NSG 221 Exam 3 - Questions and Answers Kindling Definition A process by which seizure activity in the brain is initially stimulated by the cumulative
... [Show More] effects of stress, low amounts of electrical impulses, or chemicals that sensitize the neuronal pathways Clients taking MAOIs and who eat foods containing tyramine risk experiencing a BLANK, which is potentially fatal BLANK: hypertensive crisis An individual experiencing mania can exhibit rapidly changing emotions, also known as: Liable What is the term that refers to having thoughts of killing oneself? Suicidal Idiation Mild Anxiety Definition Mild anxiety is a sensation that something is different and warrants special attention. Sensory stimulation increases and helps the person focus attention to learn, solve problems, think, act, feel, and protect him or herself. Mild anxiety often motivates people to make changes or engage in goal-directed activity. Mild Anxiety Physiological Responses: Restlessness, Fidgeting, GI "butterflies", Difficulty Sleeping, Hypersensitivity to Noise. Moderate Anxiety Definition Moderate anxiety is the disturbing feeling that something is definitely wrong; the person becomes nervous or agitated. In moderate anxiety, the person can still process information, solve problems, and learn new things with assistance from others. He or she has difficulty concentrating independently but can be redirected to the topic. Moderate Anxiety Physiological Responses: Muscle Tension, Diaphoresis, Pounding Pulse, Headache, Dry Mouth, Fast Speech, GI Upset, Frequent Urination Severe Anxiety/Panic Definition As the person progresses to severe anxiety and panic, more primitive survival skills take over, defensive responses ensue, and cognitive skills decrease significantly. A person with severe anxiety has trouble thinking and reasoning. Muscles tighten, and vital signs increase. The person paces; is restless, irritable, and angry; or uses other similar emotional-psychomotor means to release tension. In panic, the emotional-psychomotor realm predominates with accompanying fight, flight, or freeze responses. Adrenaline surge greatly increases vital signs. Pupils enlarge to let in more light, and the only cognitive process focuses on the person's defense. Severe Anxiety Physiological Response: Severe headache, Nausea, vomiting, and diarrhea, Trembling, Rigid stance, Vertigo, Pale, Tachycardia, Chest pain Panic Physiological Responses: May bolt and run or totally immobile and mute, Dilated pupils, Increased blood pressure and pulse, Flight, fight, or freeze Nursing Interventions Mild Anxiety: Mild anxiety is an asset to the client and requires no direct intervention. People with mild anxiety can learn and solve problems and are even eager for information. Teaching can be effective when the client is mildly anxious. Nursing Interventions Moderate Anxiety: With moderate anxiety, the nurse must be certain that the client is following what the nurse is saying. The client's attention can wander, and he or she may have some difficulty concentrating over time. Speaking in short, simple, and easy-to-understand sentences is effective; the nurse must stop to ensure that the client is still taking in information correctly. The nurse may need to redirect the client back to the topic if the client goes off on a tangent. Nursing Interventions: Panic During panic anxiety, the person's safety is the primary concern. The nurse must keep talking to the person in a comforting manner, even though the client cannot process what the nurse is saying. Going to a small, quiet, and nonstimulating environment may help reduce anxiety. The nurse can reassure the person that this is anxiety, it will pass, and he or she is in a safe place. The nurse should remain with the client until the panic recedes. Panic-level anxiety is not indefinite, but it can last from 5 to 30 minutes. Nursing interventions Severe Anxiety: When anxiety becomes severe, the client can no longer pay attention or take in information. The nurse's goal must be to lower the person's anxiety level to moderate or mild before proceeding with anything else. It is also essential to remain with the person because anxiety is likely to worsen if he or she is left alone. Talking to the client in a low, calm, and soothing voice can help. If the person cannot sit still, walking with him or her while talking can be effective. What the nurse talks about matters less than how he or she says the words. Helping the person take deep even breaths can help lower anxiety. Malingering Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms; it is motivated by external incentives such as avoiding work, evading criminal prosecution, obtaining financial compensation, or obtaining drugs. People who malinger have no real physical symptoms or grossly exaggerate relatively minor symptoms. Their purpose is some external incentive or outcome that they view as important and results directly from the illness. People who malinger can stop the physical symptoms as soon as they have gained what they wanted Factitious Disorder Factitious disorder, imposed on self, occurs when a person intentionally produces or feigns physical or psychological symptoms solely to gain attention. People with factitious disorder may even inflict injury on themselves to receive attention Munchausen & Munchausen by Proxy The common term for factitious disorder imposed on self is Munchausen syndrome. A variation of factitious disorder, imposed on others, is commonly called Munchausen syndrome by proxy, and occurs when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or to be a "hero" for saving the victim Primary Gain Primary gains are the direct internal benefits that being sick provides, such as relief of anxiety, conflict, or distress Secondary Gain Secondary gains are the external or personal benefits received from others because one is sick, such as attention from family members and comfort measures (e.g., being brought tea, receiving a back rub). The person soon learns that he or she "needs to be sick" to have his or her emotional needs met. Hypersomnolence Disorder Definition 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 to 12 hours long, and the person has difficulty waking up Narcolepsy Definition Chronic excessive sleepiness characterized by repeated, irresistible sleep attacks. After sleeping 10 to 20 minutes, the person is briefly refreshed until the next sleep attack. Circadian Rhythm Sleep-Wake Disorder Definition Circadian rhythm sleep-wake disorders are persistent or recurring sleep disruption resulting from altered functioning of circadian rhythm or a mismatch between circadian rhythm and external demands. Sleep disorders related to another mental disorder........ Sleep disorders related to another mental disorder may involve insomnia or hypersomnia. Mood disorders, anxiety disorders, schizophrenia, and other psychotic [Show Less]