Goal Nursing intervention Rationale Evaluation Patient will verbalize -Obtain baseline -Baseline data are After 24 hours, the feelings of less assessment of anxiety essential in evaluating patient was able to anxiousness and fears level and coping the effectiveness of verbalize feelings of And worst, it can even lead to related psychological conditions, like substance abuse and personality difficulties. Preload & Afterload. Anxiety can be a debilitating condition that affects many patients, but with the right nursing diagnosis and care plan, it can be managed effectively. 10. She has worked in Medical-Surgical, Telemetry, ICU and the ER. 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. Here are some nursing assessment tips you can use to create an individualized care plan for anxiety: 1. Garboczy, S., Szeman-Nagy, A., Ahmad, M. S., Harsanyi, S., Ocsenas, D., Rekenyi, V., Al-Tammemi, A. Copyright 2023 RegisteredNurseRN.com. According to Nanda the definition for anxiety is the state in which an individual or group experiences feelings of uneasiness or apprehension and activation of the autonomic nervous system in response to a vague, nonspecific threat. Long term Goals The client will be able to function in presence of a phobic object or situation without experiencing panic anxiety by the time of discharge from treatment. We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. Observe how the client uses coping techniques and defense mechanisms to cope with anxiety.Asking questions requiring informative answers helps identify the effectiveness of coping strategies currently used by the client. The client will discuss a phobic object or situation with the nurse or therapist within 5 days. 24. . This process is critical in the management of anxiety, as it allows nurses to identify the root cause of the patients anxiety and develop a care plan that addresses their specific needs. There are two types, specific and social. The nurse should develop an atmosphere of empathic understanding while focusing on the present situation by giving feedback about current reality. Shortness of breath Anxiety Level (definition: severity of manifested apprehension, tension, or uneasiness arising from an unidentifiable source): The patient will exhibit any degree (severe, substantial moderate, mild) or no degree of: restlessness pacing hand wringing distress uneasiness muscle tension facial tension irritability indecisiveness The client will verbalize awareness of feelings and healthy ways to deal with them. The structure provides a feeling of security for the anxious client. Prioritized nursing diagnosis includes acute pain, deficient fluid volume, and ineffective health maintenance. 26. Analyzed and provided recommendations towards scheduling and or adjusting PPS assessments, which also included OMRA's. The person with severe anxiety disorders begins to manifest excessive autonomic nervous system signs of the fight-or-flight stress response. The common signs and symptoms of anxiety can vary depending on the severity of the condition, but commonly include feelings of nervousness or restlessness, rapid breathing or shortness of breath, chest pain or tightness, sweating, trembling or shaking, fatigue, and difficulty concentrating. 23. See our full. 2. However, it is important to note that not all patients will respond to nursing care plans in the same way. The EKG Graph. 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. In addition, her mother has been diagnosed with stage 4 breast cancer. Anxiety related to cessation of alcohol as evidenced by anxiety and restlessness. If you or someone you know is experiencing any of these symptoms, it is important to seek help from a healthcare professional. Encourage verbalization of feelings related to this inability. Some of the most common causes of anxiety include: It is important to identify the underlying cause of a patients anxiety in order to develop an effective nursing diagnosis and care plan. The following are some of the common treatment options: Its important to note that anxiety is a treatable condition, and seeking help from a healthcare provider is the first step towards managing the symptoms. Lets dive into the five anxiety nursing diagnoses and care plans that can make a significant difference in patient outcomes. The presence of a trusted individual provides the client with a feeling of security and assurance of personal safety. Consider the clients use of coping strategies that the client has found effective in the past.This enhances the clients sense of personal mastery and confidence. Whether you are a nurse working in a hospital, clinic, or community setting, understanding the best practices for caring for patients with anxiety is essential. Lu, G., Jia, R., Liang, D., Yu, J., Wu, Z., & Chen, C. (2021, October). Fear and anxiety will diminish as the client begins to accept and deal positively with reality. Reduce or eliminate problematic coping mechanisms.Denial can be an effective defense mechanism when the situation is too stressful to cope with. In addition, effective nursing care plans can help prevent the development of more serious mental health conditions. 7. 17. 21. -The nurse will encourage the patient to verbalize her own anxiety and coping patterns. Anxiety related to situational stressors as evidenced by restlessness, increased heart rate, and sweating. The client becomes pale and hypotensive and experiences poor muscle coordination. Long term goal: After 2 weeks of nursing care, the client will be able to demonstrate behaviors that protect self from injury and will have reality orientation necessary in learning/ retaining essential aspects in daily living. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders. Stage 2. Recognition of precipitating factor(s) is the first step in teaching the client to interrupt the escalation of the anxiety. Assess for the presence of culture-bound anxiety states.The context in which anxiety is experienced, its meaning, and responses to it that are culturally mediated. Encourage participation in these activities, and provide positive reinforcement for participation, as well as for achievement. At this stage, the client may experience palpitations and chest pain. Anxiety may intensify to a panic level if the client feels threatened and unable to control environmental stimuli. A person in panic anxiety may perceive touch as a threatening gesture. 