intense persistent fear, shyness and social withdrawal
when faced with unfamiliar settings and people.
Separation anxiety disorder: ✔️Ans -a childhood disorder marked by
excessive anxiety, even panic, whenever the child is separated from home or
parent.
Separation anxiety disorder:
DSM-V: ✔️Ans -a level of fear or anxiety regarding separation from parents or
primary caregiver which is beyond developmental expectations.
At least 3 sx of excessive worry for at least 4 weeks: refusal to attend school,
repeated physical complaints (headaches, stomach aches) with anticipated
separation, nightmares related to separation.
DSM-V: Separation Anxiety is a developmentally inappropriate or excessive
fear or anxiety concerning separation for those to whom the individual is
attached:
a. 3 of the following: ✔️Ans -1. recurrent excessive distress when anticipation
or experiencing separation from home or major attachment figures.
2. persistent excessive worry about losing, harm to them, injury, disasters or
death to major attachment figures
3. persistent excessive worry about an untoward event to person that will
separate them from major attachment figure (MAF): get lost, kidnapped,
accident become ill
4. Persistent reluctance nor refusal to go out, away from home, to school,
work, elsewhere: fear of separation.
5. Persistent excessive fear or reluctance to be alone or without MAF at home
or in other settings
6. Persistent excessive reluctance to sleep away from home
7. Repeated nightmares about separation.
, 8. Repeated physical symptoms when separated from MAF: headaches,
stomachaches, N/V.
MAF ✔️Ans -major attachment figure in separation anxiety.
Separation anxiety DSM-V additional criteria ✔️Ans -A. The fear, anxiety, or
avoidance is persistent lasting at least 4 weeks in children and 6 mo in adults
B. Causes clinically significant impairment in social academic, occupational, or
other important area of functioning
C. Not better explained by other mental disorder: austism, delusions,
hallucinations, agoraphobia, GAD, having an illness anxiety disorder. .
Generalized anxiety disorder is characterized ✔️Ans -by a pattern of frequent,
persistent worry and anxiety that is out of proportion to the impact of the
event or circumstance that is the focus of the worry.
The distinction between generalized anxiety disorder and normal anxiety is
emphasized by the use of the word "excessive" in the criteria and by the
specification that the symptoms cause significant impairment or distress.
Has the oldest median age of onset.
GAD
most often coexists with other mental disorder: ✔️Ans -Usually social or
specific phobia, panic or depressive disorder
50-75% have another mental disorder.
Percentage of anxiety patients with GAD ✔️Ans -25 %
Usually late adolescence/early adult onset, but oldest median age onset.
Parts of the brain affected by GAD ✔️Ans -basal ganglia, limbic system, frontal
cortex.
Occipital lobe has the highest concentration of benzo receptors.
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