Stress & PTSD
What is the body’s initial stress response called?
Fight-or-flight (sympathetic nervous system activation)
Define mild anxiety.
Heightened alertness, improved learning, problem-solving enhanced.
Main characteristic of somatic symptom disorder?
Physical symptoms without medical cause that cause distress/impairment.
SSRIs and SNRIs are first-line treatments for what disorders?
Anxiety disorders, PTSD, depression.
Principle of ethics meaning “do no harm.”
Nonmaleficence.
Give one SMART goal for a patient with PTSD.
“The patient will use one relaxation technique to reduce anxiety from 8/10 to 5/10 within 24 hours.”
Give one nursing intervention for severe anxiety.
Stay with patient, use simple directions, reduce stimuli, provide safety.
What is the nursing priority intervention for somatic symptom disorder?
Focus on feelings/emotions, not symptoms; avoid unnecessary medical workups.
Example of a benzodiazepine (generic).
Lorazepam, alprazolam, diazepam, clonazepam.
Difference between voluntary and involuntary admission?
Voluntary = patient agrees; Involuntary = admitted without consent due to risk of harm to self/others.
Name one evidence-based treatment for PTSD.
Trauma-focused CBT, EMDR, SSRIs, or group therapy.
Identify the defense mechanism: A patient who was fired blames their boss for being unfair.
Projection.
Communication strategy with somatic patients?
Validate distress, shift focus from physical complaints to coping strategies.
Which med is non-addictive and used for GAD, takes weeks to work?
Buspirone.
What is the nurse’s duty to warn?
Legal obligation to break confidentiality if a patient threatens identifiable others.
List two techniques from Box 10.1 Stress Reduction
Deep breathing, progressive muscle relaxation, guided imagery, journaling, or meditation.
Table 11.3 – intervention for panic-level anxiety?
Remain with patient, use firm short sentences, provide quiet environment, possible medications.
Which comorbidity is most common with somatic disorders?
Depression and anxiety.
Black Box warning for all antidepressants?
Increased risk of suicide in children, adolescents, and young adults.
What is the patient’s right with restraints and seclusion?
Least restrictive measures used first, must have time-limited order, continuous monitoring, dignity preserved.
Nursing priority for a patient with flashbacks or dissociation?
Ensure safety and reorient to present reality.
Which defense mechanism is always maladaptive?
Denial (when it prevents necessary reality testing).
What is the nurse’s main role when creating a care plan for a patient with somatic symptom disorder?
Establish a therapeutic relationship, set realistic goals that focus on functioning rather than eliminating symptoms, and encourage use of coping strategies.
Which antihypertensive is used for nightmares in PTSD?
Prazosin.
What are the key components of the Mental Status Exam (MSE)?
Appearance, behavior, speech, mood/affect, thought process/content, cognition, insight/judgment.