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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Social Isolation

Nursing Diagnosis

  • Social Isolation

May be related to

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  • Maturational crisis.
  • Panic level of anxiety.
  • Past experiences of difficulty in interaction with others.
  • Repressed fears.

Possibly evidenced by

  • Uncommunicative
  • Withdrawn
  • No eye contact
  • Insecurity in public
  • Expression of feelings of rejection
  • Preoccupation with own thoughts; repetitive meaningless actions

Desired Outcomes

  • Client will willingly attend therapy activities accompanied by trusted support person.
  • Client will voluntarily spend time with other clients and staff members in group activities.
Nursing InterventionsRationale
Convey an accepting and positive attitude by making brief, frequent contacts.An accepting attitude increases feeling of self-worth and facilitates trust.
Show unconditional positive regard.To convey your belief in the client as a worthwhile individual.
Be with the client to offer support during group activities that may be frightening or difficult for him or her.The presence of a trusted individual provides emotional security for the client.
Be honest and keep all promises.Honesty and dependability promote a trusting relationship.
Be cautious with touch. Allow client extra space and avenue for exit if he becomes too anxious.A person in panic level anxiety may perceive touch as a threatening gesture.
Administer tranquilizing medications as ordered; monitor adverse side effects.Short-term use of antianxiety medications helps to reduce the level of anxiety in most individuals.
Discuss with the client the signs of increasing anxiety and techniques for interrupting the response such as breathing exercises, thought stopping, relaxation, meditation.Maladaptive behaviors are manifested during times of increased anxiety.
Give recognition and positive reinforcement for client’s voluntary interaction with others.Positive reinforcement enhances self-esteem and encourages repetition of acceptable 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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