Overview of Anxiety | Nursing Diagnosis for Anxiety
Anxiety (also called angst or worry) is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. It is the displeasing feeling of fear and concern. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness, and dread. Anxiety is considered to be a normal reaction to a stressor. It may help an individual to deal with a demanding situation by prompting them to cope with it. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder. (Wikipedia.org)
Patients exhibit symptoms when an imbalance develops between the number of open receptor sites and the number of available neurotransmitters. Neurotransmitters are released from one side of a synapse and land on a specific receptor site across the synapse. A second mechanism exists (a reuptake mechanism) to remove excess neurotransmitters left within the space between where they are released and where they fill the receptor sites. When there are insufficient neurotransmitters available to fill the open neurotransmitter receptor sites, the patient develops symptoms. Patients experience an uncontrollable feeling of anxiousness which is present more days than not.
Symptom onset is typically in late teens through early thirties. Anxiety is more common in women and in patients with a family history of anxiety.
Prognosis of Anxiety | Psychiatric Nursing for Anxiety
Without proper treatment the anxiety will continue, and symptoms may even progress. The patient’s quality of life is adversely affected. Social functioning becomes impaired and in some cases the patient becomes more socially isolated.
Physical symptoms continue, at times necessitating visits to a primary care provider or even the emergency room. With proper treatment, the symptoms are controlled, neurotransmitter balance is restored, and remission is achieved. The symptoms will typically recur at a later point, even when properly treated. It may be months or years after a successful course of treatment before the symptoms recur. The treatment that was effective in the past will typically be effective again in the future. A longer treatment course is recommended for subsequent treatment cycles when using SSRIs (selective serotonin reuptake inhibitors).
Signs and Symptoms of Anxiety| Nursing Diagnosis for Anxiety
- Fear, tension, apprehension due to alteration in neurotransmission
- Persistent worry
- Trouble concentrating
- Irritability and restlessness
- Tachycardia, palpitations, elevated blood pressure due to autonomic nervous system stimulation
- Hyperventilation due to fear, elevated heart rate, and palpitations
- Sweating, tremors due to autonomic nervous system stimulation
- Sleep disturbance and fatigue due to alteration in neurotransmission
- Headache due to nervous system irritability and lack of sleep
Interpreting Test Results of Anxiety | Nursing Diagnosis for Anxiety
- Normal lab results
Nursing Diagnosis for Anxiety: Treatment of Anxiety
Treatment of Anxiety| Nursing Diagnosis for Anxiety
- Administer anxiolytics for acute management: alprazolam, clonazepam, clorazepate, diazepam, lorazepam, oxazepam.
- Monitor for respiratory depression or decrease in blood pressure.
- Have benzodiazepine antagonist (flumazenil) on hand to reverse effect if needed.
- Administer antidepressants: selective serotonin reuptake inhibitors—paroxetine, selective serotonin and norepinephrine reuptake inhibitors—venlafaxine, tricyclics.
- Administer buspirone.
- Administer beta-blockers for symptom control.
- Psychotherapy.
- Cognitive-behavioral therapy.
- Relaxation techniques such as biofeedback.
- Desensitization—repeated exposures to graded doses of the object or situation that produces the anxiety.
- Group therapy.
- Family therapy.
- Emotive therapy.
Nursing Diagnosis for Anxiety and Nursing Interventions
Most Common Nursing Diagnosis for Anxiety
- Sleep pattern disturbance
- Anxiety
- Fear
- Impaired social interaction
- Ineffective role performance
Nursing Interventions for Anxiety
- Monitor medication intake.
- Discuss patient response to therapy.
- Monitor vital signs, watch for elevation in blood pressure with some medications.
- Monitor weight; some medications are associated with changes in weight.
- Monitor sleep; ask patient about restful sleep during the night or difficulty falling asleep.
- Teach patient to avoid alcohol intake with benzodiazepine use.
Sample of Psychiatric Nursing Diagnosis: Nursing Diagnosis for Anxiety.
