Dmncp_anxiety.docx

ASSESSMENT Subjective Cue: “Nababaraka gad ako nga maospital ako utro kahuman hini nga akon pagkaadmit. Damo paman gud tak irintindihon nga iba asya karuyag ko na umuli.” as verbalized by the patient.

Objective Cues:  Trouble concentrating or thinking about anything other than the present worry. 

Feeling weak and tired.



Face appears worried.

NURSING DIAGNOSIS Anxiety r/t threat or change in health and socioeconomic status as evidenced by uncertainty and expressions of concern about future events.

SCIENTIFIC GOAL RATIONALE Anxiety is associated After 30 minutes of with circumstances in nursing care, the which a person client will be able to: perceives a stimulus as a threat, irrespective 1. Demonstrate of whether it may problem actually be solving and threatening or not. effectiveness The stimulus evokes a of resources patterned reaction involving cognitive, 2. Verbalize emotional, behavioral, appropriate motor and visceral range of responses. The feelings response include sympathetic nervous 3. Appear system activation, relaxed and alterations in report of attention and anxiety is concentration, sleep reduced to a disturbances, manageable ritualized behavior level and changes in motor responsiveness.

Source: Principles of Pathophysiology – Bullokc, Shane (SRG )

INTERVENTION Independent: 1. Identify and acknowledge client’s perception of threat or situation. Encourage expressions of, and avoid denying feelings of anger grief, sadness and fear.

2. Observe verbal and nonverbal signs of anxiety, and stay with client. Intervene if client displays destructive behavior.

RATIONALE

1. Ongoing anxiety related to concerns about impact of Diabetes Mellitus on future lifestyle, matters left unattended or unresolved, and effects of illness on family may be present in varying degrees some time and may be manifested by symptoms of depression. 2. Client may not express concern directly, but words or actions may convey sense of agitation, aggression and hostility.

3. Maintain confident 3. Client and SO may manner, without false be affected by assurance. anxiety or uneasiness displayed by health team members.

EVALUATION After 30 minutes of nursing care, the client was able to: 1. Demonstrate problem solving and effectiveness of resources 2. Verbalize appropriate range of feelings 3. Appear relaxed and report of anxiety is reduced to a manageable level

Honest explanations may alleviate anxiety.

4. Encourage independence, selfcare and decision making within accepted treatment plan.

4. Increase independence from staff promotes selfconfidence and reduces feelings of abandonment that can accompany in going home for the patient.

5. Orient client and SO to routine procedures and expected activities. Promote participation when possible.

5. Predictability and information can decrease anxiety for client.

6. Answer all questions factually. Provide consistent information.

7. Encourage client and SO to communicate to one another, sharing questions and concerns.

6. Accurate information about situation reduces fear.

7. Sharing information elicits support and comfort and can relieve

tension of unexpressed worries. 8. Provide privacy to client and SO.

9. Provide rest periods and uninterrupted sleep time and quiet surroundings with client controlling type and amount of external stimuli.

8. Allow needed time for personal expression of feelings; may enhance mutual support and promote more adaptive behaviors. 9. Conserves energy and enhances coping abilities.

Source: Nursing care plans: Guidelines for individualizing client care across the life span by Marilyn Doenges; Mary Frances Moorhouse; Alice C. Murr