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Monday, June 11, 2012

Anxiety Nursing Diagnosis

Definition: Vague uneasy feeling of discomfort or dread accompanied by an autonomic response (the source often nonspecific or unknown to the individual); a feeling of apprehension caused by anticipation of danger. It is an alerting signal that warns of impending danger and enables the individual to take measures to deal with the threat.

Anxiety is probably present at some level in every individual’s life, but the degree and the frequency with which it manifests differs broadly. Each individual’s response to anxiety is different. Some people are able to use the emotional edge that anxiety provokes to stimulate creativity or problem-solving abilities; others can become immobilized to a pathological degree. The feeling is generally categorized into four levels for treatment purposes: mild, moderate, severe, and panic. The nurse can encounter the anxious patient anywhere in the hospital or community. The presence of the nurse may lend support to the anxious patient and provide some strategies for traversing anxious moments or panic attacks.


Anxiety

Related to :

  • Anesthesia
  • Anticipated/actual pain
  • Disease
  • Invasive/noninvasive procedure:
  • Loss of significant other
  • Threat to self-concept

Evidenced by
  • Physiological :
    • Increase in blood pressure, pulse, and respirations
    • Dizziness, light-headedness
    • Perspiration
    • Frequent urination
    • Flushing
    • Dyspnea
    • Palpitations
    • Dry mouth
    • Headaches
    • Nausea and/or diarrhea
    • Restlessness
    • Pacing
    • Pupil dilation
    • Insomnia, nightmares
    • Trembling
    • Feelings of helplessness and discomfort

  • Behavioral :
    • Expressions of helplessness
    • Feelings of inadequacy
    • Crying
    • Difficulty concentrating
    • Rumination
    • Inability to problem-solve
    • Preoccupation


Outcome :

1. Demonstrate a decrease in anxiety A.E.B.:
  • A reduction in presenting physiological, emotional, and/or cognitive manifestations of anxiety.
  • Verbalization of relief of anxiety.

Nursing InterventionAssist patient to reduce present level of anxiety by :
  • Provide reassurance and comfort.
  • Stay with person.
  • Don't make demands or request any decisions.
  • Speak slowly and calmly.
  • Attend to physical symptoms. Describe symptoms:


2. Discuss/demonstrate effective coping mechanisms for dealing with anxiety.

Nursing Intervention
  • Discuss alternate strategies for handling anxiety. (Eg.: exercise, relaxation techniques and exercises, stress management classes, directed conversation (by nurse), assertiveness training)
  • Set limits on manipulation or irrational demands.
  • Help establish short term goals that can be attained.
  • Identify and reinforce coping strategies patient has used in the past.
  • Discuss advantages and disadvantages of existing coping methods.
  • Give clear, concise explanations regarding impending procedures.
  • Focus on present situation.
  • Reinforce positive responses.
  • Initiate health teaching and referrals as indicated 

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