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Exam 3 blueprint - Test prep
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Mental Health Nursing (NSG221)
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Herzing University
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NSG 221-Mental HEALTH
EXAM 3 STUDY BLUEPRINT
Unit 7 – Anxiety Disorders
Topic Location Student Notes
Levels of Anxiety
a. Physical Characteristics
b. Nursing Interventions
c. Therapeutic Responses
NSG 221.07.
(x2)
NSG 221. 07.
(x1)
Levels of Anxiety
1. Mild
a. A sensation that something is different and needs special
attention
i. Sensory stimulation increases and helps the person focus attention
to learn, solve problems, think, act, feel, and protect him
ii. motivates people to make changes or engage in goal-directed
activity
b. Psychological Responses
i. Wide perceptual field
ii. Sharpened senses
iii. Increased motivation
iv. Effective problem-solving
v. Increased learning ability
vi. Irritability
c. Physiological Responses
i. Restlessness
ii. Fidgeting
iii. GI “butterflies”
iv. Difficulty sleeping
v. Hypersensitivity to noise
d. Nursing Interventions:
i. No direct interventions
2. Moderate
a. disturbing feeling that something is definitely wrong
i. becomes nervous or agitated
b. can still process information, solve problems, and learn new
things with
assistance from others
c. has difficulty concentrating independently but can be redirected
to the
topic
d. Psychological Responses
i. Perceptual field narrowed to immediate task
ii. Selectively attentive
iii. Cannot connect thoughts or events independently
iv. Increased use of automatisms
e. Physiological Responses
i. Muscle tension
ii. Diaphoresis
iii. Pounding pulse
iv. Headache
v. Dry mouth
vi. High voice pitch
vii. Faster rate of speech
viii. GI upset
ix. Frequent urination
f. Nursing Interventions:
i. Nurse must be certain the client is following what they are saying
1. Use short, simple, and easy-to-understand sentences
Severe: Psychological Responses
i. Perceptual field reduced to one detail or scattered details
ii. Cannot complete tasks
iii. Cannot solve problems or learn effectively
iv. Behavior geared toward anxiety relief and is usually ineffective
v. Doesn’t respond to redirection
vi. Feels awe, dread, or horror
vii. Cries
viii. Ritualistic behavior
ix. Trouble thinking and reasoning
viii. May be suicidal
b. Physiological Responses
i. May bolt and run or totally immobile and mute
ii. Dilated pupils
iii. Greater increase in blood pressure and pulse
iv. Flight, fight, or freeze
c. Safety is the priority
i. cannot perceive potential harm and may have no capacity for
rational thought
d. Nursing Interventions:
i. nurse must keep talking to the person in a comforting manner,
even though the client cannot process what the nurse is saying ii.
small, quiet, and nonstimulating environment may help reduce
anxiety
1. nurse can reassure the person that this is anxiety, it will
pass, and he or she is in a safe place
iii. nurse should remain with the client until the panic recedes.
iv. Panic-level anxiety is not indefinite, but it can last from 5 to 30
minutes.
*severe and panic anxiety the more primitive survival takes over,
defensive responses follow, cognitive skills decrease
1. Nursing Interventions
a. First and foremost, the nurse must assess the person’s anxiety
level because
that determines what interventions are likely to be effective
b. Mild
i. No direct interventions c. Moderate
i. Nurse must be certain the client is following what they are saying
ii. Use short, simple, and easy-to-understand sentences
iii. nurse must stop to ensure that the client is still taking in
information correctly
iv. nurse may need to redirect the client back to the topic if the
client goes off on a tangent
d. Severe
i. nurse’s goal must be to lower the person’s anxiety level to
moderate or
mild before proceeding with anything else
ii. essential to remain with the person because anxiety is likely to
worsen if
he or she is left alone
iii. 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
iv. Helping the person take deep, even breaths can help lower
anxiety
v. can no longer pay attention or take in information
1. What the nurse talks about matters less than how he or she says
the words
e. Panic
i. nurse must keep talking to the person in a comforting manner,
even
though the client cannot process what the nurse is saying
ii. small, quiet, and nonstimulating environment may help reduce
anxiety
iii. nurse can reassure the person that this is anxiety, it will pass, and
he or she is in a safe place
iv. nurse should remain with the client until the panic recedes.
f. nurse must be aware of his or her own anxiety level
i. Remaining calm and in control is essential if the nurse is going to
work effectively with the client
2. Therapeutic Responses
a. nurse can reassure the person that this is anxiety, it will pass, and
he or she is in
a safe place
b. nurse should remain with the client until the panic recedes.
c. can no longer pay attention or take in information
Anxiety Disorders NSG 221.07.
ii. can include palpitations, sweating, tremors, shortness of breath, a
sense of suffocation, chest pain, nausea, abdominal distress,
dizziness, paresthesias, and vasomotor lability
iii. has a fight, flight, or freeze response
5. Nursing interventions
a. treated with CBTs
b. deep breathing
c. Relaxation
d. Medications
i. Benzodiazepines
ii. SSRI antidepressants
iii. tricyclic antidepressants
iv. antihypertensives such as clonidine (Catapres) and propranolol
(Inderal)
6. Care Plan/Priority Outcome
a. Outcomes for clients with panic disorders
i. client will be free from injury.
ii. client will verbalize feelings.
iii. client will demonstrate use of effective coping mechanisms.
iv. client will demonstrate effective use of methods to manage
anxiety
response.
v. client will verbalize a sense of personal control.
vi. client will reestablish adequate nutritional intake.
vii. client will sleep at least 6 hours per night
Characteristics of Various Disorders
a. Disruptive Behavior Disorder
b. Mood Disorder
c. Generalized Anxiety Disorders (GAD)
i. Pharmacological Therapy
a.) 1 st & 2nd line treatment
b.) Teaching
NSG 221 07.
