Explain how cigarette smoking impacts the lungs at the physiologic level.

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Question Answered step-by-step Explain how cigarette smoking impacts the lungs at the physiologic level. Health Science Science Nursing NUR MISC Share QuestionEmailCopy link Comments (0)

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Question Answered step-by-step Ms. Isaac has become edgy, easily fatigued, and excessively worried... Ms. Isaac has become edgy, easily fatigued, and excessively worried during the 8 months since her boyfriend broke up with her. She has difficulty focusing. Her worries cause distress and dysfunction and lead her to repeatedly seek out reassurance. Although some of these symptoms could also be attributable to a depressive disorder, she lacks most other symptoms of a major depression. Instead, Ms. Isaac meets criteria for DSM-5 generalized anxiety disorder (GAD).More acutely, Ms. Isaac has developed intense anxiety about leaving her apartment and entering the local supermarket. These symptoms suggest that Ms. Isaac may meet DSM-5 criteria for agoraphobia, which requires fears and avoidance of at least two different situations. Her agoraphobia symptoms have persisted only a few months, however, which is less than the 6-month DSM-5 requirement. Depending on whether the clinician thought the agoraphobia symptoms warranted clinical attention, Ms. Isaac could receive an additional diagnosis of "unspecified anxiety disorder (agoraphobia with inadequate duration of symptoms)."In addition to making a DSM-5 diagnosis, it is also important to consider what might have precipitated Ms. Isaac's GAD. Although it is not possible to be certain why someone develops a mood or anxiety disorder, consideration of psychosocial stressors that are coincident with the onset of symptoms can help with formulation, goal setting, and treatment.In this case, Ms. Isaac developed acute anxiety symptoms after her live-in boyfriend broke up with her and she moved into another apartment. Both of these events were acutely upsetting. The next part of answering "Why now?" involves thinking about how the stressors relate to long-standing issues in Ms. Isaac's life. She noted that she had "never [been] single for very long," and gave a history of difficulties with separation that began in childhood. Anxiety that is triggered by separation may suggest problems with attachment, and adult attachment styles are thought to be linked to the individual's earliest relationships. Those with secure attachments are able to form intimate relationships with others but are also able to soothe and regulate themselves when alone.Individuals with insecure attachments, on the other hand, may cling to loved ones, be unable to self-regulate when alone, and have ambivalent feelings about those upon whom they are dependent. Thinking in this way, one can hypothesize that Ms. Isaac may have become symptomatic because of an insecure attachment style linked to her earliest relationship with her mother.Clues that this may be the case include her mother's feeling that Ms. Isaac was "too clingy" during the divorce and Ms. Isaac's ambivalent feelings about her mother's efforts to be supportive. It would be helpful to understand more about Ms. Isaac's earliest relationships and the sorts of problematic attachment patterns that have developed during her romantic relationships. Such patterns would likely be recapitulated in the therapeutic relationship, where they could become a focus of treatment.   Health Science Science Nursing PSY 100 Share QuestionEmailCopy link Comments (0)
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