anxiety Flashcards
3 stages of reaction to stress
1. Alarm stage: hypothalamus notifies adrenal gland to release adrenline & norepinephrine for fuel, and to organs to prepare for potential defense
2. Resistance stage: GI tract is closed, lungs take in more air, heart beats faster & harder, muscles go into fight or flight or freeze mode,
3. Exhaustion stage: person is exhausted bc of negative response to stress & anxiety, body is depleted and may result in continous arousal of physiologic responses
adaptive behaviors
can be positive, helps person to learn
ex: using imagery method to refocus attention on pleasant scene
maladaptive behaviors
negative responses to anxiety which can lead to physiological s/s
ex: tension headaches, pain syndromes, reduced immunity
4 levels of anxiety
1. mild: restlessness, increased motivation, irritability, motivates person to engage in goal-directed activity
2. moderate : agitation, muscle tightness, difficulty concentrating independently but can be re-directed, disturbing feeling that something is wrong
3. severe: inabilitity to function, ritualistic behavior, unresponsive, vitals increase , person is pacing, restlessness, irritibility, anger
4. panic: distorted perception, loss of rational thoughts, immobility, fight flight or freeze response, vitals are high, they are only worried about defending themselves
when working with anxious pts, what is the first priority action?
assess pt’s anxiety level
allows nurse to determine proper and effective intervention
nursing interventions for 4 levels of anxiety
1. mild: no direct intervention; teaching can be effective
2. moderate: make sure pt is following nurse directions. speak in short & easy to understand sentences; may need to redirect pt
3. severe: REMAIN W/PT; goal needs to be to lower anxiety to moderate to mild; talk in low, calm, soothing voice; have pt take deep even breaths
4. panic: PT SAFETY IS MAIN CONCERN; REMAIN W/PT; keep talking in calm manner; go to small, quiet, nonstimulating environment; reassure pt it’s anxiety, they’re safe & it will pass
anxiolytic meds
most are benzodiazepines
needs to be short-term, ideally no longer than 4-6 weeks
high abuse risk
designed to be short term relief for anxiety so that they can deal with the crisis/situation and develop better coping skills
name 2 stress-related disorders that develop bc of chronic stress that is repressed
eating disorders (anorexia nervosa & bulimia)
postive reframing is…
turning the negative thoughts into postive ones
instead of “my heart is pounding. i think i am going to die” to “this is just anxiety, it will go away”
decatastrophizing is…
where the therapist uses questions to reframe the situation more realistically
“what’s the worst thing that could happen”
assertiveness training is…
*helps person take more control over life situations *& negotiate interpersonal situations & foster self-assurance
uses more “I” statements to identify feelings and communicate their needs to others (“i feel angry when you turn your back while i’m talking”)
thought stopping is…
where pt says “stop” when their negative thoughts come and they distract themselves with a more positive message
they can use rubber band on the wrist or splash cold water on their face, etc
with anxiety that develops later in life it is usually…
associated with another condition such as
* depression
* dementia
* physical illness
* medication toxicity/ withdrawl
agoraphobia
pt avoids certain places/situations and their fear is usually disproportionate to the actual danger of the place or situation
what population is anxiety most prevalent in?
- women
- people under the age 45 yrs
nearly 30% of people develop anxiety in their lifetime
