Anxiety: Nursing Diagnosis, Interventions & Care Plan

Anxiety is a typical but severe mental health condition that can profoundly impact your life. It can cause physical manifestation like chest pain, shortness of breath, headaches, and psychological symptoms like fear and worry. It can also lead to feelings of isolation and depression.

Fortunately, there are various effective treatments for anxiety available today. With the right combination of therapy, medication, lifestyle changes, and self-care strategies, you can learn how to manage your stress so it doesn’t take over your life. 

By understanding what causes your anxiety and developing coping skills to deal with it healthily, you can live a more fulfilling life free from fear and worry.

What is Anxiety?

Anxiety is an emotion characterized by fear, apprehension, and uneasiness. 

It may manifest as sweating, restlessness, muscle tension, and a rapid heartbeat. Generally speaking, it is a normal reaction to stressful situations like problem-solving at work or making tough decisions. 

In this case, anxiety can provide energy and focus to take on the challenge. However, the fear can be excessive and long-lasting for those with anxiety disorders, leading to debilitating effects.

Pathophysiology

A combination of psychological, biological, and environmental factors causes anxiety.  From a physiological perspective, it can be triggered by chemical imbalances in the brain that lead to an overactive fight-or-flight response.  Low levels of serotonin—a neurotransmitter responsible for regulating emotions—are also thought to contribute to anxiety. 

Other risk factors include:

• Prior trauma or stress.
• Family history of anxiety disorders.
• Mental health states such as depression or substance abuse.
• Lifestyle factors like inadequate sleep or poor nutrition.

What are Anxiety Disorders?

Anxiety disorders are a group of mind health conditions that cause extreme fear and worry. They can interfere with daily life, making it difficult for individuals to work, attend school or participate in activities they enjoy. 

Causes anxiety disorders

Anxiety disorders are not a result of personal weakness, character flaws, or issues with upbringing – they are no different than any other form of mental illness. While the exact cause is not clear, scientists believe that a combination of factors may be at play:

• Chemical imbalances: when subjected to high-stress levels for an extended period, it can change the chemical balance responsible for regulating mood and possibly lead to an anxiety disorder.
• Environmental factors: Experiencing a traumatic event can catalyze the development of an anxiety disorder, especially in individuals predisposed to being more vulnerable.
• Heredity: Anxiety disorders tend to be passed down from one or both parents, much like physical traits such as eye color. This means that these mental health issues can often run in families.

Types of Anxiety Disorders

There are several different types of anxiety disorders, each with its own set of symptoms.

• Generalized anxiety disorder (GAD): Generalized anxiety disorder (GAD) is characterized by excessive and unreasonable worry about day-to-day activities. Panic disorder causes sudden episodes of intense fear that can lead to panic attacks.
• Social anxiety disorder: It is also called as social phobia, is an intense fear of being judged by others or embarrassing yourself in social situations.
• Post-traumatic stress disorder (PTSD) : PTSD is a mental health condition that’s triggered by a traumatic event. It can cause flashbacks, nightmares, and difficulty concentrating.

Symptoms of anxiety

Common signs and symptoms of anxiety include: 

• feeling irritable
• sweating
• tremblingfeeling restless or on edge
• having difficulty concentrating
• feeling restless or on edge
• having difficulty concentrating
• rapid heart rate
• shortness of breath
• insomnia.

What Causes Anxiety?

Anxiety can have various causes, including genetics, trauma, and environmental factors like stress. Other risk factors, such as poor nutrition, lack of sleep, substance abuse, and certain health conditions can also contribute to anxiety.

How is Anxiety Prevented?

You can use several strategies to prevent the onset or exacerbation of anxiety. Practicing stress management strategies like deep breathing and progressive muscle relaxation can help reduce your feelings of anxiousness. 

Additionally, daily exercise, a healthy diet, and adequate sleep all play an essential role in reducing anxiety levels. Finally, maintaining positive relationships with friends and family and seeking professional help when necessary can help manage your symptoms.

How is Anxiety Treated?

Anxiety treatment typically involves a combination of therapy (Cognitive Behavioral Therapy or CBT), lifestyle changes (such as improving sleep hygiene and increasing physical activity), and, in some cases, medications. Treatment aims to help individuals identify their triggers, develop coping skills, and manage their anxiety more effectively.

Complications

If left untreated, anxiety can lead to severe complications that affect physical and mental health. These include heart disease, depression, substance abuse, insomnia, and suicidal ideation. 

It is essential to seek help early on as the earlier treatment begins, the more successful the outcomes can be for recovery.

Nursing Care Plan for Anxiety

Assessment

Objective data for anxiety

• increased heart rate,
• elevated blood pressure,
• palpitations,
• sweating,
• trembling,
• Dry mouth.

Subjective data for anxiety

• feelings of fear and dread
• feeling overwhelmed or trapped
• Difficulty concentrating and sleeping.

