Nurse's Pocket Guide

ANXIETY
• Acknowledge anxiety/fear. Do not deny or reassure client that
everything will be all right.
• Provide accurate information about the situation. Helps
client to identify what is reality based.
• With a child, be truthful, avoid bribing, and provide physical
contact (e.g., hugging or rocking) to soothe fears and provide
assurance.
• Provide comfort measures (e.g., calm/quiet environment, soft
music, warm bath, or back rub).
• Modify procedures as much as possible (e.g., substitute oral
for intramuscular medications or combine blood draws/use
fingerstick method) to limit degree of stress and avoid overwhelming
child or anxious adult.
• Manage environmental factors, such as harsh lighting and
high traffic flow, which may be confusing/stressful to older
individuals.
• Accept client as is. (The client may need to be where he or she
is at this point in time, such as in denial after receiving the
diagnosis of a terminal illness.)
• Allow the behavior to belong to the client; do not respond personally.
(The nurse may respond inappropriately, escalating
the situation to a nontherapeutic interaction.)
• Assist client to use anxiety for coping with the situation, if
helpful. (Moderate anxiety heightens awareness and permits
the client to focus on dealing with problems.)
Panic State
• Stay with client, maintaining a calm, confident manner.
• Speak in brief statements using simple words.
• Provide for nonthreatening, consistent environment/atmosphere.
Minimize stimuli. Monitor visitors and interactions to
lessen effect of transmission of feelings.
• Set limits on inappropriate behavior and help client to
develop acceptable ways of dealing with anxiety.
NOTE: Staff may need to provide safe controls/environment until
client regains control.
• Gradually increase activities/involvement with others as anxiety
is decreased.
• Use cognitive therapy to focus on/correct faulty catastrophic
interpretations of physical symptoms.
• Administer medications (antianxiety agents/sedatives), as
ordered.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
92 Cultural Collaborative Community/Home Care