Mary is a 35-year-old woman who has a history of generalized anxiety disorder (GAD). She presents with recurrent episodes of severe anxiety and panic attacks, which have significantly impacted her daily life. Mary has a history of trauma and reports difficulties managing stressors at work and in personal relationships.
Three Most Pertinent Medications:
1. Selective Serotonin Reuptake Inhibitor (SSRI): Prescribed for long-term management of generalized anxiety disorder.
2. Benzodiazepine (as needed): Prescribed for acute anxiety episodes or panic attacks.
3. Beta-blocker: Prescribed to manage physical symptoms of anxiety, such as rapid heart rate.
The assessment process for Mary involves a comprehensive review of her medical history, psychiatric history, and a thorough exploration of her current stressors and coping mechanisms. Standardized anxiety assessment tools, such as the GAD-7 and Hamilton Anxiety Rating Scale, are utilized to quantify the severity of her symptoms. Additionally, exploring any potential triggers or underlying issues contributing to her anxiety is crucial.
One effective nursing intervention for Mary is the implementation of Cognitive-Behavioral Therapy (CBT). This therapeutic approach helps Mary identify and challenge negative thought patterns contributing to her anxiety. Through counseling sessions, Mary learns coping mechanisms and relaxation techniques, enhancing her ability to manage stressors effectively.
An ineffective intervention may be solely relying on medication without addressing the underlying issues. While medications can provide symptom relief, they may not address the root causes of anxiety. Without a holistic approach, Mary’s long-term recovery may be compromised.
Stress Reduction Techniques:
1. Mindfulness Meditation:
Description: Mary was introduced to mindfulness meditation as a stress reduction technique. This involved guided meditation sessions focusing on the present moment.
Mary reported a noticeable reduction in her overall stress levels. The mindfulness practice helped her gain better control over her anxious thoughts.
1. Progressive Muscle Relaxation (PMR):
Description: PMR involves tensing and then gradually releasing different muscle groups to induce relaxation.
Mary found PMR helpful in reducing physical tension associated with anxiety. Regular practice improved her ability to manage stress-induced muscle tension.
In summary, a comprehensive assessment, a combination of therapeutic modalities, and holistic approaches are crucial in managing severe anxiety. Effective nursing interventions should address both the psychological and physiological aspects of anxiety, while stress reduction techniques play a significant role in improving overall well-being.
Severe anxiety occurs when the body and mind react to potential threats without question. It’s a way of preparing for stress and possible negative experiences (Rose,2014). When Mr. Brown came in, he explained he was exhausted. He explained he’s been having panic attacks and described what those look like for him, which are sweating shaky voice, and heavy breathing. He takes buspirone, metoprolol, and nardil. I checked the patient’s heart rate and noticed his hands were trembling. I checked his past hx with anxiety and panic attacks. I interviewed Mr. Brown about his feelings. He said he does experience chest pain. We went across what triggers look like for him. My effective intervention was active listening; he said he doesn’t have anyone he feels understands him. He stated he felt much lighter after our conversation and agreed to attend Cognitive Behavior Therapy. My non-effective intervention was to get Mr. Brown to take his prescribed medication appropriately and as ordered. He said he does not like how they make him feel, so he can’t make any promises. I told Mr. Brown how important it is to exercise; I advised him to take a daily walk if his schedule allows him to. I also told him about breathing techniques and how they help during an attack. Deep and long breathing in and out enables you to disengage your mind from distracting thoughts and sensations.