Physiological and Psychological Responses to Anxiety

Physiological and Psychological Responses to Anxiety

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.

2 Nursing Interventions for Pemphigus Vulgaris

2 Nursing Interventions for Pemphigus Vulgaris

Pemphigus Vulgaris  

Pemphigus vulgaris is a chronic blistering skin disease with skin lesions that are rarely pruritic, but which are often painful.

Pemphigus vulgaris is an autoimmune, intraepithelial, blistering disease affecting the skin and mucous membranes.

1. Acute Pain related to damage to the soft tissue, soft tissue erosion.

Goal: Pain is reduced / lost or adapted.

Expected outcomes:

• Subjectively reported reduced pain or can be adapted. Pain scale: 0 -1.
• Can identify activities that increase or decrease the pain.
• The patient is not restless.

Interventions:

1. Assess PQRST approach (P = Provocation / Palliation, Q = Quality / Quantity, R = Region / Radiation, S = Severity Scale, T = Timing)
Rationale: Being a basic parameter to determine the extent of intervention required and as the evaluation of the success of the intervention pain management.

2. Explain and help the patient with pain relief action nonpharmacological and noninvasive.
Rationale: The approach by using relaxation and other nonpharmacological have shown effectiveness in reducing pain.

3. Perform nursing management of pain:

a. Set the physiological position.
Rationale: It would increase the intake of oxygen into the subcutaneous tissue inflammation. Setting ideal position is in the opposite direction to the lesion pemphigus.

b. Perform maintenance of oral hygiene.
Rationale: Overall patient's oral cavity can be eroded and exposed surfaces. Necrotic tissue can form in this area so that adds to the suffering of patients and interfere with food intake. Weight loss and hypoproteinemia may occur. Careful oral hygiene care is very important to keep the oral mucosa is kept clean and allow the regeneration of the epithelium. Rinse the mouth that often must be done to cleanse the mouth and reduces pain in the area of ​​ulceration. Be kept moist lips by applying a lip moisturizer.

c. Rest client
Rationale: Rest is needed during the acute phase. This condition will increase the supply of blood to the inflamed tissue.

d. If necessary premedication before performing wound care.
Rationale: wet and cool compresses or immersion therapy is protective measures that can reduce pain. Patients with extensive lesions and pain should receive premedication prior to the preparation of an analgesic before the skin care began.

e. Environmental management: calm environment and limit visitors.
Rationale: Tranquil environment will decrease the pain stimulus of external and visitor restrictions will help increase oxygen conditions of the room, which will be reduced if many visitors who were in the room.

d. Teach deep breathing relaxation techniques.
Rationale: Improve input oxygenation in patients, resulting in lower secondary pain from inflammation.

e. Teach technique of distraction during painful.
Rationale: Distraction can reduce internal stmulus.

f. Perform touch management.
Rationale: It can help reduce pain. Light massage can increase blood flow and automatically helps the blood supply and oxygen to the painful area, and reduce the sensation of pain.

4. Collaboration with physicians for providing analgesic.
Rationale: Analgesics block the path of pain so the pain will be reduced.


2. Impaired Skin Integrity related to local necrosis secondary to tissue accumulation of pus in the hair follicles.

Goal: Improved skin integrity optimally.

Expected outcomes:

• Increased tissue growth, improved wound state, spending pus in the wound no longer exists, the wound closed.

Interventions:

1. Assess soft tissue damage that occurs on the client.
rationale:
Being the basic data to provide information about wound care interventions, what tools will be used, and the type of solution that will be used.

2. Perform maintenance bullae.
Rationale: The patient with bullae broad area, has a characteristic odor which will be reduced after secondary infection under control. The patient's skin after a bath, the skin is dried carefully and sprinkled with powder that is not irritating so that the patients can move more freely in bed. The amount of powder that is pretty much it may be necessary to keep the patient's skin is not sticky on the sheets. Hypothermia often happens and actions for keeping the patient warm and comfortable is a priority in nursing activity.
Increased tissue growth, improved wound state, spending pus in the wound no longer exists, the wound closed.

3. Increase the intake of nutrients in patients.
Rationale: Nutrition is necessary to increase the intake of the needs of the body's tissues.

4. Evaluation of tissue damage and the development of tissue growth.
Rationale: If still not reached of the evaluation criteria, then it needs to be re-examined factors that can inhibit the growth of the wound.

6 Nursing Interventions for Glaucoma

6 Nursing Interventions for Glaucoma

Nursing Interventions  

Nursing Diagnosis and Interventions for Glaucoma


1. Acute Pain related to an increase in IOP

Goal: Pain is reduced and the client is on the comfort level.

Expected outcomes:

• The Client do not complain of pain.
• Normal intraocular pressure / down.
• Calm facial expression.

Interventions:

• Assess the type, intensity and location of pain. Use pain scale to determine the level of analgesic doses.
• Keep the rest in bed in a quiet room and dark with the head elevated 30 ° or in a comfortable position.
• Rest of clients in the room that does not dazzle with the head rather an extension or a comfortable position for the client.
• Encourage relaxation techniques.
• Avoid nausea, vomiting, give anti-emetic if necessary.
• Collaboration with physicians in providing analgesic.

