ELDER TIP A benzodiazepine with a long half-life tends to accumulate in an older patient’s system and may cause oversedation. Benzodiazepines are sometimes given along with opioids to add to the analgesic effect or as a preanesthetic. Remember, if the elderly psychiatric patient is scheduled for surgery, he may take longer to recover from anesthesia if these combinations are used.
Tricyclic antidepressants or higher doses of short-acting benzodiazepines may relieve severe anxiety and panic attacks. Buspirone, an antianxiety drug, causes the patient less sedation and poses less risk of physical and psychological dependence than the benzodiazepines.
Psychotherapy for generalized anxiety disorder has two goals: helping the patient identify and deal with the cause of the anxiety and eliminating environmental factors that precipitate an anxious reaction. In addition, the patient can learn relaxation techniques, such as deep breathing, progressive muscle relaxation, focused relaxation, and visualization.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Anxiety disorder, generalized:
Treatment
(Handbook of Diseases)
A combination of drug therapy and psychotherapy may help a patient with generalized anxiety disorder. Benzodiazepine anxiolytics relieve mild anxiety and improve the patient’s ability to cope. They should be used cautiously, however, because they can be addictive. Buspirone, a nonbenzodiazepine anxiolytic, is an alternative to the benzodiazepines because it causes less sedation and poses less risk of physical and psychological dependence.
Psychotherapy for generalized anxiety disorder has two goals: helping the patient identify and deal with the underlying emotional and psychological issues and eliminating environmental factors that precipitate an anxious reaction. In addition, the patient can learn relaxation techniques, such as deep breathing, progressive muscle relaxation, focused relaxation, and visualization.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Skin, clammy:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Take the patient’s vital signs frequently and monitor urine output. If clammy skin occurs with an anxiety reaction or pain, offer the patient emotional support, administer pain medication, and provide a quiet environment.
Patient teaching
If an underlying illness is related to the patient’s clammy skin, provide information on the condition. If the condition is related to an alteration in the patient’s blood glucose level, provide information on management of hypoglycemia and early signs of a falling blood glucose level. Provide information on the importance of nutrition and hydration.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Anxiety:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient relaxation techniques and practice them with him. Encourage the patient to verbalize his anxiety and listen to him attentively. Help the patient identify and explore coping mechanisms that he used in the past. Work with the patient to identify stressors and guide him in effective coping skills.
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Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Skin, clammy:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Because the patient with cool, clammy skin may be acutely ill, provide emotional support to him and his family. Explain what’s happening using short, simple sentences. Orient them to the intensive care unit, if applicable, explaining the equipment and the unit’s routines.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Anxiety:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Provide supportive care, as indicated by the patient's signs and symptoms.
▪ Provide a calm, quiet atmosphere.
▪ Administer medications, as ordered, to reduce anxiety.
▪ Treat the underlying cause of the patient's anxiety, if known.
▪ Encourage the patient to express his feelings and concerns.
Patient teaching
▪ Teach the patient anxiety-reducing measures, such as distraction, relaxation techniques, or biofeedback.
▪ Teach the patient coping mechanisms to help control his anxiety.
▪ Explain the underlying causes of his anxiety, if known.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Skin, clammy:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Take the patient's vital signs frequently.
▪ Monitor the patient's intake and output.
▪ Provide measures to correct the underlying condition. For example, if clammy skin occurs with an anxiety reaction or pain, offer the patient emotional support, administer pain medication, and provide a quiet environment.
Patient teaching
▪ Explain the underlying disorder and its treatment.
▪ Orient the patient to the intensive care unit.
▪ Explain any diagnostic tests or procedures.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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