Card Set Information
What is anxiety?
-Defined as a vague feeling of dread
-Unwarranted by the situation
- Accompanied by feelings of uneasiness and apprehension
What is the difference between Anxity vs Fear?
With fear, there is something or someone that is dangerous
Nursing considerations with mild anxiety
-Client very susceptible to learning and solving problems; they are “eager for information”.
-Educate, educate, educate!
-Teach stress management
-The client is able to focus on task at hand but forget multi-tasking!
-They are selectively attentive and
their perceptual field is decreased
-Able to learn but not to their full potential
-Nurse’s role is more assistive, hands-on, and facilitative
-Feedback from the client is useful
Nursing considerations with mild anxiety
-Are they following what you are saying?
-Speak in short, simple, and easy-to-understand sentences
-Teach relaxation and coping skills
-Redirect client prn, based on feedback
-Focus on coping and problem-solving
What is the Nursing Goal for Patients with anxiety?
To prevent client’s anxiety from worsening or progressing
what are some symptoms of severe anxiety?
-Perceptual field is further reduced—sees one detail or scattered details
-Cannot complete tasks, solve problems, or learn new material
Snapshot of a person experiencing severe anxiety
-Cannot relieve their anxiety
-Sense of awe, dread, or horror
-Trembling, pale, crying
-Nausea, vomiting, diarrhea
Nursing considerations for clients with severe anxiety
The person with severe anxiety cannot focus or solve problems
Remain with the person
Talk in a low, calm, and soothing voice
If they cannot sit still, walk with them
Encourage deep, even breaths
Provide structure—consider exercise
What are some symptoms of panic?
Perceptual field focuses on self
Cannot “process” information
May be mute
Distorted perceptions could result in delusions or hallucinations
May bolt or runCould be suicidal
Nursing care for the client experiencing panic
THE PERSON’S SAFETY IS YOUR PRIMARY CONCERN
Select a safe, quiet, and non-stimulating environment
Reassure the client that they are safe and the anxiety will pass
Remain with them at all times until the panic has passed (5-30 minutes)
Medications for short-term anxiety disorders-anxiolytic drugs
Chronic anxiety disorders
Symptoms no longer serve as a signal of danger
Condition has become chronic
Adversely affects the client’s functioning—socially, occupationally.
Represents an emotional disability
What are some Anxiety disorders?
Panic, with or without agoraphobia
Phobia (social or specific)
Generalized anxiety disorder
Posttraumatic stress disorder (PTSD) and Acute stress disorder
Anxiety due to a medical condition
Substance-induced anxiety disorder
What are some Biological theories about anxiety disorders?
—inherited tendencies—moderate heritability
What are some Psychodynamic theories of anxiety disorders?
Overuse of defense mechanisms
“Learned” behavioral responses
Treatment of anxiety disorders
Medications (anxiolytic,antidepressants, and/or beta blocker drugs)
What is cognitive behavior therapy?
Cognitive behavior therapy uses treatment and methods such as positive reframing to assist in changing one’s maladaptive behavior.
The therapist initially works with the client making them aware of their negative thinking and how it affects personal feelings and behaviors.
What are some Examples of methods used in cognitive behavioral therapy?
Positive coping statements
Decatastrophizing Assertiveness training
What is an example of Positive Reframing
”This is anxiety, it will go away”
What is an example of Positive coping statements or Positive Self-talk?
“I’ve done this before (passed tests), I can do it again.”
What are some exmaples of Decatastrophizing?
What’s the worst thing that could happen?
Distraction to stop the negative thoughts or actions
What are some examples of Assertiveness training?
Helps the client assume control over life and situations
Uses “I” to frame their concerns, needs, and feelings to others
“I feel angry when you do not listen to me and leave the room when I am speaking”
What are some Strategies for dealing with stress?
Realize there are certain things you cannot control
Learn to relax
Eat well balanced meals
Limit caffeine and alcohol
Get enough rest and sleep
Set realistic goals and expectations
Learn progressive relaxation, imagery, journaling, meditation
Goals for stress management
Manage your symptoms—do not allow them to mange you.
Be pro-active to decrease stressors
Consider use of medications short-term
Become proficient with non-pharmacologic strategies
Learning and teaching progressive muscle relaxation, guided imagery, and assertiveness training
The Relaxation Response
Based on the premise that a physical state of deep rest counteracts the body’s fight or flight responses.
1.The client exerts deliberate tension to a muscle group followed by….
2.Subsequent relaxation of that muscle group resulting in muscle relaxation as the tension ebbs away
3.Controlled breathing increases the effectiveness of the process
What is the Procedure for progressive muscle relaxation
Step One—sit in a comfortable place away from noise or distractions
Step Two—clear your mind and focus on your breathing
Step Three—clear your mind
Step Four—take several “controlled breaths” (breathe in through your nose and out through your mouth very slowly)
Progressive muscle relaxation component
Start with your hands and tense them for 8-10 seconds then release and relax the same area for 8-10 seconds
Follow a progression with all body areas
Arms, shoulders, neck…
Forehead, eyes, jaw…
Thighs, calves, feet, and toes…..
What are some Suggested verbal cues for relaxation procedure?
Trust in God
All things are passing
*To assure success, practice twice a day for at least one week
What are some Precautions with relaxation therapy?
If the patient has a history of muscle spasms, back problems, or serious injuries—current or in the past—special variations and consultations may be needed
The relaxation response may produce orthostatic hypotension
What is guided imagery?
The use of relaxation and mental visualization to improve mood and/or physical well-being.
What are some Benefits from guided imagery?
Reduction of stress and anxiety
Enhanced sleep and rest
Assist in dealing with losses
Special forms of imagery used with ,Healing,Pain control, and Mental rehearsal
What are some Precautions with guided imagery?
May induce sleep or decrease reaction time
Images may provoke negative visualizations
Should be considered adjunctive therapy
What are some suggestions for guided imagery?
Allow at least 15-20 minutes
Wear comfortable clothes
Dim the lights and close your eyes
May use music, nature sounds, etc. during the process
Avoid and remove all distractions
What are some techniques for guided imagery?
Attain a relaxed state first
May use deep-breathing or imagine you are climbing stairs and with each step you are more relaxed
Imagery is most effective when the mind and the body are still
Focus on details
: sight, smell, sound, senery, overall mood
Once you have arrived at your special place—Work through fears,Address uncertainties,Confront problems or challenges,Let it go, and Attain enlightenment
What is Assertiveness training?
Purpose—to increase control over life’s situations by communicating needs and fostering self assurance
Exercise in assertiveness training
Write a sentence summarizing a recent stressful situation
Write a sentence that assertively addresses the situation
Use tact and diplomacy
What is Meditation?
Making a choice to focus your mind on something