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Release of GABA
Slows nueral transmission which has a calming effect
Panic disorder
Without agoraphobia is characterized by frequent panic attacks
Treatment for Panic Disorder
Antidepressants, keep pt calm
Systematic desensitization
Helps to gradually overcome stressor
Somatoform disorder
Multiple prolonged physical problems, multi-system that is not in line with actual observed symptoms
OCD

Obsessive Compulsive disorder
Recurring intrusive thoughts, that cause recurring ritualistic behaviors that temporarily reverse anxiety. Behavior to "fix" things
Antianxiety meds
How they work
Bind to receptors at the same time as GABA allowing GABA to have a greater effect, making the person more calm
Slows down CNS, does not cause respiratory depression
Benzodiazapines
Controlled Substancs--
addiction is very likely but the therapeutic effect is more important.
Benzodiazapines
What they do
Induce sleep, treat insomnia, reduce anxiety levels, treat alcohol abuse, control seizures
Benzodiazapines
Assessment
Sedation level, safety and fall risk,  Resp Rate, depression/suicide risk.
Generalized anxiety disorder GAD
excessive anxiety or worry about numerous things that last for 6 months or more
GAD
S and S
Restlessness, fatigue, poor concentration, irritability, tension, sleep disturbance
Post traumatic stress disorder
PTSD
repeated reexperiencing of a highly traumatic event that involved actual or threatened death or serious injury.
PTSD
S and S
dreams and flashbacks reexperiencing of trauma, persistant avoidance of stimuli associated with trauma, nubness of general responsiveness
trust is a common concern
Acute Stress disorder
PTSD that is resolved within 4 weeks
Valium (diazepam)
Works w/in 2 hours
Adverse Effects: dizziness, drowsiness, lethargy, hangover, blurred vision
Do not use with alcohol, do not stop abruptly,
Klonopin (clonazepam)
Onset 1 hr// Peak 2 hr
Adverse effects- behavioral changes, drowsiness, ataxia
Xanax (alprazolam)
onset/peak 1-2 hours
Adverse effects- dizziness, drowsiness, and lethargy
Ativan (Lorazepam)
Onset 1 hr// Peak 1-6 hr
adverse effects: Lethargy, drowsiness, dizziness, headache, blurred vision fall risk!
Librium (Chlordiazeproxe)
potentiates GABA, causes sedation, treats anxiety, onset 1-2 hour// peak .5-4 hour
dizziness, drowsiness, hangover, headache
Ambien (Zolpidem)
treats insomnia, no analgesic properties, binds to GABA receptors, onset rapid, peak .5-2 hours,
adverse effects- abnormal thinkin,g, amnesia, dizziness, and anaphlaxis. risk for injury
Sopoforic-
Sleep producing
Benzodiapines
restrictions
No Driving, Construction on tall buildings, smoking all hazard
Axis I
Major Mental disorder


(schizophrenia)
Axis II
Personality Disorders or Mental Disorder

(Character traits that aren't affective)
Axis III
General Medical Conditions that may affect diagnosis

(HTN, DM)
Axis IV
Psychosocial and environmental factors affecting the situation

(Derpression, Divorce)
Axis V
Global Assessment of Functioning Scale (GAF) score

1-100
1-lowest
100- highest
What can an APRN do that a generalist RN cannot?
Psychotherapy- group individual or family
Medication Prescription and treatment
Consultation
beneficence
Duty to do what is beneficial to others
Autonomy
Right to self determine choices affecting self
Justice
Right to fair treatment
Fidelity
Doing no wrong to the client
Seclusions and Restraints
must present harm to self or others,
endanger faculty, less restrictive measures not satisfactory, DOCUMENTATION
Proper orders for R/S
type, reason, time limits, NO PRN ORDER, MD signature
x of y cards