• Physical indicators: Physical signs of anxiety include dry mouth, increased vital signs, diarrhea, frequent urination, nausea, heavy sweating, hyperventilation, fatigue, insomnia, sexual dysfunction, irritability, and tension.
• Emotional indicators: Emotionally, one may experience fearfulness, a feeling of impending doom or helplessness, low self-confidence, and anger or guilt.
• Cognitive indicators: Cognitive effects of anxiety may range from increased awareness and improved problem-solving skills at low levels to narrowed perceptual fields, missing details, decreased problem-solving abilities, and distorted logical thinking at higher levels.
• Social indicators: Anxiety can also affect one’s occupational, social, and familial roles significantly, such as causing problems in marital or parental functioning.
• Spiritual indicators: Furthermore, the spiritual aspects of anxiety can manifest in feelings of hopelessness, helplessness, and anger towards God for allowing it.
• Suicidality: When dealing with anxious patients, especially those suffering from panic disorder, a suicide assessment is essential.

Anxiety Nursing Diagnosis

[For Anxiety/Recurring panic attacks]

• lack of knowledge regarding cause and treatment
• unconscious conflict about essential values and goals of life
• situational and maturational crises
• threat of death
• unmet needs
• being exposed to the phobic stimulus
• traumatic experiences

[For Fear]

• threatening environmental stimuli
• unrealistic expectations
• lack of knowledge regarding cause and treatment
• inability to cope with stressors or perceived threats

[For Ineffective coping]

• limited problem-solving skills and resources
• difficulty in recognizing, expressing, and regulating emotions
• lack of social support

Nursing Diagnosis [Risk for impaired social interaction]

• fear and avoidance of social situations
• lack of personal insight into anxiety symptoms and behaviors
• inability to interact effectively with peers or family members

Nursing Interventions For Anxiety

1.  Provide a therapeutic environment: create an environment conducive to relaxation and emotional support for the patient.
2.  Educate about anxiety disorders: help the patient understand anxiety disorder, its causes, effects, symptoms, and available treatments.
3.  Encourage healthy lifestyle habits: encourage the patient to get adequate sleep, exercise regularly, eat a balanced diet, and avoid substance use.
4.  Promote relaxation techniques: teach the patient various relaxation methods such as deep breathing exercises, progressive muscle relaxation, and mindfulness meditation.
5.  Refer for psychotherapy: refer the patient to an appropriate mental health professional for further counseling and therapy if necessary.
6.  Monitor suicidal ideation: assess for any signs of suicidal thoughts or behaviors and intervene appropriately if needed.
7.  Involve family members: consider involving family members in the treatment plan, as they can provide much-needed emotional support during stressful times.
8. Implement cognitive behavioral strategies: use cognitive-behavioral approaches to help the patient identify unhealthy thought patterns and replace them with positive ones.
9. Monitor medication: monitor the patient’s response to prescribed drugs and report any side effects or adverse reactions to the doctor.
10. Follow up with necessary referrals: ensure the patient follows through with appropriate referrals for continued care and treatment.

Related FAQs

What are four examples of NANDA nursing diagnosis?

1. Risk for Impaired Skin Integrity: This diagnosis applies when there is an increased risk of skin breakdown due to friction, shearing, moisture, or environment. 
2. Activity Intolerance: This diagnosis identifies a patient’s reduced ability to engage in required activities due to physical or psychological limitations. 
3. Ineffective Coping: This diagnosis is applicable when a patient has difficulty dealing with an illness or treatment, leading to feelings of distress. 
4. Readiness for Enhanced Knowledge: This diagnosis is applicable when a patient displays motivation and willingness to learn more about their health condition or illness. 

What is the most diagnosed anxiety disorder?

Generalized anxiety disorder (GAD) is the most commonly diagnosed anxiety disorder. It is characterized by persistent and excessive worrying that interferes with daily activities.

What is the most common intervention for anxiety?

Cognitive behavioral therapy (CBT)  is considered to be the most common intervention for anxiety. It is a type of psychotherapy that focuses on identifying and changing negative or unhelpful patterns of thinking and behavior. CBT is effective in treating various types of anxiety disorders, including generalized anxiety disorder, social anxiety disorder, panic disorder, social anxiety disorder, and specific phobias.

Final Words

Anxiety can be a crippling illness, but it can be managed effectively with support and understanding. A comprehensive nursing care plan for anxiety should include assessment, nursing diagnosis for anxiety, education, lifestyle modifications, psychotherapy referral, and medication monitoring.

It is important to remember that every patient’s experience with anxiety may differ, and there is no “one-size-fits-all” approach to care. It is essential to tailor the care plan according to each patient’s needs and preferences while paying close attention to signs of relapse or worsening symptoms. 

With the right amount of patience, understanding, and support, individuals can learn how to manage their anxiety successfully and lead a healthier life.

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References

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

https://en.wikipedia.org/wiki/Anxiety

https://www.nimh.nih.gov/health/topics/anxiety-disorders