Showing posts with label Anxiety. Show all posts
Showing posts with label Anxiety. Show all posts

Monday, October 5, 2015

Physiological and Psychological Responses to Anxiety


Autonomic nervous system responses to fear and anxiety cause involuntary activities in the body including the self-defense mechanism. Sympathetic nerve fibers "activate" vital signs at any sign of danger for preparing the body's defenses. The adrenal glands release adrenaline (epinephrine), which causes the body to take in more oxygen, dilates pupils, and increases arterial pressure and heart rate while making constricting peripheral blood vessels and makes shunting of blood from the gastrointestinal and reproductive system and increases glycogenolysis be free glucose to sustain heart , muscle, and central nervous system. When the danger has ended, parasympathetic nerve fibers reverse this process and restore the body to its normal state until the signs of the next threat to re-activate the sympathetic response (Videbeck, 2008).

Anxiety causes the response of cognitive, psychomotor and physiological uncomfortable, such as difficulty thinking logically, increased motor activity, agitation, and increased vital signs. To reduce discomfort, individuals try to reduce the discomfort level to perform adaptive behavior that is new or defense mechanisms. Adaptive behavior can be a positive thing and helps individuals adapt and learn, for example: using imagination techniques to refocus attention on the beautiful scenery, relaxation of the body sequentially from head to toe, and breathing slowly and regularly to reduce muscle tension and vital signs. Negative response to anxiety can lead to maladaptive behaviors, such as headache due to tension, pain syndromes and stress-related responses that lead to immune efficiency (Videbeck, 2008).

Anxiety can be passed from one individual to another individual through words, for example, heard a shout "fire" in a crowded room or hear the sound vibrating from the mother who can not find the child in a crowded mall. Anxiety may be communicated nonverbally through empathy, a sense of self-adjust the position of others for some time (Sullivan, in Videbeck, 2008).

When people become anxious, they use defense mechanisms to reduce anxiety. Defense mechanisms is the cognitive distortions used by a person to maintain a sense of control over stressful situations. This process includes self deception, limited awareness of the situation, or the emotional commitment is lacking. Most defense mechanisms arise from the subconscious so that individuals do not consciously use it. When the patient can not explain the accident that had just happened, his mind was using the mechanism of repression (forget the terrifying events that unconsciously).

Some individuals use excessive defense mechanisms and it stopped them learn a variety of appropriate methods to cope with situations that cause anxiety. Dependence on one or two defense mechanisms can also inhibit the growth of emotional, causing poor problem-solving skills, and cause trouble in a relationship.

Friday, September 6, 2013

Anxiety related to Laparotomy

Nursing Care Plan for Laparotomy - Nursing Diagnosis : Anxiety


A laparotomy is a surgical incision (cut) into the abdominal cavity. This operation is performed to examine the abdominal organs and aid diagnosis of any problems, including abdominal pain. In many cases, the problem – once identified – can be fixed during the laparotomy. In other cases, a second operation is required. Another name for laparotomy is abdominal exploration.

Anxiety

A vague, uneasy feeling of discomfort or dread accompanied by an autonomic response, with the source often nonspecific or unknown to the individual; a feeling of apprehension caused by anticipation of danger. It is an altering signal that warns of impending danger and enables the individual to take measures to deal with threat.

Defining Characteristics:

Behavioral
  • Diminished productivity;
  • scanning and vigilance;
  • poor eye contact;
  • restlessness;
  • glancing about;
  • extraneous movement (e.g., foot shuffling, hand/arm movements);
  • expressed concerns resulting from change in life events;
  • insomnia;
  • fidgeting

Affective
  • Regretful;
  • irritability;
  • anguish;
  • scared;
  • jittery;
  • overexcited;
  • painful and persistent increased helplessness;
  • rattled;
  • uncertainty;
  • increased wariness;
  • focus on self;
  • feelings of inadequacy;
  • fearful;
  • distressed;
  • apprehension;
  • anxious

Physiological
  • Voice quivering

Objective
  • Trembling/hand tremors; insomnia

Subjective
  • Shakiness; worried; regretful


Nursing Diagnosis for Laparotomy : Anxiety related to surgical procedure, preoperative procedures.

Outcomes:
  • Patients will demonstrate the ability focus on new knowledge and skills.
  • Identification of symptoms as an indicator of anxiety itself.
  • Showed no aggressive behavior.
  • Communicating and handling negative feelings appropriately.
  • Relaxed and comfortable in the move.

Interventions and Rational :
1. Monitor patient's signs and symptoms of anxiety while nursing assessment.
R /: Assessment of patients with anxiety conditions carefully allows nurses to make nursing priorities.

2. Focus discussion on stressors that affect the condition of the patient.
R /: Focus discussion facilitates the ability of the patient to express fears and feelings are felt and build a therapeutic relationship.

3. Discuss the patient's perception will be a surgical procedure, the fear associated with the operation.
R /: Discussion will make the patient's perception and fear to express themselves and explore self-knowledge.

4. Provide information procedure before surgery, the patient's illness and surgery preparation
R /: Measures to increase knowledge and anxiety reduction.

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