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. Uncertainty and lack of predictability contribute to anxiety. Writing a Nursing Care Plan Step 1: Data Collection or Assessment Step 2: Data Analysis and Organization Step 3: Formulating Your Nursing Diagnoses Step 4: Setting Priorities Step 5: Establishing Client Goals and Desired Outcomes Short-Term and Long-Term Goals Components of Goals and Desired Outcomes Step 6: Selecting Nursing Interventions His or her thinking skills become limited and irrational. 3. The lighting, temperature, sounds, smells, and color palette of an environment are very important to how comfortable, relaxed, and safe the client feels. Sometimes it is necessary to acknowledge what the client says and affirm that they have been heard. Registered Nurse, Free Care Plans, Free NCLEX Review, Nurse Salary, and much more. This includes addressing both physical and emotional symptoms, as well as considering the patients social and environmental factors. 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. Maintain a calm, non-threatening manner while working with clients. -The patient verbalize interest in talking with a psychiatrist. Treatment is indicated when a client shows marked distress or suffers from complications resulting from the disorder. Short-term goal: The patient will remain free of destructive behavior and will report a decrease in stress. Ms. Smith, 34-year-old, primigravida, on her 35 th week of pregnancy, presented to the obstetric department with complaints of SOB, mild headache, nausea, +2 pitting edema of both lower limbs, and facial puffiness. Reassure client of his or her safety and security. Anxiety disorders are affecting 40 million adults in the United States age 18 and older, or 18% of the population, according to the National Institute of Mental Health. -The nurse will provide the patient with a psychiatrist refer per md request. The flow of air blocks in the lungs. Stressful life events: Anxiety can be triggered by significant life changes, such as divorce, job loss, or the death of a loved one. 1. Encourage recognition of situations that provoke obsessive thoughts or ritualistic behaviors. Anxiety is a common mental health condition that can affect people of all ages. Support clients efforts to explore the meaning and purpose of the behavior. Be cautious with touch. -The nurse will help the patient develop 3 coping mechanisms to help with the patient anxiety attacks. A 42 year old female present to the ER with anxiety attacks. Nursing interventions for anxiety may include providing a calm and supportive environment, using relaxation techniques such as deep breathing or guided imagery, administering medications as prescribed, providing education on coping strategies and stress reduction techniques, and referring the patient to a mental health professional as appropriate. Explain ways of interrupting these thoughts and patterns of behavior (e.g., thought-stopping techniques, relaxation techniques, physical exercise, or other constructive activity with which the client feels comfortable). Administer tranquilizing medications as ordered by the physician. -The nurse will assess the patients psychological and physiologic comfort. Fear is an automatic neurophysiological state of alarm characterized by a fight or flight response to a cognitive appraisal of present or imminent danger. Other recommended site resources for this nursing care plan: Here are some references and sources you can use to further your research about anxiety nursing diagnosis: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Gil Wayne ignites the minds of future nurses through his work as a part-time nurse instructor, writer, and contributor for Nurseslabs, striving to inspire the next generation to reach their full potential and elevate the nursing profession. Ensure the clients safety during panic-level anxiety.During panic-level anxiety, the clients safety is the primary concern. The client may be unaware of the relationship between emotional problems and compulsive behaviors. Family members may also assist by providing a collaborative resource for monitoring the severity of the clients anxiety symptoms and response to treatment interventions (Bhatt & Bienenfeld, 2019). The nurse should remain with the client until the panic recedes because panic-level anxiety can only last from 5 to 30 minutes (Videbeck, 2018). Free Cheatsheets. The client may report feeling tense. Treatment may include therapy, medication, lifestyle changes, and self-care techniques. 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. The team will strive for goals and outcomes such as the following; Here are some anxiety nursing diagnostic label examples: Here are some related nursing care plans for anxiety: As a nurse, conducting assessments for anxiety nursing diagnosis is an essential part of your role. With an assessment of your patient's level of impairment, stressors, and present coping abilities, you can apply individualized outcomes and appropriate interventions in your nursing profession. In this article, we will explore five common nursing diagnoses and care plans for patients with anxiety, providing insights and strategies for effective care. The following are the steps involved in the nursing process for anxiety: By following the nursing process, nurses can effectively manage anxiety in their patients and improve their overall quality of life. Focusing on small goals that are attainable in a short period keeps the patient motivated to improve daily. There are several different types of anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias. Disclosure: Included below are affiliate links from Amazon at no additional cost from you. Do this in advance of procedures when possible, and validate the clients understanding.With preadmission client education, clients experience less anxiety and emotional distress and have increased coping skills because they know what to expect. 