Anxiety Flashcards
Define anxiety
an uncomfortable feeling of apprehension, dread, uneasiness and uncertainty
What is the difference between “normal” anxiety and abnormal anxiety?
-normal motivates us to make and survive change
-abnormal anxiety occurs in situations that do not pose a threat
When does anxiety become pathological?
-no real threat exists
-it is of greater than expected intensity
-it prevents fulfillment of roles
-it is accompanied by flashbacks, obsessions, or compulsions
-it inhibits daily/social functioning
-it lasts longer than expected
What is found in an assessment of mild anxiety?
-alert
-no thought distortions
-still open to problem solving
-slight discomfort
-restlessness
-irritability
-tension-relieving behaviours (ex. smoking)
What are the nursing interventions for mild anxiety?
-stay calm, engage in conversation
-use open-ended questions
-active listening
-check past coping behaviours, what worked; explore alternatives
What is found in an assessment of moderate anxiety?
-anxiety increases
-selective inattention
-can problem-solve with assistance as thinking becomes less clear
-increased physical tension
-more extreme tension-relieving behaviours
What nursing interventions should be used for moderate anxiety?
Goal is to intervene at this level before it increases!!
-offer more 1:1 attention
-coach on deep breathing techniques
-use simple communication
-work together through problem-solving
-encourage physical activity and distraction
What are the assessment findings for severe anxiety?
-distorted perceptions
-unable to focus
-learning and problem-solving is not possible
-increase in somatic complaints
-may see hyperventilation
What are the nursing interventions for severe anxiety?
Goal: reduce anxiety to moderate level
-increase level of observation, de-stimulate the environment, focus on here and now (they will have tunnel vision)
-provide anxiolytic
-role play deep breathing, focus on what the client CAN do
What are the assessment findings of panic?
-loss of touch of reality
-possible hallucinations
-++psychomotor agitation
-poor reasoning and inattention
-may become mute
What are the nursing interventions for panic?
-don’t touch the client but let your presence be known
-stay calm
-use clear and simple statements
-reinforce reality
-maintain physical safety of clients
-provide PRN meds and assess
What are the types of cognitive distortions?
emotional reasoning
catastrophizing
control fallacies
perfectionism
should/must statements
What is the statistic relating anxiety to depressive disorders?
anxiety disorders are co-occurring with depressive disorders in 60% of cases
Which anxiety disorders are most likely to seek treatment?
panic disorder and generalized anxiety disorder (GAD)
What are the aspect of Panic Disorder?
-panic attacks
-repeated panic attacks that increase in duration and intensity over a period of 1-2 months meets the diagnostic criteria for panic disorder
-may be associated with Agoraphobia
Describe the aspects of a Panic Attack
-discrete periods of fear or discomfort (10-30 min)
-come out of the blue
-physical sensation of: accelerated HR, cold sweat, feeling of choking, SOB, derealization, depersonalization, fear of dying/losing control, numbness, tingling
-causes concern/fear of when another one will occur
-clients commonly present in ER before being diagnosed with panic disorder
What are the risk factors for Panic Disorders?
-family history
-substance and stimulant use or abuse
-undertaking severe stressors
-genetic predisposition
-female gender
-for children: physical or sexual abuse
Nursing interventions for Panic Disorders
Breathing control: reduce hyperventilation and interrupt a panic attack– takes practice
Nutritional planning: decrease hypoglycemic events, decrease caffeine intake
Relaxation techniques: progressive muscle-relaxation exercises to “get out of their own head”
What is the psychopharmacologic treatment of panic disorders?
antidepressants: SSRIs, SSNRIs, TCAs
anxiolytics: benzodiazepines
Beta blockers: propranolol, useful for performance anxiety
What are the teaching points that are important for psychopharmacologic treatment of panic disorders?
avoid OTC meds, consider sedative effects, avoid alcohol, do not abruptly discontinue medication
What do Barbiturates do for treating anxiety?
-barbitals
-increase GABA channel opening duration
-death in overdose
-should NEVER be prescribed for psychiatric purposes
What do Benzodiazepines do for the treatment of anxiety?
-increase GABA channel opening frequency
-lower toxicity in overdose
-immediate and noticeable relief of anxiety symptoms
-causes tolerance (high change for abuse and addiction)
-have been shown to make anxiety and depression worse in the long term
What are the side effects of Benzodiazepines?
-sedation
-memory impairment
-cognitive dulling
-dizziness
-not recommended for patients over 65 years
What are some examples of Benzodiazepines?
“-azepam’s”
Diazepam
Clonazepam
Lorazepam
“azolam’s”
Alprazolam
Triazolam
