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CONCEPT
OF
ANXIETY
Prepared by: Eric F. Pazziuagan, RN,
MAN
Anxiety
The initial responses to a psychic
threat (Peplau).
 Anxiety in response to stress is
inevitable in everyday life...
LEVELS OF ANXIETY
Mild: +1
 Psychomotor

symptoms:

◦ Preparation of body for
constructive action.
◦ Slight muscle tension.
◦ Slight fidget...


Emotional symptoms:
◦ Occasional slight irritability.
◦ Feeling challenged.
◦ Confident (Use of adaptive coping
mechani...
 Interventions:

◦ Discuss source of anxiety (steps
of learning)
◦ Problem solve
◦ Accept anxiety as natural;
tolerate an...
Moderate: +2


Psychomotor Symptom:
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦

Preparation of body for protective action.
Moderate muscle tensi...
 Emotional

symptoms:

◦ Feeling uncomfortable, on edge,
keyed up
◦ Motivated to decrease anxiety.
◦ Increased irritabili...


Cognitive symptoms:
◦ Difficulty in concentrating
◦ Easily distracted, can focus with
assistance
◦ Circumstantiality
◦ ...
 Interventions:

◦ Decrease anxiety- ventilation, crying,
exercise, relaxation techniques.
◦ Refocus attention; relate fe...
Severe: +3


Psychomotor signs:
◦
◦
◦
◦
◦
◦
◦
◦
◦

Preparation of body for fight or flight.
Extreme muscle tension.
Incre...
 Emotional

symptoms:

◦ Extreme discomfort.
◦ Feeling of dread.
◦ Hypersensitivity.
◦ Defensiveness with threats and
dem...
 Cognitive

symptoms:

◦ Distorted perceptions.
◦ Difficulty focusing, even with
assistance.
◦ Flight of ideas.
◦ Ineffec...
 Interventions:

◦ Decrease anxiety, stimuli and
pressure.
◦ Use kind, firm, simple
directions.
◦ Use time out (seclusion...
Panic: +4
 Psychomotor

symptoms:

◦ Actual flight, fight, or
immobilization.
◦ Suicide attempts or violence.
◦ Depletion...
 Emotional

symptoms:

◦ Feeling overwhelmed and out
of control.
◦ Rage
◦ Desperation.
◦ Feeling totally drained (Use
of ...
 Cognitive

symptoms:

◦ Disorganized perceptions
◦ Disorganized or irrational
reasoning and problem solving
◦ Neologisms...
Interventions:

◦Guide firmly, or
physically take control
◦Give intramuscular
injection
◦Order restraints, if
needed
COPING WITH
ANXIETY
Adaptive
Solves

the problem that
is causing the anxiety, so
the anxiety is decreased.
The patient is objective,
rationa...
Palliative
 Temporarily

decreases the
anxiety but does not solve
the problem, so the anxiety
eventually returns.
 Tempo...
Maladaptive
Unsuccessful

attempts to
decrease the anxiety
without attempting to
solve the problem.
The anxiety remains.
Dysfunctional
Is

not successful in
reducing anxiety or
solving the problem.
Even minimal functioning
becomes difficult,...
Most common adaptive
techniques:
Problem-solving
 Assertiveness
 Positive self-talk and self-acceptance
 Stress and ang...
Assignment:
Give actual patient examples of the
following types of coping:

1.

◦
◦
◦
◦
2.

3.
4.

Adaptive
Palliative
Mal...
Concept of Anxiety
Concept of Anxiety
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Concept of Anxiety

