STUDY - Technical - New Dacian's Medicine
Anxiety
(Classical / Allopathic Medicine)
A subjective
reaction to a real or imagined threat, anxiety is a
nonspecific feeling of uneasiness or dread. It may be mild,
moderate, or severe. Mild anxiety may cause slight physical or
psychological discomfort. Severe anxiety may be incapacitating
or even life-threatening.
Everyone
experiences anxiety from time to time - it's a normal response
to actual danger, prompting the body (through stimulation of
the sympathetic and parasympathetic nervous systems) to
purposeful action. It's also a normal response to physical and
emotional stress, which can be produced by virtually any
illness. Anxiety can also be precipitated or exacerbated by
many nonpathologic factors, including lack of sleep, poor
diet, and excessive intake of caffeine or other stimulants.
However, excessive, unwarranted anxiety may indicate an
underlying psychological problem.
ALERT:
If the patient displays acute, severe anxiety:
- quickly take his vital signs, and determine his reason for seeking care (this will serve as a guide for how to proceed)
- try to keep him as calm as possible; suggest relaxation techniques and talk in a reassuring, soothing voice.
If the patient displays mild or moderate anxiety, perform a focused assessment.
If the patient displays acute, severe anxiety:
- quickly take his vital signs, and determine his reason for seeking care (this will serve as a guide for how to proceed)
- try to keep him as calm as possible; suggest relaxation techniques and talk in a reassuring, soothing voice.
If the patient displays mild or moderate anxiety, perform a focused assessment.
HISTORY:
Ask the patient about the duration of his anxiety. Is the anxiety constant or sporadic? Did he notice any precipitating factors?
Ask the patient if the anxiety is exacerbated by stress, lack of sleep, or excessive caffeine intake. Does rest, exercise, or a tranquilizer alleviate it?
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient about the duration of his anxiety. Is the anxiety constant or sporadic? Did he notice any precipitating factors?
Ask the patient if the anxiety is exacerbated by stress, lack of sleep, or excessive caffeine intake. Does rest, exercise, or a tranquilizer alleviate it?
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
PHYSICAL
ASSESSMENT:
Focus on complaints that may trigger or be aggravated by anxiety.
If significant physical signs don't accompany the patient's anxiety, suspect a psychological basis.
Determine the patient's level of consciousness, and observe his behavior.
Focus on complaints that may trigger or be aggravated by anxiety.
If significant physical signs don't accompany the patient's anxiety, suspect a psychological basis.
Determine the patient's level of consciousness, and observe his behavior.
SPECIAL
CONSIDERATIONS:
Many drugs cause anxiety, especially sympathomimetics and central nervous system stimulants, and many antidepressants cause paradoxical anxiety.
Many drugs cause anxiety, especially sympathomimetics and central nervous system stimulants, and many antidepressants cause paradoxical anxiety.
PEDIATRIC
POINTERS:
Anxiety in children usually results from painful physical illness or inadequate oxygenation. Its autonomic signs tend to be more common and dramatic than in adults.
Anxiety in children usually results from painful physical illness or inadequate oxygenation. Its autonomic signs tend to be more common and dramatic than in adults.
AGING ISSUES:
In elderly patients, distractions from the patient's ritual activity may provoke anxiety or agitation.
In elderly patients, distractions from the patient's ritual activity may provoke anxiety or agitation.
PATIENT
COUNSELING:
Supportive care
can help relieve anxiety. Provide a calm, quiet atmosphere,
and make the patient comfortable. Encourage him to express his
feelings and concerns freely.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)