Angelite Nurses: Anxiety

Anxiety

(_)Actual (_) Potential

**Related To:**
*[Check those that apply]*
(_) Anesthesia (_) Anticipated/actual pain (_) Disease (_) Invasive/noninvasive procedure:_________ _____________________________________ (_) Loss of significant other (_) Threat to self-concept (_) Other:_____________________________ ____________________________________ ____________________________________

**As evidenced by:**
*[Check those that apply]*
Major: (Must be present)	[Physiological] (_) Elevated BP, P, R (_) Insomnia (_) Restlessnes (_) Dry mouth (_) Dilated pupils (_) Frequent urination (_) Diarrhea [Emotional] (_) Patient complains of apprehension, nervousness, tension [Cognitive] (_) Inability to concentrate (_) Orientation to past (_) Blocking of thoughts, hyperattentiveness

Date &
Sign.

Plan and Outcome
[Check those that apply]

Target
Date:

Nursing Interventions
[Check those that apply]

Date
Achieved:

The patient will:

(_) Demonstrate a decrease in anxiety A.E.B.:

A reduction in presenting physiological, emotional, and/or cognitive manifestations of anxiety.
Verbalization of relief of anxiety.

(_) Discuss/demonstrate effective coping mechanisms for dealing with anxiety.

(_) Other:

(_) Assist patient to reduce present level of anxiety by:

Give clear, concise explanations regarding impending procedures.
Focus on present situation.
Identify and reinforce coping strategies patient has used in the past.
Discuss advantages and disadvantages of existing coping methods.
Discuss alternate strategies for handling anxiety. (Eg.: exercise, relaxation techniques and exercises, stress management classes, directed conversation (by nurse), assertiveness training)
Set limits on manipulation or irrational demands.
Help establish short term goals that can be attained.
Reinforce positive responses.
Initiate health teaching and referrals as indicated:

(_) Other:________________
________________________
________________________
________________________

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Patient/Significant other signature

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RN signature

Angelite Nurses