Anxiety (Adult Inpatient)

Clinical Description

Care of the hospitalized patient experiencing feelings of apprehension, uneasiness, uncertainty or dread about possible future events and the ability to deal with the events.

Key Information

Anxiety is a subjective, individual experience ranging from vague discomfort to feelings of panic. It is a normal response to threatening situations.

Anxiety can become excessive and difficult to control; negatively affecting day-to-day living, physical comfort and medical diagnosis symptoms.

Clinical Goals

By transition of care

A. The patient will achieve the following goals:

Anxiety Reduction or Resolution

B. Patient, family or significant other will teach back or demonstrate education topics and points:

Education: Overview
Education: Self Management
Education: When to Seek Medical Attention

Correlate Health Status

Correlate health status to:
- history, comorbidity
- age, developmental level
- sex, gender identity
- baseline assessment data
- physiologic status
- response to medication and interventions
- psychosocial status, social determinants of health
- barriers to accessing care and services
- health literacy
- cultural and spiritual preferences
- safety risks
- family interaction
- plan for transition of care

Anxiety

Signs/Symptoms/Presentation

acting out
agitation
anger
apprehension
crying
distress
fear
helplessness
hypervigilance
increased dependence
irritability
joking
nervousness
panic
regressive behavior
restlessness
sense of impending doom
social withdrawal
worry

Physical symptoms

dry mouth
muscle tension
shortness of breath
skin flushed
skin rash
sleep disturbance
urinary frequency
urinary urgency

Vital Signs

heart rate increased

Problem Intervention

Promote Anxiety Reduction

Maintain a calm and reassuring environment; minimize noise; provide familiar items; cluster care; offer choices.
Encourage support system presence and participation.
Support expression and identification of feelings and worries; compassionately acknowledge and validate concerns.
Utilize existing coping strategies and assist in developing new strategies (e.g., music, deep breathing, relaxation techniques, massage, meditation or pet therapy).
Identify thoughts and feelings that led to current anxiety onset to enhance understanding of triggers.
Reframe anxiety-provoking situations; provide a new perspective; engage in problem-solving.
Utilize anticipatory guidance to enhance sense of control.
Consider referral for a comprehensive assessment if there are concerns about the number, severity and duration of symptoms; degree of distress; functional impairment or excessive substance use.

Associated Documentation

Complementary Therapy
Supportive Measures
Family/Support System Care

Education

CPG-Specific Education Topics

Overview

risk factors
signs/symptoms

Self Management

coping strategies
resources for support

When to Seek Medical Attention

unresolved/worsening symptoms

General Education Topics

General Education

admission, transition of care
orientation to care setting, routine
advance care planning
diagnostic tests/procedures
diet modification
opioid medication management
oral health
medication management
pain assessment process
safe medication disposal
tobacco use, smoke exposure
treatment plan

Safety Education

call light use
equipment/home supplies
fall prevention
harm prevention
infection prevention
MDRO (multidrug-resistant organism) care
personal health information
resources for support

References

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Disclaimer

Clinical Practice Guidelines represent a consistent/standardized approach to the care of patients with specific diagnoses. Care should always be individualized by adding patient specific information to the Plan of Care.