Exam 6 Anxiety Flashcards
Moderate anxiety
Tension, pounding heart, increased pulse rate and respiratory rate, perspiration, mild somatic symptoms, (gastric discomfort, headache, urinary urgency) voice tremors and shaking.
Mild anxiety
Slight discomfort, restlessness, irritability, mild tension - relieving behaviors.
Severe anxiety
Learning and problem solving not possible, dazed, confused. Behavior is automatic and aimed at reducing or relieving anxiety.
Severe anxiety s/s
Headache, nausea, dizziness, insomnia, increased trembling, pounding heart, hyperventilation, sense of impending doom or dread.
Panic
Pacing, running, shouting, screaming or withdrawal, hallucinations, or false sensory perception. Behavior erratic, uncoordinated and impulsive.
Fear
Reaction to a specific danger.
Anxiety
Is a human experience, basic emotion, vague sense of dread related to an unspecific or unknown danger.
Normal anxiety
Is a healthy reaction necessary for survival.
Provides energy needed to carry out task involved in living and caring out goal
Mild anxiety
Everyday living, allows an individual to perceive reality in sharp focus.
Moderate anxiety
Perceptual field narrows, details are excluded. Ability to think clearly is hampered, but learning and problem solving can still take place just not at optimal levels.
Severe anxiety
May focus on one particular detail or many scattered details. Have difficulty noticing what is going on around them even when it is pointed out to them.
Panic
Most extreme level of anxiety. Results in markedly disturbed behavior. They can’t process what is going on around them.
Phobia
A persistent irrational fear of a specific object, activity or situation that lead to a desire for avoidance or actual avoidance of the object, activity or situation
Social phobia or social anxiety disorder. SAD
Severe anxiety or fear to social or performance situations.
Obsession
Thoughts, impulses or images that persist and recur so that they cannot be dismissed.
Compulsions
Ritualistic behaviors an individuals feels driven to preform in an attempt to reduce anxiety.
GAD generalize anxiety disorder
Excessive anxiety or worry about numerous things, last for 6 months or longer.
Post Traumatic Stress Disorder PTSD
Persistent re-experiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others. To which the individual responded with intense fear, helplessness or horror.
Acute stress disorder. ASD
Resolves within 4 weeks. Occurs within one month after exposure to a highly traumatic event.
Three symptoms of ASD
Subjective numbing, detachment, absence of emotional responsiveness
Substance-Induced anxiety disorder
Symptoms of anxiety that develop with the use of a substance.
Medical condition anxiety
Due to a direct medical condition such as hyperthyroidism
Panic attack
Sudden onset of extreme apprehension or fear, usually associated with feeling of impending doom.
Nursing intervention mild anxiety
+1.
Identify and discuss the source of the anxiety.
Promote problem solving
Tolerate and benefit from it.
+2
Nursing intervention moderate anxiety
Encourage ventilation
Exercise
Help client focus
May need oral medication
+3
Nursing interventions severe anxiety
Short simple commands Decrease the anxiety provoking stimuli Redirect the client Seclude (time out) May need IM injection
+4
Nursing interventions panic
Guide firmly Take physical control IM medications Short, simply commands Restrain as needed for safety of client and others. Remember have to get doctors order for restraints. Secure environment.
Anti-anxiety medications
Anxiolytics CNS depressants. Respiratory depression Don't mix with other CNS depressants or alcohol. Don't drive or use machinery Avoid in pregnant of lactating women
Ativan
Generic lorazepam
Given IV, PO IM
IV onset 3-5 minutes.
Caution in renal and hepatic impairment, myasthenia gravis, organic brain syndrome or Parkinson’s disease.
Contraindicated with narrow angle glaucoma.
Xanax
Generic alprazolam
PO
Use withdrawal precautions - seizures or other strong withdrawal symptoms may occur with abrupt discontinuation.
Contraindicated with narrow angle glaucoma and per-existing hypotension.
Valium
Generic diazepam
PO,IV,IM
Contraindicated in narrow angle glaucoma
Caution with other CNS depressants, low albumin levels, or hepatic disease.
Buspar
Generic buspirone
PO
increases toxicity of digoxin and haldol
Adverse effects: dizziness, light headed ness
Avoid use in hepatic or renal impairment
Paxil
Generic paroxetine
PO
contraindicated in concurrent administration with MAOIs or administering within two weeks of discontinuation of MAOIs.
Caution in history of seizures, mania, renal, or cardiac disease.
Acute benzodiazepine toxicity
Benzodiazepine receptor antagonist may be given.
Such as Romazicon
First tier alternate therapies for anxiety
Kava, inositol, magnesium, valerian, melatonin, chamomile, Passion flower
Points to remember
Important to educate and be educated regarding side effects or adverse reactions.
Supposed to be natural does not mean its safe.
Always include vitamin supplements and herbals in list of patients medications
Alternative therapies
Acupuncture Cognitive behavior therapy Acupressure Massage therapy Reduction of caffeine and stimulants
Defense mechanisms and coping strategies
Response or adaptation to stress(anxiety).
May be conscious, usually unconscious response.
Responses vary with individual.
Some functional some dysfunctional. Vary in degrees.
Dysfunctional can increase anxiety.
