Nursing Care Plan for Anxiety

Nursing Assessment

Rationale

Check to see if any anxiety states are culturally specific.

Anxiety's meaning, context of experience, and reactions to it are all influenced by culture.

Determine the patient's anxiety level. Mild, moderate, severe, and panicked are Hildegard E. Peplau's four categories for anxiety.

The physiological manifestations of anxiety in a patient with low anxiety will be minor or nonexistent. The vital signs will be in the expected ranges. Although the patient will seem at ease, they may experience anxiety symptoms like "butterflies in the stomach." With more lively facial expressions and vocal tones, the patient with mild anxiety may come across as more energized. Both normal and slightly elevated vital signs are possible. The patient can say that they are tense. Symptoms of increased autonomic nervous system activity, such as raised vital signs, diaphoresis, urine urgency and frequency, dry mouth, and muscular tension, are present in patients with severe anxiety. The patient could have palpitations at this time.

Assess the patient's perception of a stressful circumstance in light of cultural ideas, norms, and values.

It's possible that the patient's experience of stress is influenced by cultural norms.

Analyze your body's response to anxiousness.

Somatoform disorders, which are marked by physical symptoms like pain, nausea, weakness, or dizziness but have no obvious medical explanation, are another condition where anxiety plays a role.

As a way to verify your findings, ask the patient whether they are feeling nervous.

A common physical and psychological reaction to internal or external life events, anxiety is very individualistic.

To distinguish between the patient's anxiety level as a transient reaction state and a persistent personality feature, use the state-trait anxiety inventory.

For evaluating anxiety in adults, Spielberger's State-Trait Anxiety Inventory is regarded as the gold standard. The application is accessible in more than 40 languages and is written at a sixth-grade reading level.

Track the patient's coping strategies and anxiety-reducing coping processes.

Asking questions that call for detailed responses enables one to assess the efficacy of the patient's existing coping mechanisms. This strategy could provide the patient a sense of involvement in their care. Reading, keeping a journal, or engaging in physical exercise like walking are all examples of coping mechanisms. People employ defence mechanisms to maintain their sense of self and control their distress. Some defensive strategies, including humour, sublimation, or repression, are quite effective at controlling anxiety. With prolonged usage, other protection mechanisms can result in less adaptable behaviour. These defence strategies include self-image splitting, displacement, suppression, denial, and projection.

Nursing Interventions

Rationale

Recognize that the patient is anxious.

The patient can believe that the symptoms they are having are fake because there isn't always a known source of worry. Validating the patient's sentiments and expressing acceptance of them are accomplished by acknowledging them.

To reassure patients that they are not alone and to facilitate expression or clarification of needs, worries, unknowns, and inquiries, use presence, touch (with permission), verbalization, and manner.

Communication is facilitated by being personable and supportive.

As necessary, acquaint the patient with the surroundings, new situations, or individuals.

Being aware of the surroundings helps the patient feel comfortable and may reduce their anxiety. If the patient feels threatened and is unable to manage surrounding cues, anxiety may become panic-inducing.

Engage the patient in calm conversation.

The hypersensitive patient may catch the anxiousness of the nurse or other healthcare professional. In a relaxed and non-threatening setting, the patient feels more stable.

Accept the patient's arguments without challenging them.

If the patient's defenses are not in danger, they could feel safe and protected enough to examine their conduct.

Converse using straightforward language and succinct sentences.

Patients who are suffering moderate to severe anxiety may not be able to comprehend anything more than basic, concise, and straightforward instructions.

Encourage the patient to express or respond to their own feelings of pain, discomfort, or threats to their well-being (e.g., talking, crying, walking, or other physical or nonverbal expressions).

Anxiety can sometimes be reduced by speaking, or in another way, expressing feelings.

Reduce sensory stimulation by maintaining a calm and quiet setting; keep "scary" equipment hidden.

When there is a lot of activity, equipment, and noise surrounding the patient, their anxiety might worsen. Growing anxiety may start to frighten the patient and other people.

Assist the patient in identifying anxiety triggers that could call for treatment.

The patient might reassess the hazard or come up with fresh solutions after gaining understanding.

Allow the patient to discuss their feelings of anxiety and, if they can be identified, look into situations that make them feel nervous.

The patient can understand the issue more accurately and identify variables contributing to the anxious sensations by discussing circumstances and feelings that cause worry.

