Running head: ANXIETY NURSING DIAGNOSIS 1

Anxiety Nursing Diagnosis

Student’s Name

Institutional Affiliation
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Anxiety Nursing Diagnosis

Overview

Anxiety is featured in Nanda nursing diagnosis list under the 9th Domain. Anxiety is a

form of an actual nursing diagnosis which is defined as the feeling of apprehension and

discomfort as a means of responding to the disturbance of the normal environmental pattern.

Unlike in the case of fear which is related to a more specific and obvious threat, anxiety is not

related with a clear and identifiable basis of threat. I am interested to study anxiety because the

feeling of being anxious is inevitable in life. Moreover, anxiety is found to act as the motivators

of many in decision-making, problem-solving, as well as when dealing with stress-associated

events. According to Taghavi Larijani and Saatchi (2019), anxiety aids in preparing the person

physiologically and psychologically. It guides the sympathetic system of a person to increase

attention and focus.

The severity of the symptoms of anxiety is based on the intensity of the individual’s

perceived threat. There are cases whereby the coping mechanisms mastered by an individual

cannot overcome the anxiety hence driving him/her to develop maladaptive behaviors. The

degree of the manifestations of the anxiety feeling will determine if a person is suffering from

severe, moderate, or mild anxiety which is manifested by different symptoms. For instance, mild

anxiety increases the perception and alertness rate of an individual. As a result, mild anxiety is

considered to be somehow constructive since it creates an environment and a chance of learning

(Blevins, 2011). Mild anxiety is also associated with symptoms such as nail biting, and hair-

twisting as a means of eliminating the tension.

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Moderate anxiety is featured by mild tremors, increased heart respiratory rates, and high-

pitched voice. Taghavi Larijani and Saatchi (2019) state that an individual with moderate anxiety

is likely to experience learning difficulties as a result of selective attention and lack of

concentration. An individual with severe anxiety will experience nausea, headache, vomiting,

and nausea alongside the symptoms evident in the case of moderate anxiety. Moreover, severe

anxiety is featured with increased irritability and self-absorption (Blevins, 2011). Panic is

considered as the highest level of anxiety which is featured by dyspnea, palpitations, sweating

and choking. An individual with panic anxiety will display destructive behaviors and amnesia.

Importance of a Standardized Care Map

A standardized care map is important for all nurses since it enhances communication.

According to Blevins (2011), a standardized care map focuses on using a standardized language

to improve communication of nursing care, internationally and nationally. The standardization is

important since it alerts the nurses to be effectively implement interventions which may not be

common within their areas of care administration. A standardized nursing care map is also

beneficial since it outline a care plan which offers direction for an individualized care of the

patient (Taghavi Larijani & Saatchi, 2019). A standardized care map includes a care plan which

flows from each patient’s list of diagnosis and is organized to address specific individual needs.

The standardized care map facilitates care continuity among nurses. The proposed care map

fosters a means of communication even in the events where a healthcare firm keeps changing the

nursing staff or in the event of shift changes.

NANDA Nursing Diagnoses

Chronic Pain (Domain 12: Comfort)

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Chronic pain is an example of a NANDA Nursing diagnosis classified under domain 12

(Comfort). Chronic pain refers to the unpleasant emotional and sensory experience which arises

from potential or actual tissue damage. According to de Cordova et al. (2010), chronic pain is

any form of pain which lasts for over 12 weeks. The pain can be classified as chronic

nonmalignant pain or chronic malignant pain. Malignant pain has a unique cause such as cancer

while a nonmalignant form of pain is associated with tissue injury which is not progressive.

Insomnia (Domain 4: Activity/Rest)

Insomnia, listed under Domain 4 (Activity/Rest) is the disruption in the quality and

amount of sleep which impairs functioning. The condition is complicated and is likely to be

chronic or temporary (de Cordova et al., 2010). Short term insomnia can be experienced as a

form of response to the work-schedule variations, traveling beyond normal time zones, and

overnight stressors. Long-term insomnia is associated with substance abuse such as alcohol and

drugs and other aspects such as depression, chronic pain, aging and obesity.

