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 Information

General Anxiety
2013-01-09 22:32:21

Mental Health
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