Determine level of anxiety provide basis for intervention Accept patients

Determine level of anxiety provide basis for

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Determine level of anxiety, provide basis for intervention Accept patients’ feelings of anxiety o Prevent anxiety transferred o Prevent anxiety from escalating Provide emotional security o Give factual information. Medication, time, procedure, treatment, expectations. FACTS! o Use self in a therapeutic way o Nonjudgement, silence, offer self, interpersonal qualities, therapeutic communication Promote safety o Physical & physiologic (sitter) o Meet basic needs (hydration, nutrition, elimination, hygiene) Avoid making demands or requiring decisions o Reduce further anxiety, confusion, agitation Promote sleep (opposite of anxiety) o Sleep reduces CNS tension
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o Warm bath, light snack, quiet task, reading, music Provide medication o Reduces anxiety at the bio-cellular level. Physiologic support o Requires gradual, long term tapering Protect from impulsive acts o Aggression, self-harm = frequent observation, 1:1 sitter Allow defense mechanisms o Protective, add to patient o Maladaptive, for survival if used sparingly o Temporarily reduces anxiety Initially allow “worry time” or “compulsive time” o Gradually reduce, wean-off Reduce physical stimulants o Pain, discomfort, caffeine Reduce environmental stimulants o Noise, lighting, temp Treat physical complaints as matter of fact o Not to make a big deal out of it. Minimize. Don’t increase patient’s anxiety o Decrease intensity of anxiety o Avoid confrontation concerning the physical defense (patient says I cent feed myself. Nurses sets up tray and tells them to try their best and you will come back and check on them) Provide recreational and diversional activities o Teaches new behavior o Provide distraction and occupation o Promote rest and activity (walks, puzzles, coloring books) Work in the “here and now” o Prevent reoccurrence. What can be changed now to support the future Provide feedback on anxious behaviors o Increase self-awareness, empowerment (point out picking at hair, kicking leg) Identify sources of anxiety o Increase awareness, empowerment (work, boss, relationships, kids, school) Discuss effects of ineffective coping o Promote insight, alternatives for change (drinking, sleeping, smoking) Explore secondary gains Explore alternate coping behaviors o Options for adaptive behaviors Behavior modification: Based on premise that behaviors are learned; maladaptive behaviors can be eliminated, and healthy behaviors can be learned!!! Role modeling o Modeling adaptive behaviors through practice and imitation o Deep breathing o Guided imagery o Exercise o Journaling Operant conditioning
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o Positive reinforcement o Receiving rewards for adaptive behaviors o Self “pat on the back” Systematic desensitization o Exposure to phobic/obsessive stimulus in gradual amounts over time o While avoiding use of the rituals or avoidant behaviors (no fear) Reduces emotional response o Develops tolerance “give it a try” Cognitive behavioral therapy (CBT) o Mind over matter o
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  • Winter '17
  • Deborah Cridor

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