Anxiety disorders are abnormal states in which the most striking features are mental and physical symptoms of anxiety, occurring in the absence of organic brain disease or another psychiatric disorder. Risk For Self-Directed Violence Risk For Self-Directed Violence Administer tranquilizing medications as ordered by the physician. The nurse should develop an atmosphere of empathic understanding while focusing on the present situation by giving feedback about current reality. In anxiety disorders secondary to a general medical condition, specialty consultation may be indicated (Bhatt & Bienenfeld, 2019). Long-term goal: The patient will use effective coping strategies and seek support and help as needed. Progressive muscle relaxation can be practiced individually or with the support of a narrator (Norelli et al., 2022). The client will appear relaxed and report anxiety is reduced to a manageable level. 29. In addition, her mother has been diagnosed with stage 4 breast cancer. Reassure the client of his or her safety and security. Active listening involves showing interest in what the client has to say, acknowledging that you are listening and understanding, and engaging with them throughout the conversation (Rivier University, 2023). Goal/Desired Outcome. Evaluate for suicidal and homicidal risk.Suicidal ideation should be assessed by asking about passive thoughts of death, desires to be dead, thoughts of harming self, or plans or acts to harm self. Informed and empowered clients participate with the healthcare team in exploring options for overcoming disease and establishing the conditions for maximizing health consistent with their own socio cultural frame of reference (Stubbe, 2017). ADHD. A step by step approach might be easier for the patient to retain. Confrontation with Coworkers? Reassurance attempts to dispel the anxiety of the client by implying that there is no sufficient reason for it to devalue the clients judgment and communicates the nurses lack of empathy and understanding. Anxiety is a common mental health condition that affects millions of people worldwide. Lessen sensory stimuli by keeping a quiet and peaceful environment; keep threatening equipment out of sight.Anxiety may intensify to a panic state with excessive conversations, noise, and equipment around the client. Be cautious with touch. Short-term goal: The patient will remain free of destructive behavior and will report a decrease in stress. Each individuals experience with anxiety is different. Assist the client in strengthening problem-solving abilities. Relaxation techniques provided by nurses help the clients divert their attention to other things that will make them feel at ease, change their mindset into a positive one, control thinking, and manage their emotions, especially fear, sadness, and overthinking about their condition. Pass your board exam. The client will demonstrate an appropriate range of feelings and lessened fear. Anxiety appears to be caused by an interaction of biopsychosocial factors. Help the client, Verbalization of feelings in a nonthreatening environment may help the client come to terms. Each type of anxiety disorder has its own set of symptoms and treatment options. Bhatt, N. V., & Bienenfeld, D. (2019, March 27). 27. The following are nursing interventions for chronic anxiety: Panic disorder is a type of anxiety disorder characterized by recurrent and unexpected panic attacks. Analyzed and provided recommendations towards scheduling and or adjusting PPS assessments, which also included OMRA's. Provide information regarding psychotherapy.Cognitive and behavioral psychotherapy can be used alone or in addition to pharmacotherapy. Short term goal The client will discuss a phobic object or situation with the nurse or therapist within 5 days. Pass Rates. Assist the client in developing new anxiety-reducing skills (e.g., relaxation, deep breathing, positive visualization, and reassuring self-statements).Discovering new coping methods provides the client with various ways to manage anxiety. This plan should include strategies for assessing and monitoring the patients symptoms, providing emotional support and counseling, promoting relaxation and stress reduction, and educating the patient on coping mechanisms and healthy lifestyle habits. Providing client with choices will increase his or her feelings of control. Help client identify areas of life situation that are not within his or her ability to control. The presence of the nurse may lend support to the anxious patient and provide strategies for effectively coping with anxious moments or panic attacks. It can be a result of fear, uncertainty, circular and racing thoughts, and the avoidance of certain behaviors. Clients with significant discomfort from their anxiety can benefit from emergency anxiolytic treatment, primarily with a benzodiazepine. These defense mechanisms include displacement, repression, denial, projection, and self-image splitting. By using nonverbal cues such as nodding and saying I see, the nurse can encourage the client to continue talking. This checklist is an especially good resource for treatment planning, due in part to how brief and to-the-point it is. Sudden and complete elimination of all avenues for dependency would create intense anxiety on the. Anxiety is linked to fear and manifests as a future-oriented mood state that consists of a complex cognitive, affective, physiological, and behavioral response system associated with preparation for the anticipated events or circumstances perceived as threatening (Chand & Marwaha, 2022). Overall, the success of nursing care plans for anxiety depends on a variety of factors, including the patients individual needs, the effectiveness of the care plan, and the patients willingness to participate in their own care. Nursing care plans: Diagnoses, interventions, & outcomes. The client may fear for his or her life. Family relationships are disrupted; financial, lifestyle, and role changes make this a difficult time for those involved with the client, and they