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20 Cards in this Set

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a painful uneasiness of mind. a state of heightened tension accompanied by a vague feeling of apprehension, expectation, or dread.
always anticipatory
not due to external threats
anxiety
response to actual present, external danger. it does not persist, since the external danger that gives rise to it is soon eliminated.
fear
4 levels of anxiety
mild
moderate
severe
panic
s/s of mild anxiety
motivates person to problem solve
responses to mild anxiety
sleep, eat more, exercise, smoke, cry, drink, laugh, curse
interventions for mild anxiety
mobilizing self through heightened awareness, but nurses job is to help them identify anxiety (label it), help identify source, teach problem solving and ways to deal with it (come up with a plan)
s/s of moderate anxiety
person still has productive use of cognitive abilities
•decreased attention & concentration, alertness – feels physically tense
•increase tension, discontent
responses to mild-moderate anxiety
defense mechanisms used to protect or relieve anxiety, overuse of DM can impair ability to deal with reality and ability to function
interventions for moderate anxiety
still can think but need attention & reassurance (stay with them & talk about their feelings). Identify what is causing anxiety (label it), many times people don’t know what to label it and feel relieved that they aren’t going crazy. Same as above id sources, problem solve, ways to deal. Provide person opportunity to talk about feelings, concerns – even about being labeled w/anxiety. What does that mean to them?
s/s of severe anxiety
non-productive level of anxiety
•unable to concentrate or problem solve
•feeling of dread
responses to moderate-severe anxiety
if left untreated will develop physiological problems (neuro, dermo, GI, cardio)
Severe – extended pds of time can lead to actual anxiety disorders (diagnosis) – somatoform and dissociative disorders – their personality fractures they disassociate in their head – mild form (miss exit while driving because of thinking)
interventions for severe anxiety
short attention span – learning not possible – goal is always to lower anxiety by one level. Interventions meet physical needs, besides talking in a directive manner w/patient (lets go to your room) – reduce stimuli, provide reassurance by staying w/them, offer medication (also at panic level), talking kept to a minimum (simple, brief & very concrete), listen for feelings or expressions of concern
s/s of panic anxiety
-can’t focus at all, misperceive environment
-terrorized, learning cannot occur
responses to panic anxiety
Extreme, unable to process lose touch w/reality, may develop serious psychological problems including delusions, hallucinations, impairment of functioning
interventions for severe-panic anxiety
think they’re having a heart attack when they come to ER, chest pain, can’t catch breath, headache, urinary freq, dry mouth, diaphoretic, tachycardic, cannot focus on anything, feel like suffocating, choking, like they’re losing it – going crazy. May try to flee situation – running amuck or frozen & unresponsive. Misperceive environment and are at risk of striking out because they don’t know what’s going on – delusions,
Reduce stimuli, medicate, stay with pt, be directive, authoritative, very simple commands, meet physical needs – goal is to decrease anxiety by at least 1 level.
As anxiety is diminishing and ability to concentrate comes back, can start talking about what happened –what was going on.
4 ways we cope w/anxiety
1. Acting out
2.Somatization
3.Freeze in the spot
4.Learning/problem solving
What coping mechanism for anxiety is this - angry outbursts (throw, hit), cry, physical/verbal abuse, laughter
acting out
What coping mechanism for anxiety is this - experience emotional anxiety as physical symptoms ( headache, GI symptoms, pseudo-seizures)
somatization
What coping mechanism for anxiety is this - withdraw & go into depression
freeze in the spot
What coping mechanism for anxiety is the most effective?
learning/problem solving