Coping
Anxiety vs Stress
Anxiety is emotional
Stress is external
Different levels of anxiety- (need to know the difference)
__mild________sensation that something is
different and warrants special attention.
Sensory stimulation increases and helps the
person focus attention to learn, solve
problems, think, act, feel, and protect him
or herself.
• ___moderate__________ disturbing feeling that something is
definitely wrong; the person becomes nervous or
agitated. The person can still process information,
solve problems, and learn new things with
assistance from others. He or she has difficulty
concentrating independently but can be
redirected to the topic.
• ____severe_________ more primitive survival skills take over,
defensive responses ensue, and cognitive skills
decrease significantly. The person has trouble
thinking and reasoning. Muscles tighten, and vital
signs increase. The person paces; is restless, irritable,
and angry; or uses other similar emotional–
psychomotor means to release tension
Anxiety disorders-
Generalized anxiety disorder
SAD- seasonal depression
Panic disorder
Phobia
OCD
Eating disorders,anorexia,bulimia
Risk factors- genetics, stressful, ptsd, perfectionism, low self esteem, sociocultural pressures
Generalized anxiety disorder- excessive and unrealistic anxiety. Worry more often than not.
Onset in childhood to teens. Depression is a pairing
Restlessness, fatigue, impaired concentration, irritability, muscle tension, sleep disturbances.
Must have 4 to be diagnosed in a 6 month period.
Assessment findings- decreased attention span, feelings of discomfort, apprehension,
restlessness, irritability
, First med to prescribe is an SSRI (zoloft), Buspar, quick fi could be xanax, ativan,clonipine
Working with pts with anxiety-
Mild anxiety- talking through problems with the pt
Moderate anxiety- speak in clear short simple sentences, make sure they understand info
correctly
Severe anxiety- pt cant usually make decisions. Don't leave these pts alone. Calm low soothing
tone of voice. PRN meds
Separation anxiety- children younger than 18.
s/s- clinginess, stomach pain, excessive worry, fearing being alone
Cultural considerations- asian cultures usually express somatic symptoms- headaches,
backaches, fatigue, dizziness, stomach problems
Susto- diagnosed in hispanic clients.
Older adults- anxiety is common in elders. GAD, phobias, panic, OCD, PTSD
Frequently diagnosed with alzheimers/dementia
Understand the triggers. Dont give a bunch of anxiety meds
Panic attack- discrete episodes. 15-30min of rapid and intense anxiety
Rule out medical problems first
Diagnosed by- recurrent PAs followed by 1 month of persistent concern
Treatment- medication, CBT, clonadine or propranolol
Helpful interventions- stay with the pt, deep breath to prevent respiratory alkalosis, techniques
to help relax
Phobias-
OCD-
Eating disorders-
Anorexia Nervosa- begins ages 14-18
Profound sense of emptiness
Medical management- malnourished pts may need TPN, weight gain and adequate food intake
are often the criteria for determining the effectiveness of treatment
Amitriptyline, Olanzapine, Fluoxetine (antidepressents) to treat
Medical complications- mennorhea, atrophy (muscle and fat loss), osteoporosis, hair growth,
metabolic hypothyroidism, hypoglycemia, bradycardia, hypotension, arrythmias, constipation,
bowel obstruction, bloating, dry brittle skin
Bulimia nervosa- late adolescence into adult. Secretive. Binge eating and purging.
s/s- eroded teeth, some may have seizures from fluid shifts. fatique/weakness, sores on
knuckles from teeth
treatment - therapy, antidepressents
Anxiety vs Stress
Anxiety is emotional
Stress is external
Different levels of anxiety- (need to know the difference)
__mild________sensation that something is
different and warrants special attention.
Sensory stimulation increases and helps the
person focus attention to learn, solve
problems, think, act, feel, and protect him
or herself.
• ___moderate__________ disturbing feeling that something is
definitely wrong; the person becomes nervous or
agitated. The person can still process information,
solve problems, and learn new things with
assistance from others. He or she has difficulty
concentrating independently but can be
redirected to the topic.
• ____severe_________ more primitive survival skills take over,
defensive responses ensue, and cognitive skills
decrease significantly. The person has trouble
thinking and reasoning. Muscles tighten, and vital
signs increase. The person paces; is restless, irritable,
and angry; or uses other similar emotional–
psychomotor means to release tension
Anxiety disorders-
Generalized anxiety disorder
SAD- seasonal depression
Panic disorder
Phobia
OCD
Eating disorders,anorexia,bulimia
Risk factors- genetics, stressful, ptsd, perfectionism, low self esteem, sociocultural pressures
Generalized anxiety disorder- excessive and unrealistic anxiety. Worry more often than not.
Onset in childhood to teens. Depression is a pairing
Restlessness, fatigue, impaired concentration, irritability, muscle tension, sleep disturbances.
Must have 4 to be diagnosed in a 6 month period.
Assessment findings- decreased attention span, feelings of discomfort, apprehension,
restlessness, irritability
, First med to prescribe is an SSRI (zoloft), Buspar, quick fi could be xanax, ativan,clonipine
Working with pts with anxiety-
Mild anxiety- talking through problems with the pt
Moderate anxiety- speak in clear short simple sentences, make sure they understand info
correctly
Severe anxiety- pt cant usually make decisions. Don't leave these pts alone. Calm low soothing
tone of voice. PRN meds
Separation anxiety- children younger than 18.
s/s- clinginess, stomach pain, excessive worry, fearing being alone
Cultural considerations- asian cultures usually express somatic symptoms- headaches,
backaches, fatigue, dizziness, stomach problems
Susto- diagnosed in hispanic clients.
Older adults- anxiety is common in elders. GAD, phobias, panic, OCD, PTSD
Frequently diagnosed with alzheimers/dementia
Understand the triggers. Dont give a bunch of anxiety meds
Panic attack- discrete episodes. 15-30min of rapid and intense anxiety
Rule out medical problems first
Diagnosed by- recurrent PAs followed by 1 month of persistent concern
Treatment- medication, CBT, clonadine or propranolol
Helpful interventions- stay with the pt, deep breath to prevent respiratory alkalosis, techniques
to help relax
Phobias-
OCD-
Eating disorders-
Anorexia Nervosa- begins ages 14-18
Profound sense of emptiness
Medical management- malnourished pts may need TPN, weight gain and adequate food intake
are often the criteria for determining the effectiveness of treatment
Amitriptyline, Olanzapine, Fluoxetine (antidepressents) to treat
Medical complications- mennorhea, atrophy (muscle and fat loss), osteoporosis, hair growth,
metabolic hypothyroidism, hypoglycemia, bradycardia, hypotension, arrythmias, constipation,
bowel obstruction, bloating, dry brittle skin
Bulimia nervosa- late adolescence into adult. Secretive. Binge eating and purging.
s/s- eroded teeth, some may have seizures from fluid shifts. fatique/weakness, sores on
knuckles from teeth
treatment - therapy, antidepressents