may react in many different ways. Use simple words and brief messages, spoken calmly and clearly, to explain hospital experiences to clients. The client becomes pale and hypotensive and experiences poor muscle coordination. Box breathing is a breathing exercise to assist clients with stress management and can be implemented before, during, and/or after stressful experiences. Guided imagery is a relaxation exercise intended to assist clients with visualizing a calming environment. Longer-term therapy currently consists of SSRIs, often with additional psychotherapeutic techniques. -The patient verbalize interest in talking with a psychiatrist. Short Term Goal / Objective: Mary will work with therapist/counselor to help expose and extinguish irrational beliefs and conclusions that contribute to anxiety. In some cases, the patient may require hospitalization or other advanced interventions, which will require close collaboration with the healthcare team. Recommend client to keep a log of episodes of anxiety. SMART Goals for Nursing With Clear Examples By Ida Koivisto, BSN, RN, PHN Goals provide a keen sense of motivation, direction, clarity, and a clear focus on every aspect of your career or (nurse) life. Buy on Amazon. Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client CareIdentify interventions to plan, individualize, and document care for more than 800 diseases and disorders. In this nursing care plan, the main focus is to remove the air blocks so that the proper amount of oxygen enters the lungs. Administer tranquilizing medication, as ordered by the physician. The person may be unable to make decisions. The client will willingly attend therapy activities accompanied by a trusted support person within 1 week. It can affect our ability to function normally, and even convince us that were losing our minds. Consider passing the NCLEX as a short-term goal and an . https://nursestudy.net/psychosocial-nursing-diagnosis/, Constipation Nursing Diagnosis and Care Plan, Drowsiness, dizziness, confusion, and addiction, Nausea, insomnia, sexual dysfunction, and weight gain, Physical symptoms such as sweating, trembling, or rapid heartbeat. It is a huge factor in establishing rapport with the client in gaining cooperation during treatment, and care, providing interventions, and helping clients deal with their anxiety (Cacayan et al., 2021). Social phobiarelates to profound fear of social or performance situations inwhich embarrassment could occur. The client will discuss a phobic object or situation with the nurse or therapist within 5 days. St. Louis, MO: Elsevier. Acute anxiety, as a form of acute mental anguish, can lead to unsafe or self-injurious behavior (Bhatt & Bienenfeld, 2019). The lighting, temperature, sounds, smells, and color palette of an environment are very important to how comfortable, relaxed, and safe the client feels. Intervene when possible to eliminate sources of anxiety.Anxiety is a normal response to actual or perceived danger; if the threat is eliminated, the response will stop. The patient also reports to having constant diarrhea, forgetfulness, irritability, and angry outbursts at her children. Caffeine-containing products, such as coffee, tea, and colas, should be discontinued or at least decreased to a low reasonable level. Compare. 2. The nurse must keep talking to the person in a comforting manner, even though the client cannot process what the nurse is saying. The state scale can be used to determine the actual levels of anxiety intensity induced by stressful procedures (Karger, 2017). Hildegard E. Peplau described 4 levels of anxiety: mild, moderate, severe, and panic.The client with mild anxiety will have minimal or no physiological symptoms of anxiety. Initially meet clients dependency needs as required. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. Assist the patient in judging the situation realistically. This can be conveyed by physical presence of nurse. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams. - Skin is intact but red and non-blanchable. Treatment may include therapy, medication, lifestyle changes, and self-care techniques. The client may be unaware of the relationship between emotional concerns and anxiety. This nursing care plan is for patients who are experiencing powerlessness. She reports to having uncontrollable anxiety attacks while at work, sleeping, and driving. The trait scale consists of 20 statements that ask people to describe how they generally feel. Accept the clients defenses; do not dare, argue, or debate.If defenses are not threatened, the client may feel secure and protected enough to look at behavior. Encourage the client to consider positive self-talk like Anxiety wont harm me, I can take this step by step, I need to breathe and stretch right now, and I dont have to be perfect can be helpful in calming the patient and reducing their anxiety.Cognitive therapies focus on changing behaviors and feelings by changing thoughts. The presence of a trusted individual provides the client with a feeling of security and assurance of personal safety. Encourage the client to talk about traumatic experiences under nonthreatening conditions. Fear is an automatic neurophysiological state of alarm characterized by a fight or flight response to a cognitive appraisal of present or imminent danger. In this lesson we cover everything you need to successfully complete a nursing care plan for a ptsd patient. The tool is written at the sixth-grade reading level and is available in more than 40 languages. Preeclampsia Case Scenario. Fear and anxiety will diminish as the client begins to accept and deal positively with reality. Anxiety related to a recent medical diagnosis and fear of the unknown as evidenced by reports of restlessness, fear, and worry. 