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Concept of Anxiety

  1. 1. CONCEPT OF ANXIETY Prepared by: Eric F. Pazziuagan, RN, MAN
  2. 2. Anxiety The initial responses to a psychic threat (Peplau).  Anxiety in response to stress is inevitable in everyday life.  The way in which individuals cope with anxiety and stress is important in understanding the quality with which individuals are functioning in their personal, social, and occupational roles. 
  3. 3. LEVELS OF ANXIETY
  4. 4. Mild: +1  Psychomotor symptoms: ◦ Preparation of body for constructive action. ◦ Slight muscle tension. ◦ Slight fidgeting. ◦ Energetic. ◦ Good eye contact.
  5. 5.  Emotional symptoms: ◦ Occasional slight irritability. ◦ Feeling challenged. ◦ Confident (Use of adaptive coping mechanisms)  Cognitive symptoms: ◦ ◦ ◦ ◦ ◦ ◦ Alertness Awareness of surroundings Concentration Accurate perceptions Attentiveness Logical reasoning and problem-solving skills
  6. 6.  Interventions: ◦ Discuss source of anxiety (steps of learning) ◦ Problem solve ◦ Accept anxiety as natural; tolerate and benefit from it.
  7. 7. Moderate: +2  Psychomotor Symptom: ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Preparation of body for protective action. Moderate muscle tension. Increased BP, pulse, and respirations. Startle reflex. Slight perspiration. Difficulty sitting still. Repeated fidgeting. Periodic slow pacing. Increased rate of speech. Sporadic eye contact.
  8. 8.  Emotional symptoms: ◦ Feeling uncomfortable, on edge, keyed up ◦ Motivated to decrease anxiety. ◦ Increased irritability. ◦ Decreased confidence (use of palliative coping mechanisms).
  9. 9.  Cognitive symptoms: ◦ Difficulty in concentrating ◦ Easily distracted, can focus with assistance ◦ Circumstantiality ◦ Tangentiality ◦ Loose associations ◦ Narrowed perceptions ◦ Decreased attention span ◦ Misperception of stimuli ◦ Problem solving and reasoning skills with effort, or assistance.
  10. 10.  Interventions: ◦ Decrease anxiety- ventilation, crying, exercise, relaxation techniques. ◦ Refocus attention; relate feelings and behaviors to anxiety; then use problem-solving techniques; give oral medication, if needed.
  11. 11. Severe: +3  Psychomotor signs: ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Preparation of body for fight or flight. Extreme muscle tension. Increased perspiration. Continuous and rapid pacing. Reflex responses. Loud or rapid speech, or both. Poor eye contact. Somatic symptoms. Sleep disturbance.
  12. 12.  Emotional symptoms: ◦ Extreme discomfort. ◦ Feeling of dread. ◦ Hypersensitivity. ◦ Defensiveness with threats and demand. ◦ Use of maladaptive coping mechanisms.
  13. 13.  Cognitive symptoms: ◦ Distorted perceptions. ◦ Difficulty focusing, even with assistance. ◦ Flight of ideas. ◦ Ineffective reasoning and problemsolving skills ◦ Disorientation. ◦ Delusions and hallucinations, if prolonged. ◦ Suicidal or homicidal ideations, if prolonged.
  14. 14.  Interventions: ◦ Decrease anxiety, stimuli and pressure. ◦ Use kind, firm, simple directions. ◦ Use time out (seclusion) ◦ Give intramuscular medications, if needed.
  15. 15. Panic: +4  Psychomotor symptoms: ◦ Actual flight, fight, or immobilization. ◦ Suicide attempts or violence. ◦ Depletion of body resources. ◦ Eyes fixed. ◦ Hysterical or mute. ◦ Incoherent.
  16. 16.  Emotional symptoms: ◦ Feeling overwhelmed and out of control. ◦ Rage ◦ Desperation. ◦ Feeling totally drained (Use of dysfunctional coping mechanisms)
  17. 17.  Cognitive symptoms: ◦ Disorganized perceptions ◦ Disorganized or irrational reasoning and problem solving ◦ Neologisms. ◦ Clang associations. ◦ Word salad. ◦ Out of contact with reality. ◦ Personality disorganization.
  18. 18. Interventions: ◦Guide firmly, or physically take control ◦Give intramuscular injection ◦Order restraints, if needed
  19. 19. COPING WITH ANXIETY
  20. 20. Adaptive Solves the problem that is causing the anxiety, so the anxiety is decreased. The patient is objective, rational and productive.
  21. 21. Palliative  Temporarily decreases the anxiety but does not solve the problem, so the anxiety eventually returns.  Temporary relief allows the patient to return to problem solving.
  22. 22. Maladaptive Unsuccessful attempts to decrease the anxiety without attempting to solve the problem. The anxiety remains.
  23. 23. Dysfunctional Is not successful in reducing anxiety or solving the problem. Even minimal functioning becomes difficult, and new problems begin to develop.
  24. 24. Most common adaptive techniques: Problem-solving  Assertiveness  Positive self-talk and self-acceptance  Stress and anger management  Learning skills needed for communication and relationships  Conflict management  Time management  Community living skills 
  25. 25. Assignment: Give actual patient examples of the following types of coping: 1. ◦ ◦ ◦ ◦ 2. 3. 4. Adaptive Palliative Maladaptive Dysfunctional What are the palliative techniques that can be used to decrease the effects of anxiety? What is crisis? How does it differ from stress? What are the strategies for crisis intervention?

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