ANXIETY

Anxiety is a common and normal response to a new ans stressful situation such as caring for an ill person. When people are ill and hospitalized,they may feel afraid,nervous,and overwhelmed. Many experience anxiety during their ilness, caused bye worries of medical procedures, fear of being aburden, pain and discomfort, or even as a result of terminal ilness.

Family and friends caring for an ill person also become anxious. The caregivers anxiety may be becaused by worrying about a loved one's illness and their ability to cope with it and poor communication between the person and the caregiver. At times, the anxiety of the person with terminal ilness can even be a source of the caregiver'a anxiety.

There are two distinct forms of anxiety:

• Acute anxiety ; people with acute anxiety often suffer short - term episodes of restlessness and are overactive. In more extreme cases, this individuals experience panic attacks accompanied bye breathing problems.
• Choronic anxiety; people with chronic anxiety experience long term problems, such as fatique, insomnia, trouble concentrating and problems such as fatique, insomnia, trouble concentrating and problems witj decision-making.

Signs and symptons of anxiety may have the folloeing physical signs or symptoms af anxiety:

• Difficulty solving problems and concentrating
• Feeling excitable
• Increases muscle tension (appears tense)
• Trembling and shaking
• Headaches
• getting angry
• Shortness of breath
• Rapidirregular heartbeat
• Dizziness
• Irritability
• Excessive worrying
• Fatique
• Insomnia
• Dry mouth
• Sweating
• Diarrhea
• frequent Urination

If more than one of the above symptoms exist, call or see a doctoror other member of the health care team. They will evaluate the possible causes of anxiety and make recommendations for treatmen orreferral.

Treatmen

Treatmen for anxiety may vary, depending on the underlying cause and individula. Your health care professional may recommend psychoterapy or a combination of both.Although teratment does not cure, it proves effective in relieving anxiety symptomps.

Medication

There are several types of medication available for traetment of anxiety. They include :

• Benzodiazepines : these have been the standard treatment for anxiety for several years. Although effective, they have side effects, including risk dependency and abuse. Examples of benzodiazepines include Xanax, Klonipin, Valium, Ativan and Paxipam.
• Anti-depressants: Specifically, the SSRIs have increasingly been prescribed as anti-anxiety medication. They are effective and less habit forming than the benzodiazepines. Side effects include weight gain and sexual dysfunction. Example include Prozac, Zoloft, Paxil and Luvox.
• Beta-blockers: including Inderal and Tenormin block the nerve that stimulates the heart to beat faster.
• azapirones: Buspirone ( Buspar ) is used to great generalized anxiety. Common side effects include dizziness, drowsiness and nausea.

if one medication is not effective, your doctor may prescribe another or combinations.

You can also help bye :

• determine what thoughts are causing anxiety,Identify triggers
• Talking to some one who has been through the situation causing anxiety.
• Increase pleasant, distracting activities.
• Increase companionship and time spent with friends and family who care.
• relieve physicallsymptoms such as pain or other side effects.
• participate in relaxation techniques such as medication, muscle therapy, mild exercise, etc.

If you are experiencing symptoms of anxiety, you should talk to someone who can help a friend. someone who has experienced anxiety before, a nurse, phychiatrist, psychologist or a social worker. They are well trained and will be glad to hear and discuss about your feelings.

CARDIO PULMONARY RESUSCITATION

Cardio pulmonary resuscitation ( CPR ) is a technique of basic life support for the purpose of oxygenating the brain and heart until appropriate, definitive medical treatment can restore
normal heart and ventillatory action. Respiratory arrest has been associated with a better survival than cardiac arrest. Once cardiac arrest occur, the outcome of resuscitative effort is poor.Complete apnea signals need rapid and vigorus action to prevent cardiac arrest. In such situations, nurse must be prepared to initiate action immediately.Neurologically intact survival has occured only in those patients who received immediate resuscitation and respond promptly.Cardio pulmonary resuscitation is an emergency procedure that consists of artificial respiration and external cardiac massage, instituted after cardiopulmonary arrest.

The basic principles of life support center on the ABC of CPR :
1.Airway
2.Breathing
3.Circulation

Cardinal symptoms of cardiact arrest are the following :
1. Sudden loss of consciousness
2.Absence of carotid / femoral pulses
3.Absence of audible heart sounds
4.Convulsions
5.Dilation of pupil with gray or ash color


FAST FACT
For effective cardio pulmonary resuscitation victim is placed on the back i.e, in the supine position on a firm, flat, hard surface, supporting head and neck. With loss of consciousness the tounge wich is attached to the lower jaw, relaxes and falls back, obstructing the air way.To open the air way head is positioned with either head tilt/ chin-lift or jaw thrust maneuver.

When achild requires CPR,consider the size, not just the age. For example,youg children who can be palced on the rescue's thigh should receive infant CPR. Since many older children with severe chronic ilness or disability remain small in size. So pediatric CPR may be appropriate.After the initial two breaths, the pulse is pulpated to determine the presence of heart beat. The carotid is the most central and accessible artery in children over 1 year of age.However the very short and often fat neck of the infant renders the carotid pulse difficult to palpate. Therefore it is preferable to use the brachial pulse in the infant, located on the inner side of the upper arm.Absence of a carotid or brachial pulse is considered sufficient indication to begin external cardiac massage.

External chest compressions consist of serial, rhythmic compressions of the chest to maintain circulation to vital organs untill the child achieves spontaneous vital signs or ALS can be provided.Chest compressions are always interspersed with ventilation of the lungs. The volume of air in an infant's lung is small, and the air passages are considerably smaller,with resistance to flow. Therefore smlal puffs of air are delivered.It is essential to prevent over-extension of the head of small infants, since this tends to close the flexible trachea.

The patient who has been resuscitated is at risk for another episode of cardiac arrest.If the victim is breathing or resumes effective breathing after emergency interventions,placed in the recovery position .but if rescue breathing or RPR required victim should not be placed in the recovery position.