2. Disturbed Sensory Perception (visual) related to damage to the nerve fibers due to increased IOP.

Goal: Decrease of visual field can be reduced.

Expected outcomes:

• The client can use the drug correctly.
• Cooperative in every action.
• Realized loss of eyesight permanently.
• Vision did not decline further.

Interventions:

• Assess and record the visual acuity.
• Assess functional description of what can be seen / not.
• Environment with the ability to adjust the vision.
• Orient on the environment: Put the tools that are often used in client outreach vision, Provide adequate lighting, Put the tools in place which remains, Provide reading materials with great writing, avoid glare.
• Use the clock sound.
• Assess the amount and type of stimuli that can be accepted by the client.
• Advise on alternative forms of stimulation such as radio, TV.

3. Risk for injury related to a decrease in the visual field.

Goal: The client was not injured.

Expected outcomes:

• The client can explain how to prevent injury.
• The is able to demonstrate on alertness anxiety.
• The officer asked for help when the ends meet.

Interventions:

• Orient the client to the environment when it arrives.
• Explain the origin of a decrease in peripheral vision and do like bumping into objects.
• Suggest to turn his head to look into each side.
• Arrange the room in order to walk around freely.
• Make modifications to the environment to move all the dangers: Get rid of the obstacles on a walk. Get rid of the foot rolls. Get rid of items that may injure the client. Help clients and families to evaluate the home environment against the dangers that may occur.

4. Risk for infection related to the surgical wound.

Goal: infection can be prevented / controlled.

Expected outcomes:

• Free from signs and symptoms of infection.

Interventions:

• Wash hands before and after nursing actions.
• Improve sufficient nutrients (nutritious and contain vitamin A).
• Monitor signs and symptoms of systemic and local infections.
• Monitor susceptibility to infection.
• Inspection condition of the wound / surgical incision.
• Instrusikan clients to drink antibiotics as recommended.
• Teach clients and families about the signs and symptoms of infection, and how to avoid infection.

5. Disturbed body image related to the lesions on the skin which affects its appearance.

Goal: The client can accept the situation.

Expected outcomes:

• Discuss strategies to cope with changes in body image.

Interventions:

• Assess the patient's knowledge of the existence of a potential disability associated with surgery or skin changes.
• Monitor the patient's ability to see the changes against him.
• Encourage the patient to discuss feelings about the changes in the appearance of the surgery.
• Give support group for people nearby.

6. Anxiety related to loss of vision, lack of knowledge.

Goal: Anxiety is reduced.

Expected outcomes:

• Reduced feeling nervous.
• Reveals an understanding of the plan of action.
• Relaxed body position.

Interventions:

• Carefully deliver permanent loss of vision.
• Give the client the opportunity to express about the condition.
• Maintain a relaxed condition.
• Explain the purpose of each action.
• Prepare bell on the bed and instructed the client to indicate when asking for help.
• Maintain effective pain control.

Home Care - How to Relieve Severe Nausea in Pregnant Women

Home Care - How to Relieve Severe Nausea in Pregnant Women

Obstetrical Nursing  

Home Care - How to Relieve Severe Nausea in Pregnant Women

Nausea is the sensation issued a strong food or want to vomit. Vomiting sensation is accompanied by signs of autonomic, such as hypersalivation (excessive saliva expenditure), diaphoresis, tachycardia, pallor, and tachypnea. Nausea is closely linked to the occurrence of anorexia and vomiting.

Nausea can also occur due to take medication, the effects that occur after surgery and radiation. Nausea often occurs during the first trimester to a pregnant woman.
Nausea can also be caused by extreme pain due to accidents or other issues, anxiety, alcohol poisoning (drunk) because of excessive consumption, or it can also be caused by food and beverages are not tasty.

Nausea during early pregnancy is often called morning sickness, because it generally occurs in the morning. Really just happened the morning ?, Not really, because there are some pregnant women can occur at any time throughout the day. Because the exact cause is unknown, treatment of this problem can have different effectiveness. But do not worry because there are some things you can do.

Increased estrogen and thyroxine become one of the causes of nausea in pregnant women. Sometimes in some women, the nausea lasts until severe. Therefore to avoid it, you can do some of the following home care.

Get plenty of rest
When you are pregnant, you are advised to have plenty of time to rest. Rest will make your body relax and minimize fluctuation of hormones that can cause nausea.

After sleep, get up slowly
When waking from sleep, get up slowly. If you wake up suddenly, then there is a jolt that will shock your body and can make you sick.

Eating healthy food
While pregnant, avoid foods that can trigger nausea. One of them is caffeine. Caffeine is a proven bad for your pregnancy because it can increase the acid in the stomach which would exacerbate nausea.

Increase your physical activity
Physical activity you do, can reduce severe nausea because physical activity will accelerate your body's metabolic system so that you avoid nausea.