Stress Management

In this discussion, we’ll discuss anxiety, effective and ineffective interventions, and stress
management. Please include the following in your initial posting:
Describe a client from your clinical setting or work who experienced severe anxiety or panic.
Include a brief history and three most pertinent medications.
• Describe the assessment process for this patient.
• Identify at least one effective and one non-effective nursing intervention. Why did they
work? What didn’t work?
• Name and describe two stress reduction techniques you have used and whether they were
helpful or not in reducing stress.
Respond to at least to two other classmates and explain if you agree or disagree with how they
would handle a client who was having severe anxiety. If you do not agree, please provide how
they could have approached the client differently and provide supporting rationale and citations.
Remember that your posts must exhibit appropriate writing mechanics including using proper
language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or
reference materials, be sure to provide proper attribution and/or citation.


In my clinical setting, I encountered a client named Sarah who was experiencing severe anxiety and panic attacks. Sarah had a history of generalized anxiety disorder (GAD) and had been struggling with her symptoms for several years. She had a significant family history of anxiety disorders, which contributed to her predisposition.

Sarah’s three most pertinent medications included:

  1. Sertraline (Zoloft): Sarah had been prescribed sertraline as a long-term treatment for her GAD. It is a selective serotonin reuptake inhibitor (SSRI) that helps regulate serotonin levels in the brain, which can reduce anxiety symptoms over time.
  2. Lorazepam (Ativan): Sarah had lorazepam as a short-term intervention to manage acute panic attacks. Lorazepam is a benzodiazepine that provides rapid relief from anxiety and panic symptoms when used as needed.
  3. Propranolol (Inderal): Propranolol was prescribed to Sarah to help manage the physical symptoms of anxiety, such as rapid heart rate and trembling. It is a beta-blocker that can reduce the body’s fight-or-flight response.

The assessment process for Sarah involved a comprehensive evaluation of her mental health history, including the onset and duration of her anxiety symptoms, any triggering events, her family history, and a thorough physical examination. We also used standardized assessment tools such as the Generalized Anxiety Disorder 7-item (GAD-7) scale to quantify the severity of her anxiety symptoms and monitor her progress.

Effective Intervention: One effective nursing intervention for Sarah was teaching her relaxation techniques and mindfulness exercises. We introduced deep breathing exercises, guided imagery, and progressive muscle relaxation. These techniques helped Sarah gain better control over her anxiety and reduce the intensity of her panic attacks. She found them particularly helpful during moments of heightened stress.

Non-effective Intervention: An ineffective intervention was trying to force Sarah to confront her fears directly through exposure therapy. While exposure therapy can be beneficial for some anxiety disorders, it caused Sarah’s anxiety to worsen, leading to severe panic attacks. It was crucial to recognize that not all interventions work for every individual, and a more gradual approach was needed in her case.

Stress Reduction Techniques:

  1. Yoga: We introduced Sarah to yoga sessions, which combined physical movement with mindfulness and relaxation. She found these sessions helpful in reducing her overall stress levels and improving her ability to manage anxiety.
  2. Journaling: Encouraging Sarah to keep a journal helped her express her thoughts and emotions in a safe and structured way. This allowed her to gain insight into her triggers and patterns of anxious thinking, contributing to a better understanding of her anxiety.

In response to my classmates, I agree with the importance of individualized care and recognizing that what works for one client may not work for another. In cases of severe anxiety, a flexible and person-centered approach is essential to determine the most effective interventions. It’s crucial to avoid pushing clients into situations that may exacerbate their anxiety, as seen in Sarah’s case with exposure therapy. Instead, emphasizing gradual and patient-centered strategies, as well as utilizing a combination of medications and non-pharmacological interventions, can be more successful in managing severe anxiety.

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