Nursing Field Notes / Mental Health · Psychiatric Care
Anxiety Disorders 😰
NG-021MENTAL HEALTHADHD-friendly visual edition
The mind goes into a state of panic — so the body goes into fight or flight.The SNS (sympathetic nervous system) switches on, shunting blood away from the extremities toward the core for the vital organs & increasing the vital signs.
⚡ SNS Sssspeeds up vitalsHR ⬆ BP ⬆ RR ⬆ sugar ⬆ & pupils dilate!
🥤 S · M · L · XLMild → Moderate → Severe → Panic attacks!
😱 "Impending doom" = SEVERECan NOT respond to directions.
👋 Mom cries when you leave= Separation anxiety disorder.
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TYPES
STEP 1 · NAME IT
Seven classifications — same anxious engine, different trigger.
🗂️ The classifications
🌫️ GAD General Anxiety Disorder
🙈 SAD Social Anxiety Disorder
💥 Panic disorder
👋 Separation AnxietyNCLEX EXAMS
🕷️ Phobias
🔁 OCD Obsessive Compulsive Disorder
💭 PTSD Post-traumatic Stress Disorder
🧠 "Generally Sad, Panicky & Separated — Phobic, Obsessed, Traumatized." One sad sentence = GAD · SAD · Panic · Separation · Phobias · OCD · PTSD.
⭐ Exam favorite: Separation anxiety disorder
📝 HESI Question — Client states… "every time I need to leave the house for work … Mom becomes extremely anxious and cries that something terrible is going to happen to me." … supports which psychiatric diagnosis?
✅ Separation anxiety disorder
🎯 How to spot it fast
The anxiety is glued to the goodbye — distress fires when the person leaves, not at the workplace or the crowd.
🧠 "Terrible things happen when you LEAVE" = separation anxiety. The trigger is the door, not the destination.
⚡
SNS SWITCH
STEP 2 · FEEL IT
Pathophysiology — panic in the mind flips the fight-or-flight switch in the body.
🏃 Fight or flight — what the SNS does to the body
During severe anxiety the mind goes into a state of panic & so the body goes into fight or flight mode, turning on the SNS — sympathetic nervous system.
🧠 MEMORY TRICK — "SNS — Sssspeeds Up the Vital Signs!" Increasing the HR, BP, RR, sugar levels, & dilating the pupils!
🧪 ATI Question — physiological signs of anxiety
Which of the following are physiological signs of anxiety? Select all that apply — all five!
✅ Increased pulse rate 📈
✅ Hyperglycemia 🍬
✅ Dilated pupils 👁️
✅ Dilated bronchioles 🫁
✅ Peripheral vasoconstriction 🥶
🩸 The shunt story
The SNS tells the body to shunt blood flow away from the extremities & toward the core of the body for the vital organs — and to increase the vital signs.
🧠 "Core gets the blood, hands get the cold." Everything that helps you run goes UP — everything at the edges gets clamped DOWN.
🥤
LEVELS
STEP 3 · GRADE IT
Grade anxiety like a drink order — the exam question is almost always "which level is this?"
🥤 Small → EXTRA Large
🧠 Order it like a soda:Small = Mild · Medium = Moderate · Large = Severe · EXTRA Large = Panic Attacks! Same first letters — Small-Mild is the only mismatch to memorize.
📊 Mild vs Moderate vs Severe — what you'll see
Level
👀 What you see
🧠 Perception
😤 Mild
Restless, irritability
intact
😟 Moderate
Increased RR & HR · pacing back & forth
Slightly reduced perception
😱 Severe
Increased RR & HR "hyperventilation" · pacing back & forth · feeling of "Impending Doom"
Perception is GREATLY reduced: can NOT respond to directions
🧠 The 3 D's of SEVERE: Doom, Death-talk, Deaf to directions. If perception is gone and they can't follow you — it's severe.
🚨 Exam alert — every one of these clients is SEVERE
📝 ATI:"The client is pacing the hallway and tells the nurse he has a feeling of impending doom." → Severe
📝 HESI Q1: patient tells the nurse, "I feel like I am going to die." → Severe
📝 HESI Q2: male patient is running & keeps repeating, "They are coming!" — neither follows staff directions nor responds to verbal efforts to calm him → Severe
Can't follow directions = severe — every time.
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QUICK RECALL
SAY IT OUT LOUD
🥤 S / M / L / XLMild · Moderate · Severe · Panic attacks!
🩸 Blood → COREAway from extremities, toward vital organs.
😱 "I'm going to die" + deaf to directions= SEVERE anxiety.