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). 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). 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). Acute anxiety, as a form of acute mental anguish, can lead to unsafe or self-injurious behavior (Bhatt & Bienenfeld, 2019). 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. Nursing Interventions and Rationales 1. The following are nursing interventions for acute anxiety: Encourage deep breathing exercises to promote relaxation Teach relaxation techniques such as progressive muscle relaxation Provide a calm and quiet environment Administer medications as ordered by the physician Diagnosis 2: Chronic Anxiety Buy on Amazon, Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). By accessing any content on this site or its related media channels, you agree never to hold us liable for damages, harm, loss, or misinformation. The key difference is that this syndrome occurs within 4 wk of the traumatic event and only lasts 2 days to 4 wk. Phobias: Characterized by a persistent and severe fear of a clearly identifiable object or situation despite awareness thatthe fear is unreasonable. Teach the use of appropriate community resources in emergency situations (e.g., suicidal thoughts), such as hotlines, emergency rooms, law enforcement, and judicial systems.The method of suicide prevention found to be most effective is a systematic, direct-screening procedure that has a high potential for institutionalization. The nurse can assess anxiety in a patient by asking open-ended questions about the patients emotional state and evaluating the patients behavior and physical symptoms. 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. Educate the client and family about the symptoms of anxiety.If the client and family can identify anxious responses, they can intervene earlier than otherwise. - Affected area may have felt firm, boggy, mushy, warmer, or cooler to touch. Give positive reinforcement for nonritualistic behaviors. The formatting isnt always important, and care plan formatting may vary among different nursing schools or medical jobs. Based on data analysis, nurses attitudes or behaviors matter when interacting with a client with anxiety. They can interfere with daily activities and may even lead to physical symptoms. Monitor for effectiveness and for adverse side effects. (Example: Client may choose. While the patient is explaining this to you she cries many times and has poor eye contact. Use presence, touch (with permission), verbalization, and demeanor to remind clients that they are not alone and to encourage expression or clarification of needs, concerns, unknowns, and questions.Being supportive and approachable promotes therapeutic communication. Providing frequent and understandable explanations may reduce the clients fear and anxiety, clarifies misconceptions, and promotes cooperation. History, physicalexamination, and laboratory findings support a specific diagnosis, for example, hypoglycemia, pheochromocytoma, orthyroid disease. 16. Assist the patient in judging the situation realistically. Do not treat a patient based on this care plan. The trait scale consists of 20 statements that ask people to describe how they generally feel. Converse using simple language and brief statements.When experiencing moderate to severe anxiety, clients may be unable to understand anything more than simple, clear, and brief instructions. Patients dealing with chronic, life-altering, or . With the right treatment, patients with anxiety can lead fulfilling lives and achieve their goals. Anyone from all walks of life can suffer from anxiety disorders. Patients with anxiety will present with symptoms physiologically, emotionally, or cognitively. Her experience spans almost 30 years in nursing, starting as an LVN in 1993. The client will demonstrate an appropriate range of feelings and lessened fear. Shortness of Breath Nursing Care Plans Diagnosis and Interventions Shortness of Breath NCLEX Review and Nursing Care Plans Often known as dyspnea, shortness of breath is the sensation of not being able to get enough air into the lungs. Acknowledging the patient's feelings will help the patient feel she or he is being heard and can assist the patient in becoming more trusting and comfortable with the nurse. The client will appear calm but may report feelings of nervousness such as butterflies in the stomach. The client with moderate anxiety may appear energized, with more animated facial expressions and tone of voice. The nurse may also have the client describe events in detail and focus on the specifics of who, what, when, and where to reinforce reality (Carpenito, 2013). Mild anxiety can enhance a persons perception of the environment and readiness to respond. Provide massage and backrubs for the client to reduce anxiety.This aids in the reduction of anxiety. The nursing care plan should be focused on promoting their physical and emotional well-being and improving their ability to manage anxiety symptoms. Here are nine (9) nursing care plans (NCP) and nursing diagnoses for major depression: Risk For Self-Directed Violence Impaired Social Interaction Spiritual Distress Chronic Low Self-Esteem Disturbed Thought Processes Self-Care Deficit Grieving Hopelessness Deficient Knowledge 1. Additionally, nurses should provide education to patients and their families about anxiety and the treatment options available. Assess clients level of anxiety. 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. Long-term goal: The patient's anxiety will return to a manageable level and they will experience a sense of having control over . Nursing Diagnosis Ineffective coping related to 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.
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