Mental Health Nursing
A man was restless and observed to have an increased physical activity after a heated argument with another…
A man was restless and observed to have an increased physical activity after a heated argument with another person. After the assessment, the following data was gathered: agitated, diaphoretic, distorted perception. What is the patient's level of anxiety?
Explanation
Core Concept: According to Peplau's levels of anxiety, severe anxiety is characterized by a greatly reduced perceptual field. The individual focuses only on scattered details, has distorted perception, experiences increased motor activity (restlessness, pacing), and may be agitated or diaphoretic. They cannot solve problems or learn new things at this level.
Clinical Presentation:
- Agitation, restlessness, increased physical activity, diaphoresis.
- Distorted perception, selective inattention, inability to follow complex directions.
Diagnosis:
- First-line diagnostic plan: Clinical observation of behavioral and physiological signs of anxiety.
- Gold standard test: Standardized anxiety scales (e.g., Hamilton Anxiety Rating Scale) for psychiatric assessment.
Management:
- Acute management: Reduce environmental stimuli, maintain a calm demeanor, use short and simple sentences, and stay with the patient to provide a sense of safety. Administer PRN anxiolytics if ordered.
- Gold standard long-term/definitive management: Cognitive-behavioral therapy (CBT), stress management techniques, and long-term psychiatric medication management if an underlying anxiety disorder is diagnosed.