7 Anxiety and Panic Disorders Nursing Care Plans

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Anxiety is a vague feeling of dread or apprehension (uneasiness); it is the activation of the autonomic nervous system in response to an external or internal stimuli that can have behavioral, emotional, cognitive, and physical symptoms. In contrast, fear is the feeling of apprehension over a specific threat or danger to the person.

Anxiety disorders comprise a group of conditions that share a key feature of excessive anxiety with ensuing behavioral, emotional, cognitive, and physiologic responses. People suffering from anxiety disorders can demonstrate unusual behaviors such as panic without reason, unwarranted fear of objects, or unexplainable or unwavering worry. They experience significant distress over time, and the disorder significantly impairs their daily routines, social lives, and occupational functioning.

Anxiety disorders are diagnosed when anxiety no longer function as a signal of danger or a motivation for needed change but becomes chronic and permeates major portions of the person’s life, resulting in maladaptive behaviors and emotional disability.

Panic disorder is composed of discrete episodes of panic attacks usually of 15 to 30 minutes of rapid, intense, escalating anxiety in which the person experiences great emotional fear as well as physiologic discomfort. It is diagnosed when the person has recurrent, unexpected panic attacks followed by at least one month of persistent concern or worry about future attacks or their meaning or significant behavioral change related to them.

Nursing Care Plans

Nurses encounter anxious clients and families in a variety of situations. The nurse must first assess the person’s anxiety level because this determines what interventions are likely to be effective. Treatment of anxiety disorders usually involves medication and therapy. A combination of both produces better results than either one alone.

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When working with an anxious person, the nurse must be aware of her own anxiety level. It is easy for the nurse to become easily anxious – remaining calm and in control is essential if the nurse is going to work effectively with the client.

The following are seven (7) nursing care plans (NCP) and nursing diagnosis (NDx) for patients with anxiety and panic disorders: 

  1. Anxiety
  2. Fear
  3. Ineffective Coping
  4. Powerlessness
  5. Social Isolation
  6. Self-Care Deficit
  7. Deficient Knowledge
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Ineffective Coping

Nursing Diagnosis

May be related to

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  • Situational crises
  • Maturational crises
  • Fear of failure

Possibly evidenced by

  • Ritualistic behavior or obsessive thoughts
  • Inability to meet basic needs
  • Inability to meet role expectations
  • Inadequate problem solving

Desired Outcomes

  • Client will decrease participation in ritualistic behavior.
  • Client will demonstrate ability to cope effectively.
  • Client will verbalize signs and symptoms of increasing anxiety and intervene to maintain anxiety at manageable level.
  • Client will demonstrate ability to interrupt obsessive thoughts and refrain from ritualistic behaviors.
Nursing InterventionsRationale
Assess client’s level of anxiety. Investigate the types of situations that increase anxiety and result in ritualistic behaviors.Helping the client recognize the precipitating factors is the first step in teaching the client to interrupt the escalating anxiety.
Initially meet the client’s dependency needs as necessary.Sudden and complete elimination of avenues for dependency would create anxiety and will burden the client more.
Encourage independence and give positive reinforcement for independent behaviors.Positive reinforcement enhances self-esteem and encourages repetition of desired behaviors.
During the beginning of treatment, allow plenty of time for rituals. Do not be judgmental or verbalize disapproval of the behavior.To deny client this activity can precipitate panic level of anxiety.
Support and encourage client’s efforts to explore the meaning and purpose of the behavior.Client may be unaware of the relationship between emotional problems and compulsive behaviors. Recognition and acceptance of problems is important before change can occur.
Gradually limit the amount of time allotted for ritualistic behavior as client becomes more involved in unit activities.Anxiety is minimized when client is able to replace ritualistic behaviors with more adaptive ones.
Encourage the recognition of situations that provoke obsessive thoughts or ritualistic behaviors.Recognition of precipitating factors is the first step in teaching client to interrupt escalation of anxiety.
Provide positive reinforcement for nonritualistic behaviors.Positive reinforcement enhances self-esteem and encourages repetition of desired behaviors.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans for mental health and psychiatric nursing:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
  • Are nurses eligible to give mandala coloring activities to inpatients and college students for anxiety and stress

    • I just came over this, though this has been asked 3 years ago yet. Yes, I would say it can help them. I had my students do their own mandala and they commented that doing it has helped them with their stress and anxieties especially during this lockdown and pandemic.

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