Академический Документы
Профессиональный Документы
Культура Документы
Learning Objective
Formulate nursing diagnoses
Identify expected outcomes and
short term nursing goals
Develop a patient education plan to
promote the relaxation responses
Analyze nursing intervention related
to anxiety responses
Evaluate nursing care
Introduction
Anxiety is part of everyday life
Its basic to the human condition and
provides a valuable warning system to
the individual
Its necessary for survival
Its preservationof self anxiety
occurs as a result of a threat to a
persons selfhood, selfesteem or
identity
Define
Anxiety is an emotion and a
subjective individual experience
Cannot be observed directly A
nurse infers the patient is anxiety
based on behavior
Anxiety communicated
interpersonally
(Stuart & Laraia, 2001 dan Stuart & sundeen, 1998)
Contd
Anxiety is an emotion without a specific
object.
Its provoked by the unknown and
precedes all new experiance (Ex:
entering school, starting a new job, ect)
Anxiety is experienced when the values
a person identifies with existance are
threatened
(Stuart & Laraia, 2001 dan Stuart & sundeen,
1998)
Anxiety vs Fear
The caracteristic of anxiety
differentiated it from FEAR.
Fear is an individual ideation with
a specific source or object that a
person can identify and describe
Deferentiate
Anxiety
Fear
the intelectual
the emotional
appraisal of a
responseto that
threatening
appraisal
stimulus
Caused by fear
Caused by physical
Fear produced
or psychological
exposure to a
anxiety
threatening
situation
Level of Anxiety
Peplau (1963) identify 4 levels of
anxiety
1.Mild Anxiety
2.Moderate Anxiety
3.Severe Anxiety
4.Panic
(Stuart & Laraia, 2001 dan Stuart &
sundeen, 1998)
Severe Anxiety
Is Marked by significant reduction in
the perceptual field
Panic
Is associated with awe,dread and terror.
This stage details are blown out of proportion
Complete loss of control the person is
unable to do things even with direction
Involve the disorganization of the personality
Characteristic:
Increased motor activity
decreased ability to relate to others
distorted perceptions and loss of rational
thought
Contd
Panic is frightening and paralyzing
experiance
The person is unable to communicate
or function effectively
The person is incompatible with life
A prolonged periode of panic result
in exhaustion and death
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or
smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
Environment
Perceptual
field
Mild
Perceptual
Field
Moderate
Environment
Illustration
Perceptual
Field
Environment
Mild
Severe
Environment
Perceptual
Field
Panic
Adaptive Response
Response
Anticipation
Severe
Mild
Panic
Maladaptive
Moderate
Ego Oriented
Constructive
Destructive
Anticipation
Mild
Moderate
Severe
Panic
2.
3.
4.
5.
Behaviors
Predisposing Factors
Pracipitating Stressors
Coping Resources
Coping Mechanisms
Nursing Diagnoses
Planning
Implementation
Evaluation
Behaviors
Physiological responses Autonomic
nervous systems
1. The Sympathic
2. The parasympathetic
(effect: Cardiovascular, respiratory,
gastrointestinal, neuromuscular, urinary,
skin.)
Behavioral psychomotors manifestation
Cognitif
Affective
Predisposing Factors
Psychoanalytic view Traumatic
stage, with increase age and ego
development, a new kind of anxiety
arises, emitional conflict: id and
superego
Interpersonal view
Behavioral view frustration, conflict
(there are two opposing interest
choose between them)
Family study
Biological basis
Precipitating
Threat to phusical integrity
Threat to self-system (identity, selfesteem, integrated social functional)
Nursing Diagnoses
1. Anxiety
Panic level of anxiety related to ...
severe anxiety related to ...
moderate anxiety related to ...
Implementing of moderate
level of anxiety
1.
2.
3.
4.
Recognition of anxiety
Insight into the anxiety
Coping with the threat
Promote the relaxation the
relaxation response
Evaluation
1. Deduced of anxiety level
2. Not harm and injury