Anxiety All rights reserved Austin Community College

Normal Response to Stress  Situational anxiety –A test –A mastery –A job interview  Anxiety –MOTIVATES –Helps to focus –Helps thinking and retention of information

Physiologic Response to Anxiety  The individual protects themselves  Human response to anxiety was developed a long time ago when they could have been eaten  FIGHT and FLIGHT (Sympathetic Nervous System)

When Anxiety is NOT Helpful  Humans are no longer at risk for being eaten  But sometimes the Fight Flight response still occurs  When the person cannot run or fight the anxiety worsens

Anxiety and the Sympathetic Nervous System Arousal and the Autonomic Nervous System  Motor tension; shaky, muscle tension, fatigues easily  Tachycardia, pupils dilate, decrease secretion in GI tract, Sphincters contract, Convert glycogen to glucose in liver  Blood vessels dilate (peripheral)  Adrenaline; dry mouth, dizziness, nausea, diarrhea  Insomnia

Levels of Anxiety  Mild  Moderate  Severe  Panic

Mild Anxiety  Great level for maximum work efficiency  Perceptual field very broad; alert  High level problem solving can occur  Excellent level for: –learning concepts –writing a paper –teaching patient  Great level for sports

Moderate Anxiety  Perceptual field is narrowed –may be very focused or easily distracted  Increased BP, P, R.  Moderate Muscle tension  Tune out stimuli –Very focused on task at hand –May miss other observations  Can learn list of facts or do step by step tasks  Problem solving and reasoning with assistance

Severe Anxiety  Perception is reduced or distorted  Difficulty focusing even with assistance  Flight of ideas  Learning cannot take place; ineffective reasoning  Physical symptoms problematic  Behavior is directed toward relief

Panic Level  Feelings of terror  Actual flight, fight –or immobilization  May be violent  Out of contact with reality  Eyes fixed  Hysterical  Incoherent

Nursing Interventions: Mild Anxiety  Physiologic: –Warm bath –Deep breathing –back rub –Relaxation  Cognitive –Alert and Motivated to learn –Teach client concepts about illness, prognosis  Emotional –Assess using therapeutic communication. Identify feelings, guilt, anger sadness

Moderate Anxiety: Interventions  Physiological –Deep breathing –Relaxation techniques  Cognitive –Decreased attention to detail –Teach factual information  task oriented –learning to give insulin – Client can still problem solve well  Emotional/Behavioral –Therapeutic communication –Assist to identify feelings –Limit choices –Physical activity

Severe/Panic Level: Interventions  Role Changes –Become more nurturing and directive –May not be able to give choices  Physiologic –antianxiety medication –Provide for safety  Cognitive –Orient the client –Give direction –Do not expect the client to solve problems –Use simple statements –Give reassurance.  Emotional/Behavioral –Be sensitive for patients need for space –Decrease Stimuli –Careful with touch/ non-verbal communication. –Calm, firm, Quiet voice –May walk with the client –May restrain if necessary