Nursing Interventions from NIC

Anxiety

Several Nursing Interventions Classification System (NIC) interventions can be

considered for anxiety. For instance, encouraging the patient to engage in positive self-talk is an

intervention for consideration. The second intervention which can be considered is to offer the

patient with accurate information and encouragement about the meaning of events which results

to the anxiety and fears. The third intervention can include the use of empathy as a means of

encouraging the client interpret any symptoms of anxiety as normal (Butcher,

Bulechek, Dochterman & Wagner, 2018).

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Chronic Pain

For chronic pain, medication administration can be considered as an intervention. The use

of pain control measures such as non-pharmacological strategies can also be considered for

managing chronic pain. Moreover, the use of a properly developed means of evaluation to

outline changes in the pain assists in identifying the precipitating factors is also an important

intervention for this case (Butcher et al., 2018).

Insomnia

One proposed interventions which are supported under NIC includes educating the

patient on the proper food and fluid intake before retiring to bed. The second intervention for

consideration is to encourage the client to take part in daytime physical activities and avoid

strenuous ones before bedtime. The third one includes following a consistent schedule on a daily

basis for sleep and rest (Butcher et al., 2018).

Nursing Interventions from NOC

The Nursing Outcomes Classification (NOC) refers to a standardized, comprehensive

classification of a family, community or patient outcome established to evaluate the effect of

interventions offered by nurses or other health practitioners (Moorhead, Swanson, Johnson &

Maas, 2018).

Anxiety

One of the client outcomes for anxiety as stated under NOC includes having the patient

demonstrating an enhanced concentration. The second one is the client demonstrating an

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enhanced ability to reassure self. The third one is to show and enhanced external focus

(Moorhead et al., 2018).

Chronic Pain

The patient demonstrates an ability to take rest breaks and pace self when required is one

of the client outcomes. The second one includes operating on an acceptable ability level with a

limited interference from medication and pain side effects. The third one involves outlining a

description for the overall plan for the nondrug and drug relieve which is inclusive of how to

effectively and safely take medicines while including therapies (Moorhead et al., 2018).

Insomnia

The patient wakes up less frequently after falling asleep at night. Additionally, the patient

can easily fall asleep without much struggle. Also, the patient verbalizes a plan which includes

bedtime routines to be implemented (Moorhead et al., 2018).

Conclusion

Conclusively, NANDA nursing diagnosis, intervention and outcome classification

systems are effective in promoting the quality of care through the provisions of a standardized

means of communication. Through proper diagnoses, the nurses can propose valuable

interventions focused on improving the patient outcomes. As a result, the quality of care is

enhanced as a result of the NANDA, NIC, and NOC system and its components.
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References

Blevins, J. Y. (2011). Oral Health Care For Hospitalized Children. Pediatric Nursing, 37(5),

229–235.

Butcher, H. K., Bulechek, G. M.,  Dochterman, J. M., & Wagner, C. M. (Eds.). (2018). Nursing

interventions classification (NIC) (7th ed.). St. Louis, MO: Elsevier.

de Cordova, P. B., Lucero, R. J., Hyun, S., Quinlan, P., Price, K., & Stone, P. W. (2010). Using

the nursing interventions classification as a potential measure of nurse workload. Journal

of nursing care quality, 25(1), 39–45.

Moorhead, S., Swanson, E., Johnson, M., & Maas, M., (Eds.). (2018). Nursing outcomes

classification (NOC): Measurement of Health Outcomes (6th ed.). St. Louis, MO:

Elsevier.

Taghavi Larijani, T., & Saatchi, B. (2019). Training of NANDA-I Nursing Diagnoses (NDs),

Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC),

in Psychiatric Wards: A randomized controlled trial. Nursing open, 6(2), 612–619.

doi:10.1002/nop2.244
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Appendix

Standard Care Map: Anxiety

Client:

Care Plan by:

Date of Initiation:

Nursing Diagnosis Evaluation Interventions Outcomes

Panic Anxiety dyspnea, palpitations, Encouraging the patient Demonstrating an
sweating and choking to engage in positive self- enhanced ability
signs are evident talk. to reassure self.

Offering the patient with Having the patient

accurate information and demonstrate an
encouragement about the enhanced
meaning of events which concentration.
results to the anxiety and
fears.

Using empathy as a Showing an

means of encouraging the enhanced external
client interpret any focus
symptoms of anxiety as
normal.