Nursing Care Plan for Anxiety

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1. Pathophysiology of Anxiety
2. Anxiety Signs & Symptoms
3. Nursing Assessment for Anxiety
4. Nursing Interventions for Anxiety
5. Anxiety NCLEX Questions

Pathophysiology of Anxiety

When experiencing anxiety, the mind goes into a state of panic, so the body goes into fight or flight mode, turning on the sympathetic nervous system (SNS). 

The SNS tells the body to shunt blood flow away from the extremities and toward the body’s core. This is for the vital organs and to increase the vital signs.

Anxiety can be categorized into:

• General Anxiety Disorder (GAD)
• Social Anxiety Disorder (SAD)
• Panic disorder
• Separation Anxiety

And includes phobias such as:

• Obsessive Compulsive Disorder (OCD)
• Post-traumatic Stress Disorder (PTSD)

Causes

• Stress 
• Drug side effects
• Life changes
• Social pressure

Subjective (Client May Report)

• Overthinking
• Persistent worry
• Indecisiveness
• Difficulty sleeping
• Headaches
• Abdominal pain
• Difficulty concentrating
• Fatigue

Objective 

• Muscle tension
• Sweating
• Vomiting
• Gastrointestinal distress

Risk Factors

• Existing mental health disorders
• Trauma
• Stress 
• Family history
• Drug alcohol use

Anxiety Signs & Symptoms

• Restless
• Difficulty with emotional management
• Fatigue
• Difficulty concentrating
• Irritability
• Headaches
• Difficulty sleeping
• Persistent sense of impending danger, panic, or doom
• Increased heart rate
• Rapid breathing 

Nursing Assessment for Anxiety

A nursing assessment for anxiety should include effective therapeutic communication. You want to know what makes the client anxious, how long they’ve been feeling anxiety-related symptoms, and how often they experience them. 

In addition, it’s essential to know if they have other mental illnesses, such as depression or bipolar disorder. Physical manifestations of anxiety can be found with a physical exam.

Cardiac Function

• Heart palpitations
• Chest pain
• Increased heart rate

Neurological & Sensory Functions

• Tension
• Fear
• Jumpiness or jitteriness
• Impatientience

Nursing Interventions for Anxiety

• Provide education about anxiety disorders.
• Administer anti-anxiety drugs, as ordered.
• Encourage relaxation techniques such as deep breathing.
• Educate the client on the importance of sleep hygiene and reducing environmental stressors.
• Assist the client with identifying and challenging irrational thoughts.
• Goals and outcomes should include a plan for coping with anxious situations.

Anxiety NCLEX Questions

What is the primary goal of effectively coping with anxiety?

A. Do not avoid the phobia; gradually be exposed to it.

B. Avoid the phobia to ultimately cope with it.

C. Expose oneself to the phobia on an hourly basis.

D. Use anti-anxiety medications to escape the phobia.

Answer: A

A client with anxiety’s primary goal to effectively cope with it is not to avoid the phobia, but gradually be exposed to it. The client should increase their comfort level with the phobia little by little. 

This creates a gradual desensitization to the phobia. Increasing comfort while exposed to the phobia will help decrease anxiety regarding the phobia.

A client arrives for his first appointment with the mental health clinic. He is pacing back and forth, has tachypnea, difficulty concentrating, and a pounding heart rate. Which classification of anxiety does the nurse believe the client is experiencing?

A. Mild anxiety

B. Moderate anxiety

C. Severe anxiety

D. Panic attack

Answer: B

A moderate anxiety attack is when the client feels on edge, unable to control worrying, cannot relax, the client may pace back and forth, have difficulty concentrating, and has increased respiratory rate and tachycardia. 

Anxiety is an emotion of uneasiness, fear, or dread. Anxiety may cause physical symptoms such as sweating, restlessness, tenseness, and tachycardia. When a client experiences stress, anxiety may be a normal reaction.

Sources

https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140513/