Managing Stress And Anxiety In A Patient: A Case Study

Symptoms of anxiety and stress

According to the case study Stefan is suffering from stress, anxiety, and disorder. It is very essential to properly communicate with the patient in a proper manner. Proper communication is needed to collect information from the Patient. Since Stefan is suffering from stress and anxiety so the nurse should follow some techniques to perform a normal communication. Stefan seems to be stressed out and giving half information so some of the techniques which should be used are as below.

• Stressed outpatient is often annoyed due to some reason. In the case of Stefan, his loss of employment might be the reason. So the anxiety should be acknowledged and willingness to talk and listen to Stefan should be shown. He should be really convinced that the other person really wants to talk to him in an empathetic manner. Then Stefan will slowly open up and give more information about his problem (Bramhall, 2014). Acknowledgment of the anxiousness is also very important. Proper acknowledgment helps the stressed person to open up.
• An appropriate distance should be maintained during communication which is very much necessary. The nurse should not go to close to the person because he might be intimidated and should not go far away from the person also because he might feel neglected. So a balanced distance should be maintained during the conversation.
• Sometimes it takes time for the person to open up and after he opens up it is quite natural they may have an outburst of their emotion. During the outburst of emotion, it should not be interrupted and the nurse should be empathetic and listen quietly and record information if necessary from that outburst. Stefan should not be given any opinion on how to converse because that could seem to be threatening to any stressed out person.
• To gather correct information open-ended question should be asked by the nurse so that the patient has more chance to open up. The open-ended question will encourage the patient to talk freely (Hodson, 2013).
• The conversation should be made in such a way that Stefan feels that he has options from where he can answer. This is a very important point because patient suffering from anxiety often becomes violent when they feel that they have little alternatives or they are backed into a corner.
• The conversation should be carried standing in the front side of the patient which helps in increasing the confidence level of the patient and it also reduces the stress level so Stefan can converse in a regular and proper way (McGough, 2007).

It is assumed from the behavior of Stefan that he is suffering from anxiety and stress.  The features of Anxiety and stress can be easily seen from the behavior of the patient. If the psychology and behavior of Stefan are analyzed then it will be clear that he is suffering from Anxiety and distress.  According to the case study, Stefan is not standing or seating still in a fixed position. This is one of the major sign of anxiety patient. He is not able to seat in a fixed position that means his mind is disturbed he is thinking about the factors which have given him stress.

 Mainly the patient becomes very much impatient and restless when suffering from the stress. Stefan is not able to concentrate properly because when he has been asked question during the admission interview he has not answered specifically. His answers were short and not adequate for the nurse to know about his background (Aggön, 2017). This is another point which proves that Stefan is under stress. He is not able to concentrate in a proper manner and is getting distracted. His lack of concentration is another significant feature that should be noted for people suffering from anxiety. It is very important to be empathetic to this kind of patient.

Another important point is the appearance of the patient. Most of the patients suffering from anxiety face insomnia. Stefan has a beard and bag under his eyes that mean it is clear that he is also suffering from insomnia which is one of the clinical features of stress and anxiety. His hair is not combed and he is not wearing tidy ironed clothes that mean he has not paid attention to himself at all.  The stress and anxiety have taken a heavy toll on him. This is a clear sign of stress shown by Stefan. It is very much clear that due to the overstressed condition he has insomnia. 

Communication techniques for collecting information

Stefan’s hand has nicotine stains on it. This is a clear sign that he is addicted to nicotine to get relief from his distressed condition. People suffering from stress and anxiety often use nicotine to reduce their stress. This might cause another health hazard (Barjaktarovi?-Rako?evi?, Miloševi? & Cicvari?-Kosti?, 2017).

When the nurse starts a conversation with Stefan he gives a short answer. In cases of anxiety, it is seen that the patient’s speech becomes louder, quicker or quit. In the case of Stefan, he is generating the tendency to become quit with a limited answer. This is a clinical feature of developing stress and anxiety.

Several relaxation techniques can be suggested for the patients suffering from anxiety. The basic symptoms of anxiety are:

• Uncomfortable feeling
• Unconscious or Subconscious body movements
• Rapid breathing
• Feeling tired of no reason
• Thinking about some present or future impossible incidents

 Whenever Stefan entered the room he looked so uncomfortable and seemed like has least control to whatever he is doing which is a type of subconscious activity (Takuma & Shimada, 2011).  Recommended interventions for Stefan are:

Deep breathing: Deep breathing is one of the innovative interventions to be fit from anxiety. Stefan needs to sit comfortably on the chair folding both the hands on his belly.  He needs to breathe slowly and increase the depth of breathing.  It must be kept in mind that the shoulder should not be bent or folded. This must continue for at least ten to fifteen. This must be done twice a day and must be continued without any hindrance.  It can be helpful to reduce the stress factors from the mind and keeps the mind free from anxiety (Krampen, 2010).

Progressive muscle reaction:  Progressive muscle reaction defines the systematic relaxation of the muscles.  It helps to pacify the muscle strain and reduces the muscle heaviness.  Moreover, it is helpful in measuring emotional; state, thoughts, and body feeling. Thus, it can be recommended to Stefan in order to reduce his anxiety.  To achieve this, he must be advised to loosen his clothing and lie down in a plane.  Then he needs to close his eyes and tense first his hand muscles and then his leg muscles.  This exercise is capable to give him comfort to reduce the amount of stress and anxiety (Kim & Han, 2009).

