anxiety all rights reserved austin community college
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AnxietyAnxietyAll rights reserved Austin Community CollegeAll rights reserved Austin Community College
Normal Response to StressNormal Response to Stress
Situational anxietySituational anxiety– A testA test– A masteryA mastery– A job interviewA job interview
AnxietyAnxiety– MOTIVATESMOTIVATES– Helps to focusHelps to focus– Helps thinking and Helps thinking and
retention of retention of informationinformation
Physiologic Response to AnxietyPhysiologic Response to Anxiety
The individual protects The individual protects themselvesthemselves
Human response to Human response to anxiety was anxiety was developed a long time developed a long time ago when they could ago when they could have been eaten have been eaten
FIGHT and FLIGHT FIGHT and FLIGHT (Sympathetic Nervous (Sympathetic Nervous System)System)
When Anxiety is NOT HelpfulWhen Anxiety is NOT Helpful
Humans are no Humans are no longer at risk for longer at risk for being eatenbeing eaten
But sometimes the But sometimes the Fight Flight Fight Flight response still response still occursoccurs
When the person When the person cannot run or fight cannot run or fight the anxiety the anxiety worsensworsens
Anxiety and the Anxiety and the Sympathetic Nervous System Sympathetic Nervous System
Arousal and the Arousal and the Autonomic Nervous SystemAutonomic Nervous System
Motor tension; shaky, muscle tension, Motor tension; shaky, muscle tension, fatigues easilyfatigues easily
Tachycardia, pupils dilate, decrease Tachycardia, pupils dilate, decrease secretion in GI tract, Sphincters contract, secretion in GI tract, Sphincters contract, Convert glycogen to glucose in liverConvert glycogen to glucose in liver
Blood vessels dilate (peripheral)Blood vessels dilate (peripheral) Adrenaline; dry mouth, dizziness, nausea, Adrenaline; dry mouth, dizziness, nausea,
diarrhea diarrhea InsomniaInsomnia
Levels of AnxietyLevels of Anxiety
MildMild
ModerateModerate
SevereSevere
PanicPanic
Mild AnxietyMild Anxiety
Great level for maximum work Great level for maximum work efficiencyefficiency
Perceptual field very broad; alertPerceptual field very broad; alert High level problem solving can occurHigh level problem solving can occur Excellent level for: Excellent level for:
– learning conceptslearning concepts– writing a paperwriting a paper– teaching patientteaching patient
Great level for sportsGreat level for sports
Moderate AnxietyModerate Anxiety Perceptual field is narrowed Perceptual field is narrowed
– may be very focused or easily distractedmay be very focused or easily distracted Increased BP, P, R. Increased BP, P, R. Moderate Muscle tensionModerate Muscle tension Tune out stimuli Tune out stimuli
– Very focused on task at hand Very focused on task at hand – May miss other observationsMay miss other observations
Can learn list of facts or do step by step Can learn list of facts or do step by step taskstasks
Problem solving and reasoning with Problem solving and reasoning with assistance assistance
Severe Anxiety Severe Anxiety
Perception is reduced or distortedPerception is reduced or distorted Difficulty focusing even with Difficulty focusing even with
assistanceassistance Flight of ideasFlight of ideas Learning cannot take place; Learning cannot take place;
ineffective reasoningineffective reasoning Physical symptoms problematicPhysical symptoms problematic Behavior is directed toward reliefBehavior is directed toward relief
Panic LevelPanic Level
Feelings of terrorFeelings of terror Actual flight , fight Actual flight , fight
– or immobilizationor immobilization May be violentMay be violent Out of contact with reality Out of contact with reality Eyes fixedEyes fixed Hysterical Hysterical IncoherentIncoherent
Nursing Interventions: Mild AnxietyNursing Interventions: Mild Anxiety
Physiologic: Physiologic: – Warm bathWarm bath– Deep breathing Deep breathing – back rubback rub– Relaxation Relaxation
Cognitive Cognitive – Alert and Motivated to learnAlert and Motivated to learn– Teach client concepts about illness, prognosisTeach client concepts about illness, prognosis
EmotionalEmotional– Assess using therapeutic communication. Assess using therapeutic communication.
Identify feelings, guilt, anger sadness Identify feelings, guilt, anger sadness
Moderate Anxiety: InterventionsModerate Anxiety: Interventions Physiological Physiological
– Deep breathing Deep breathing – Relaxation techniquesRelaxation techniques
CognitiveCognitive– Decreased attention to Decreased attention to
detaildetail– Teach factual informationTeach factual information
task orientedtask oriented– learning to give learning to give
insulininsulin– Client can still Client can still
problem solve wellproblem solve well
Emotional/Behavioral Emotional/Behavioral – Therapeutic Therapeutic
communication communication – Assist to identify feelings Assist to identify feelings – Limit choices Limit choices
– Physical activityPhysical activity
Severe/Panic Level: InterventionsSevere/Panic Level: Interventions Role ChangesRole Changes
– Become more nurturing Become more nurturing and directiveand directive
– May not be able to give May not be able to give choiceschoices
PhysiologicPhysiologic– antianxiety medication antianxiety medication – Provide for safetyProvide for safety
CognitiveCognitive– Orient the client Orient the client – Give directionGive direction– Do not expect the client to Do not expect the client to
solve problemssolve problems– Use simple statementsUse simple statements– Give reassurance.Give reassurance.
Emotional/BehavioralEmotional/Behavioral– Be sensitive for patients Be sensitive for patients
need for spaceneed for space– Decrease StimuliDecrease Stimuli– Careful with touch/ non-Careful with touch/ non-
verbal communication.verbal communication.– Calm, firm, Quiet voiceCalm, firm, Quiet voice– May walk with the clientMay walk with the client– May restrain if May restrain if
necessarynecessary