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Clinical Processes and Symptom Management 

Clinical Processes and Symptom Management
Chapter:
Clinical Processes and Symptom Management
Author(s):

Perry G. Fine

and Matthew Kestenbaum

DOI:
10.1093/med/9780190456900.003.0003
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date: 25 May 2020

This chapter describes what to do when a patient experiences severe anxiety and uncontrolled agitation that negatively affect care and the caregiving environment. Agitation and severe anxiety (panic) represent some of the few true emergency conditions in a hospice setting, so early recognition and prevention are critical. The discussion covers causes in depth, including psychosocial/spiritual and biomedical causes. The chapter details a tactical approach to evaluating and managing severe anxiety and agitation. An example of this is assessing if the patient has an organic brain syndrome due to advancing disease with either local or systemic manifestations and reviewing medications for adverse drug reactions. It then details appropriate processes of care, such as providing pharmacotherapy for acute and recurrent agitation.

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