Use compassion to persuade the patient to see the symptoms of anxiety as normal if the situational reaction is reasonable.

Anxiety is a typical reaction to a real or imagined threat.

Encourage the patient to record all of their anxious experiences. Ask the patient to recount what happened as well as the circumstances leading up to and around the incident. The patient should keep track of how their anxiousness fades.

Identifying and examining elements that increase or decrease anxious sensations are the first steps in creating alternate reactions. The patient might not be aware of how emotional worries and anxiety are related. If the patient is okay with the notion, the log may be given to the healthcare professional, who might then assist the patient in creating better coping mechanisms. Health care professionals frequently learn about a patient's level of anxiety through their symptoms.

The patient should be encouraged to use affirmations like "Anxiety won't kill me," "I can do this one step at a time," "Right now I need to breathe and stretch," and "I don't have to be flawless."

The main goal of cognitive therapy is to alter thinking in order to alter actions and feelings. Anxiety can be lessened by substituting positive self-statements with negative ones.

Think about the patient's prior use of coping mechanisms that have worked well for them.

The patient feels more in control of himself and more confident as a result.

Reassurance that isn't essential should be avoided as it could cause further concern.

It is not beneficial to reassure someone who is apprehensive.

Help the patient acquire new coping mechanisms for anxiety (e.g., relaxation, deep breathing, positive visualization, and reassuring self-statements).

The patient can control their anxiety in a number of ways by learning new coping mechanisms.

When you can, take action to get rid of the causes of your worry.

A typical reaction to real or imagined danger is anxiety; if the threat is removed, the reaction will end.

Help the patient develop their ability to solve problems. Emphasize the rational countermeasures the patient can employ while feeling nervous.

The patient can cope better if they learn to recognise issues and weigh their potential solutions.

Use non-medical terms and calm, slow speech to explain all actions, processes, and problems involving the patient. When feasible, do this before any operations, and make sure the patient understands.

Patients who receive pre-admission patient education are less anxious and emotionally distressed and have better coping mechanisms because they are aware of what to expect. Anxiety is exacerbated by uncertainty and unpredictability.

Teach the patient how to take anti-anxiety drugs properly.

Anti-anxiety medicine used temporarily can improve patient coping and lessen anxiety's physical symptoms.

- Benzodiazepines

The effect of the inhibitory neurotransmitter gamma-aminobutyric acid is enhanced by drugs in this class (GABA). It is advised to utilise these medications for no more than three to four months. Prolonged usage of these medicines might lead to physical dependency and tolerance issues.

- HCl buspirone (BuSpar)

Compared to benzodiazepines, this medication offers fewer negative effects and a lower risk of dependency. It may take up to two weeks for the medication to have a discernible therapeutic impact due to its delayed beginning of action.

- Inhibitors of selective serotonin reuptake (SSRIs)

The Food and Drug Administration (FDA) has authorised the use of many medications in this class for the treatment of panic disorder. It is being researched if they may be used to treat other forms of anxiety.

- Non-selective beta-blockers and agonists of the alpha-2 receptor

The physical signs of anxiety associated with social phobias can be controlled by beta-blockers (e.g., stage fright). The alpha-2 agonists are used to treat anxiety brought on by nicotine and opiate withdrawal.

Remind the patient to restrict the usage of CNS stimulants.

The physical signs of anxiety can worsen after using stimulants such coffee, nicotine, theophylline, terbutaline sulphate, amphetamines, and cocaine.

Provide massage and backrubs for patient to relieve anxiousness.

This helps with anxiety reduction.

Give patients access to music of their choosing for listening.

Anxiety may be reduced in an easy, affordable, and aesthetically pleasant way using music.

Don't let alcohol, sedatives, or smoking withdrawal be the source of your uneasiness.

Anxiety is a hallmark of these drugs' withdrawal.

Don't let alcohol, sedatives, or smoking withdrawal be the source of your uneasiness.

Anxiety is a hallmark of these drugs' withdrawal.

Inform the sufferer and their loved ones about the signs of anxiety.

The patient and family can take action sooner if they can recognise worried reactions.

Teach the patient to imagine or fantasise about the absence of fear or discomfort, a circumstance that went well, a disagreement that was resolved, or the results of the surgery.

The use of guided visualisation has been effective in lowering anxiety.