Meditation:  Meditation is a most useful technique to reduce the level of stress and anxiety from the mind. This comforts both mind and body. Stefan can be recommended to try meditation every day to reduce the stress and anxiety factors from his mind. It must be done in a comfortable and quiet spot. Stefan should sit still and backbone must be straight. Breathing must be done through the nasal way. The mind must be concentrate on only a single object; that may be any word or materialistic object and think about that for a long time with natural breathe from the nose. This could be effective for Stefan to pacify his anxiety (Holding et al., 2017).

Relaxation techniques for managing stress and anxiety

Creative activity: This includes activities like painting, story reading, and writing and playing any indoor or outdoor game. This can be suggested to Stefan and allow him to indulge in any creative task. This is capable to reduce anxiety.

Suitable medication can be advised for adverse syndromes of anxiety.  As per the case study, Stefan has been advised to take Diazepam 5 to 10mg oral PRN for anxiety symptoms.  This medicine works quickly on the anxiety patients and mitigates the effects of anxiety. However, Diazepam cannot be advised for long-term treatment and some safety measures must be followed by Stefan while taking this medicine for effective result. The safety measures would be helpful in reducing the level of anxiety, increasing the effectiveness of the medicine diazepam oral dosage and motivates the inner ability of the patient to adjust and fight with anxiety (Benjamin, 2017). According to the case study, the further required information for Stefan for anxiety treatment are as follows:

• Alcohol consumption is strictly prohibited during the course of this medicine. Stefan needs to remember that diazepam does not work properly if alcohol is consumed as alcohol increases the adverse effects of anxiety. Thus, the treatment procedure can be delayed out of it.
• Consumption of sleeping pills during the course time for diazepam is highly injurious to health. The consumption of sleeping pill results in an overdose of the medicine and the symptoms like fatigue, nausea, drowsiness, unusual weight gain, insomnia, and diarrhea are notable. Thus, Stefan must not use sleeping pills during the course time of diazepam in order to avoid the adverse result of an overdose.
• If any dosage of diazepam is missed, it must be taken whenever it is remembered on that particular day. It is a regular based medicine and must be taken every day. Thus, Stefan needs to use this medicine every day as per the prescription of the healthcare staff and must consume it whenever remembered if forgotten (Czaprowski et al., 2013).
• Smoking is strictly prohibited for Stefan during the medication course for anxiety. Smoking increases the adverse effects of the anxiety and reduces the inhale feature of the anxiety medicine. Hence, he must make sure that he is not a smoker and if it is then he must have to stop it for a desirable result.
• A healthy diet is a most effective technique to reduce the vigorousness of anxiety. Stefan must follow a healthy dietary process for a positive result.  This includes low-fat food consumption, reducing the consumption of fast food, increase the consumption of fresh foods and green vegetables.  Moreover, morning walk, jogging, and physical exercises help to mitigate the adverse effects of anxiety and promotes the effectiveness of the medicines (Gordon, Wilp & Oliver, 2018).

References

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Benjamin, G. (2017). Response: Population Health Approaches to First Aid Training– A Critical Need. International Journal of First Aid Education, 1(1).

Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard, 29(14), pp.53-59.

Czaprowski, D., Leszczewska, J., Kolwicz, A., Paw?owska, P., K?dra, A., Kriš?i?nas, A., Raistenskis, J. & Kowalski, I. (2013). The Influence of Self-Stretching Based on Postisometrical Relaxation, Static Stretching Combined with Stabilizing Exercises, and Stabilizing Exercises Only on the Flexibility of One-Joint and Two-Joint Hip Flexors. Medicine, 49(10), p.69.

Gordon, E., Wilp, T. & Oliver, E. (2018). Equipping First Aid Learners to Respond in Fragile Environments. International Journal of First Aid Education, 1(2).

Hodson, M. (2013). Compassion, Caring and Communication: Skills for Nursing Practice – Second editionCompassion, Caring and Communication: Skills for Nursing Practice – Second edition. Nursing Standard, 27(43), pp.28-28.

Holding, E., Relton, C., Roberts, K. & Oliver, E. (2017). First aid intervention in the adult population: Yorkshire Health Study and its implications for first aid education. International Journal of First Aid Education, 1(2).

Kim, G. & Han, J. (2009). Development of Ontology-based Medical Mobile CRM(m-CRM). Journal of the Korea Academia-Industrial cooperation Society, 10(10), pp.2721-2727.

Krampen, G. (2010). Improvement of orthography test performance by relaxation exercises: results of a controlled field experiment in basic secondary education. Educational Psychology, 30(5), pp.533-546.

McGough, G. (2007). Communication Skills for Nursing PracticeCommunication Skills for Nursing Practice. Nursing Standard, 21(17), pp.30-30.

Takuma, Y. & Shimada, T. (2011). Effect of Duration of Muscle Relaxation during Intermittent Isometric Exercises on Deoxygenation and Lactate Accumulation in Active Muscles. Journal of Physical Therapy Science, 23(3), pp.495-501.