(x1)
NSG 221. 07-04.
(x2)
Disruptive Behavior Disorder
a. worries excessively and feels highly anxious at least 50% of the
time for 6
months or more
b. Unable to control this focus on worry
c. has 3 or more of the following symptoms:
i. Uneasiness ii. Irritability
iii. muscle tension iv. Fatigue
v. difficulty thinking vi. sleep alterations
d. Buspirone (BuSpar) and SSRI or serotonin–norepinephrine
reuptake inhibitor antidepressants are the most effective treatments
2. Mood Disorder a.
3. Generalized Anxiety Disorders (GAD)
a. Pharmacological Therapy
i. 1st & 2nd line treatment
1. SNRIs are a standard first-line treatment
a. venlafaxine include the treatment of depression, as well as
generalized anxiety disorder, social phobia, and panic disorder
2. Buspirone (BuSpar)
3. benzodiazepines
ii. Teaching
1. Buspirone (BuSpar) a. Side Effects
i. Dizziness, restlessness, agitation, drowsiness, headache, weakness,
nausea, vomiting, paradoxical excitement or euphoria
b. Rise slowly from sitting position.
c. Take care with potentially hazardous activities, such as
driving.
d. Take with food.
e. Report persistent restlessness, agitation, excitement, or
euphoria to physician.
2. Benzodiazepine
a. Side Effects
i. Dizziness, clumsiness, sedation, headache, fatigue,
sexual dysfunction, blurred vision, dry throat and mouth,
constipation, high potential for abuse and dependence
b. Avoid other CNS depressants, such as antihistamines and alcohol.
Unit 8 – Somatic Symptom Illnesses
Sleep/Wakefulness Disorders
Somatic Symptom Illnesses
a. Characteristics
i. Malingering
ii. Factitious disorders
NSG 221 08.
(x1)
a. Symptoms
b. Etiology/Causes of Mood Disorders
NSG 221 09.
(x1)
NSG 221 09.
(x1)
Depression
a. Treatment/Therapy
i. Pharmacological treatment –
Evaluating effectiveness
b. Nursing Care for Depression
NSG 221 09.
(x1)
NSG 221 09.
(x2)
NSG 221.09.02 (x2)
Bipolar
a. Characteristics
b. Nursing care
c. Pharmacological treatment
NSG 221 09.
(x1)
NSG 221 09.
(x1)
NSG 221 09.
(x2)
Suicide
a. Types of suicidal ideation
b. Nursing care/Assessing Risk
NSG 221 09.
(x1)
NSG 221 09.
(x1)
i. Priority Intervention NSG 221 09.
(x1)
Unit 10: Eating & Obsessive-Compulsive
Disorders
Eating Disorders
a. Types
b. Characteristics
c. Risk factors
i. Risks for relapse
d. Treatment options
i. Types of medications used
e. Nursing care - inpatient
NSG 221 10.
(x1)
NSG 221 10.
(x1)
NSG 221 10.
(x1)
NSG 221 10.
(x1)
NSG 221 10.
(x1)
NSG 221 10.
(x1)
Obsessive-Compulsive Disorders
a. Types
b. Behavioral manifestations
i. Symptoms – severe anxiety
c. Relaxation techniques
NSG 221 10.
(x1)
NSG 221 10.
(x1)
NSG 221 10.
(x1)
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Exam 3 blueprint - Test prep
Course: Mental Health Nursing (NSG221)
156 Documents
Students shared 156 documents in this course
University: Herzing University
Was this document helpful?
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NSG 221-Mental HEALTH
EXAM 3 STUDY BLUEPRINT
Unit 7 – Anxiety Disorders
Topic Location Student Notes
Levels of Anxiety
a. Physical Characteristics
b. Nursing Interventions
c. Therapeutic Responses
NSG 221.07.01.01
(x2)
NSG 221. 07.01.02
(x1)
Levels of Anxiety
1. Mild
a. A sensation that something is different and needs special
attention
i. Sensory stimulation increases and helps the person focus attention
to learn, solve problems, think, act, feel, and protect him
ii. motivates people to make changes or engage in goal-directed
activity
b. Psychological Responses
i. Wide perceptual field
ii. Sharpened senses
iii. Increased motivation
iv. Effective problem-solving
v. Increased learning ability
vi. Irritability
c. Physiological Responses
i. Restlessness
ii. Fidgeting
iii. GI “butterflies”
iv. Difficulty sleeping
v. Hypersensitivity to noise
d. Nursing Interventions:
i. No direct interventions
2. Moderate
a. disturbing feeling that something is definitely wrong
i. becomes nervous or agitated
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