16. Explore clients perception of threat to physical integrity or threat to self-concept. In contrast, music therapy uses various components of music, such as melody, timbre, rhythm, harmony, and pitch, to support and enhance physical, psychological, and social well-being by building a therapeutic relationship between the participant and the therapist (Lu et al., 2021). STAI is the gold standard for measuring preoperative anxiety. The nurse should also monitor the patient for signs of worsening anxiety or complications such as suicidal ideation, and intervene promptly if necessary. Provide massage and backrubs for the client to reduce anxiety.This aids in the reduction of anxiety. Based on data analysis, nurses attitudes or behaviors matter when interacting with a client with anxiety. Removing these triggers may lead to a reduction in the clients anxiety and panic attacks (Bhatt & Bienenfeld, 2019). She states they started two weeks ago and she has tried to manage them with a prescription of Xanax 0.25 mg PO that he doctor gave her a month ago but says it is not helping. The client will demonstrate problem-solving skills and effective use of resources. Encourage participation in these activities, and provide positive reinforcement for participation, as well as for achievement. Anxiety related to situational stressors as evidenced by restlessness, increased heart rate, and sweating. Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Phobias: Characterized by a persistent and severe fear of a clearly identifiable object or situation despite awareness thatthe fear is unreasonable. She reports that she found out three weeks ago her husband of 21 years has been having an affair with her best friend and that he wants a divorce. Its reliability and validity are well reported. Focusing on small goals that are attainable in a short period keeps the patient motivated to improve daily. Acknowledgment of the clients feelings validates the feelings and communicates acceptance of those feelings. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. Treatment is indicated when a client shows marked distress or suffers from complications resulting from the disorder. It is important to note that music therapy is not equal to music medicine. Ineffective coping is the inability to manage, respond to, or make decisions surrounding a stressful situation. Lets dive into the five anxiety nursing diagnoses and care plans that can make a significant difference in patient outcomes. Copyright 2023 RegisteredNurseRN.com. 6. Anxiety and Anxiety Disorders in Young People: A Cross-Cultural Perspective. Nursing Interventions -The nurse will assess the patient's psychological and physiologic comfort. Suspected Deep tissue injury: - Skin is intact; appears purple or maroon. As a nurse, one of the key components of caring for patients with anxiety is implementing nursing interventions. Health anxiety, perceived stress, and coping styles in the shadow of the COVID-19. Some hospitals may have the information displayed in digital format, or use pre-made templates. Anxiety is divided into different levels and each level has unique effects: Mild Characterized by an individual's awareness that something is different and his attention is warranted by it. In this disease, there is a deficiency of air in the lungs and an increment in the carbon-dioxide. 8. The exercise involves tensing and releasing muscles, progressing throughout the body, with the focus on the release of the muscle as the relaxation phase. During stressful life events, it is important to pay attention to the increasing levels of health anxiety and to the kind of coping mechanisms that are potential factors to mitigate the effects of high anxiety (Garboczy et al., 2021). -The patient will effectively use 3 coping mechanisms to help with anxiety attacks. It is important for nurses to work closely with patients to develop a care plan that is tailored to their specific needs and preferences. Lu, G., Jia, R., Liang, D., Yu, J., Wu, Z., & Chen, C. (2021, October). Prioritized nursing diagnosis includes acute pain, deficient fluid volume, and ineffective health maintenance. The following factors can be considered when evaluating the effectiveness of nursing care plans: Regular communication with the patient and their family members can also provide valuable insight into the effectiveness of the care plan. Nursing Care Plans Nursing Diagnosis & Intervention (10th Edition)Includes over two hundred care plans that reflect the most recent evidence-based guidelines. Provide a structured schedule of activities for the client, including adequate time for completion of rituals. If the client is comfortable with the idea, the log may be shared with the healthcare provider, who may help the client develop more effective coping strategies. Help the client work through feelings of guilt related to the traumatic event. Medical-surgical nursing: Concepts for interprofessional collaborative care. Identify ways in which the client can achieve. Cognitive therapy helps the client understand how automatic thoughts and false beliefs/distortions lead to exaggerated emotional responses, such as anxiety, and can lead to secondary behavioral consequences. The following interventions may be used: Nurses should work with patients to develop an individualized plan of care that incorporates both pharmacological and non-pharmacological interventions. Symptoms include motor tension (trembling; shakiness; muscle tension, aches, soreness; easy fatigue), autonomichyperactivity (shortness of breath, palpitations, sweating, dry mouth, dizziness, nausea, diarrhea, frequent urination), andscanning behavior (feeling on edge, having an exaggerated startle response, difficulty concentrating, sleep disturbance,irritability).Panic disorder: Characterized by a specific period of intense fear or discomfort with at least four of the following symptoms: palpitations or pounding heart, sweating, trembling or shaking, sensations of smothering or difficulty breathing, feeling of choking, chest pain, nausea, feeling dizzy or faint, feeling of unreality or losing control, numbness, and chills or flushes. Clients often ask nurses for advice about what they should do about particular problems or specific situations. 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