General Anxiety

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  1. T/F Anxiety is contagious.

    It's also subjective which means that each person is going to experience it differently. 
  2. What levels of anxiety are there?
    • mild: present in day to day living, no effect on sensory input. 
    • moderate: focus only on immediate concern. will filter out all unnecessary sensory input/information. 
    • severe: focus in narrowed on a specific detail. Behavior is aimed at relieving anxiety. Will need direction ("take two deep breaths") in order to focus on other aspects. 
    • panic: severe disorganization, feelings of terror/dread, decreased ability to think, distorted perception of reality. 
  3. What is the GABA system and how does it relate to anxiety?
    • Receptors in amygdala and hippocampus within limbic system (emotions)
    • Has an inhibiting effect in firing rates of cells
    • GABA reduces firing rate in areas of anxiety disorders
    • Mechanism in some medications for anxiety
  4. What mediates flight/fight?
  5. What are some theoretical frameworks for anxiety?
    • Psychoanalytic: conflict between id and superego
    • Interpersonal: from the bond between infant and mother
    • Behavioral: results when something interferes with goal attainment
    • Biological: Brain chemicals regulate anxiety & body responds to sympathetic system
  6. What are some precipitating factors for anxiety?
    • Situational  crisis
    • Maturational crisis: event that is a normal part of growth and development. 
    • Threat to physical integrity
    • Medical disorders
    • Threats to self-esteem & body image
    • Genetic makeup
  7. What are the elements of coping?
    • Defense mechanisms
    • Coping responses
    • Problem-solving ability
    • Economic assets
    • Supportive people
    • Cultural & spiritual beliefs
  8. What are some examples of poor coping strategies?
    • Use of substances
    • Irritability
    • Argumentativeness
    • Isolation/withdrawal
    • Can’t let go
    • Victim behavior
    • Gets stuck
  9. See handout on defense mechanisms
  10. What are some NANDAs for anxiety
    • Cognitive responses
    • Affective responses
    • Behavioral responses
  11. What are some possible nursing intervensions for anxiety?
    • Keep patient safe
    • Remain calm. Anxiety is contagious, and then it is probably self-perpetuating and exacerbating. 
    • Encourage verbalization in a 1:1 format
    • Use distraction. Give them a task, visualization/imaging, refocus topic on something over which they have control, etc. 
    • Provide information
    • Provide a quiet environment
    • Discuss potential causes-precipitants
    • Ask what they usually do to cope
    • Assist with problem-solving
    • PRN medication if needed
  12. What are some techniques to deal with anxiety?
    • Relaxation
    • Meditation
    • Exercise
    • Sleep
    • Diet: carbs-->sleep, protein-->insomnia. 
    • Positive self-talk
  13. What is Cognitive restructuring
    A way of reframing a situation so that it does not cause anxiety.

    Antianxiety medications and long-term medications for maintenance can help the process. 

    Limit use of chemical substances.
  14. What are some interventions for preventing or mitigating severe anxiety and panic attacks?
    • Remain calm and stay with patient. Have antianxiety meds ordered BEFORE THE ATTACK OCCURS! 
    • Isolate patient
    • Decrease environmental stimulation
    • Administer medication (Benzodiazepine for panic attack)
    • Provide structure
    • Be directive in instructions. "Sit down. Take a deep breath. Take another deep breath." 
    • Nonverbal intervention. Gentile touch, deep, relaxing breaths, slow monotone speech. Slow down incrementally until they are calm.

    May take as long as 10 minutes to bring'em back down.
Card Set:
General Anxiety
2013-01-09 22:32:21

Mental Health
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