Nanda Care Plan for Anxiety

Nanda Anxiety

Anxiety is a signal to awaken; warned of the danger and allows one to take action and tackle the threat.

Anxiety related to feeling uncertain / helplessness, emotional state does not have a specific object.

Panic disorder experienced by approximately 1.7% of the adult population. Lifetime incidence of panic disorder was reported 1.5% to 5%, while the panic attacks as much as 3% to 5.6%.

Panic disorder is often chronic occurred, vary widely among individuals. In the long term, 30% - 40% of patients no longer have panic attacks, 50% experience mild symptoms that do not affect his life, while the rest are still experiencing significant symptoms (Elvira, 2008).

Definition According to the Experts

1.Sigmound Freud declared that tension or anxiety that happens to an individual without a purpose or object, is not recognized and are associated with loss of self image.

2. Sullivan stated that the concern arises because of the threat to self esteem by people nearby. Anxiety in adults occurs when pretige and self dignity are threatened by others.

3. Pepleu states that anxiety can affect interpersonal relationships. Besides that anxiety is a response to the dangers of the unknown and occurs when there are obstacles to the implementation requirements.

Anxiety is different from Fear

Fear is the man dreams of a clear source, or where the person is the object which can identify and explain the object. Involves the interpretation of intellectual fear of the threatening stimulus, whereas anxiety involves the emotional response to the interpretation.

Criteria for panic attacks, obsessions and compulsions


  • Palpitations, heart beating hard
  • Sweat
  • Shaky or unsteady
  • Feeling choked
  • Chest pain
  • Nausea
  • Feeling dizzy
  • Thoughts, impulses or images over and over and settle
  • Thoughts, impulses with excessive worries
  • Individuals attempt to suppress the irrational thoughts
  • Individuals recognize the mind's obsession
  • Repetitive behavior (such as hand washing) or mental acts (eg praying, counting, muttering words without sound) so that individuals feel compelled to do in response to an obsession.

Signs and symptoms of anxiety

Patients come to the health or psychiatric services typically complain of triad-anxiety, namely;
  • the anxiety of uncertain future,
  • over the activity, and
  • a feeling of tension and fear.

Nanda Nursing Diagnosis for Anxiety
  1. Breathing pattern, ineffective
  2. Individual coping, ineffective
  3. Verbal communication, Impaired
  4. Anxiety
  5. Powerlessness
  6. Fear

Nursing Interventions, Implementation and Evaluation :

Severe anxiety / panic

Objectives are expected to:
Clients are protected from harm
Clients can adjust to his new environment
Clients can follow the activities scheduled
Clients can experience healing by decreasing the signs of symptoms

Interventions :

1. Protect clients from harm
Construct the therapeutic relationship: first thank his will and give clients the support of the fight.
Recommend the reality of pain-related coping mechanisms Do not focus on phobias, rituals or physical complaints.
Feedback on: the behavior of stress, assessment of stressors and coping resources
Reinforce the idea that physical health Dealing with emotional health.
Then begin to limit maladaptive behavior by supporting clients.

2. Environmental modifications that can reduce anxiety
Perform a calm manner to the client.
Reduce the environmental stimulation.
Limit patient interaction with others, to minimize the spread of anxiety in others.
Identification and modification of situations that affect anxiety.
Provide measures to support the physical, such as a warm bath, massage.

3. Encourage clients to do the activities that have been scheduled
Support clients to share their activities with activities such as cleaning the room, then take care garden reinforcement given socially productive behavior.
Give some kind of physical exercise such as gymnastics, relaxation.
Together with the client to create a schedule of activities.
Involve the family or other support systems that allow.

4. Collaboration for the administration of antianxiety drugs to reduce the symptoms of severe anxiety.
Collaboration of antianxiety drugs,
Observe the side effects of drugs.


Implementation, tailored to the plan of nursing actions.


1. Subjective evaluation
a) The client feels comfortable in treatment.
b) The client can gradually accept himself.

2. Objective evaluation
Clients change their behavior, there does not seem angry or aggressive symptoms
Clients can start a conversation.

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