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    Careplan

    Anxiety (Adult Inpatient)

    Oct.01.2020

    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.

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