Anxiety disorders 

are the most common mental illness in the

U.S., affecting 40 million adults in the United States age 18
and older, or 18% of the population, according to the
National Institute of Mental Health. In fact, anyone from all
walks of life can suffer from anxiety disorders. It affects the
poor, the rich, the young, the old, the sick, the healthy, and
more. However, everyone experiences anxiety differently. It
can be a result of fear, uncertainty, circular and racing
thoughts, and the avoidance of certain behaviors. It can affect
our ability to function normally, and even convince us that
we’re losing our minds. And worst, it can even lead to related
psychological conditions, like substance abuse and
personality difficulties. CONSCIOUS SEDATION
In the acute care setting, many clients undergo invasive procedures using conscious sedation. Conscious
sedation does not require the presence of an anesthesiologist. The physician is most often credentialed in
conscious sedation based on the policies and procedures of the health care facility. The role of the nurse
in conscious sedation focuses on the administration of the ordered sedative/narcotic agents and the
physiological monitoring of the client’s response to both the medications and the procedure. Common
opioids used in conscious sedation include morphine, meperidine (Demerol), and fentanyl (Sublimaze).
Opioids are administered in combination with sedatives to reduce the incidence of pain and improve the
client’s tolerance of the procedure. Common sedatives used for conscious sedation include diazepam
(Valium) and midazolam (Versed).
The American Society of Anesthesiologists (2004, p. 1) defines conscious sedation as “a drug-induced
depression of consciousness during which patients respond purposefully to verbal commands, either
alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent
airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.” When
used safely, conscious sedation provides moderate sedation/analgesia while maintaining adequate
cardiopulmonary function, protective reflexes, and the ability to respond appropriately to stimulation.
This care plan focuses on the care of the adult client who is receiving or has received conscious
sedation for an invasive procedure. Because of the nature of ongoing assessment, intervention, and
evaluation of the client’s tolerance to medications and procedure, delegation rarely occurs. Much of the
information is applicable to clients having conscious sedation in an outpatient setting (e.g., physician’s
office, surgical care center).