Anxiety Disorder Nursing Guide

This course is intended as a Quick Reference for Anxiety Disorder and will provide an overview and nursing considerations utilizing the nursing process.

Anxiety Etiology and Epidemiology 

Anxiety disorder is categorized as excessive worry or anxiety, lasting at least 6 months, about things such as: 

• Everyday life circumstances 
• Personal health 
• Social interactions 
• Work 

The anxiety and fear can cause health related problems and personal problems affecting school, work, and social interactions (DeMartini et al., 2019). 

With anxiety disorder, the individual can experience panic attacks caused by sudden intense fear that can last for minutes. Panic attacks can be triggered or be unexpected and lead an individual to experience heart palpitation, sweating, shortness of breath, impending doom, etc. (DeMartini et al., 2019). 

In the U.S., anxiety affects approximately 40 million adults (ADAA, n.d.). Even though, anxiety can be treated, only 30% of the populations are receiving treatment (DeMartini et al., 2019). 

Anxiety ICD-10 Code (unspecified): F41.9 

Anxiety Disorder Diagnosis 

To diagnose for anxiety disorder, providers should: 

• Ask about medical history. 
• Perform a physical exam. 
• Perform a blood test for a thyroid panel. 

Anxiety Treatment & Management 

To manage anxiety disorder, the goals are to: 

• Improve or maintain quality of life and function of daily living. 
• Improve mood. 
• Promote cognitive and talk therapy. 
• Promote social engagements. 

Anxiety Nursing Care Plan

Nursing Considerations 

Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnosis, interventions, expected outcomes, and education for individuals with anxiety disorder are listed below. 

Assessment Symptoms of Anxiety

Signs and Symptoms: 

• Restlessness 
• Irritability 
• Social withdrawal 
• Decrease in activities of daily living 
• Fatigue 
• Having muscle tension 
• Change in behavior and decision making 
• Difficulty controlling worries 
• Forgetting conversations 
• Problems sleeping 

Nursing Diagnosis/Risk For 

• Ineffective coping 
• Fear 
• Powerlessness 
• Social isolation 
• Self-care deficit 
• Impaired communication 
• Disturbed thought process 

Interventions 

• Collect baseline cognitive level. 
• Maintain calm state when dealing with patients. 
• Establish trust. 
• Remain with patients when anxiety is high. 
• Avoid reality checks. 
• Move to seclusion with minimum stimuli. 
• Provide reassurance. 
• Educate on anxiety. 
• Avoid forcing a patient to make decisions. 

Expected Outcomes 

• Remain safe and free from injury 
• Be comfortably able to express needs freely 
• Demonstrate relax techniques 
• Remain free from irritability 
• Reduce own anxiety 

Individual/Caregiver Education 

• Getting regular checkups 
• Eating a healthy diet 
• Getting enough rest 
• Reporting behavioral changes 
• Keeping a daily schedule 
• Avoiding activities that cause behavioral changes 
• Maintaining a medication regimen 
• Utilizing stress management 
• Finding local support 
• Seeking medical attention when in crisis 

Content Release Date 

4/1/2022

Content Expiration

12/31/2026

Course Contributor 

The content for this course was created by Relias staff writer Tiffany Fields, RN, BSN, MSN, DNP, CRNP. Tiffany has been a clinical nurse for over 20 years. She was educated and trained as a Licensed Practical Nurse in Alabama, where she practiced as a Gerontological Nurse at the local Nursing Homes. She earned her Associate, Bachelor’s and Master’s degrees in Nursing and a Doctorate in Nursing Practice. She also as a Certified Family Nurse Practitioner degree. Her clinical expertise is Adult-Geriatric Nursing and Medical-Surgical medical complexity. She is currently Assistant Director of Nursing at a Rural Hospital as well as a writer for Relias. 

Resources 

• National Institute of Mental Health https://www.nimh.nih.gov/ 
• Anxiety & Depression Association of America https://adaa.org/ 
• American Counseling Association https://www.counseling.org/ 

References 

• Anxiety & Depression Association of America (ADAA). (n.d.). Facts & Statistics. Accessed August 3, 2021 at: https://adaa.org/understanding-anxiety/facts-statistics 
• Borza, L. (2017). Cognitive-behavioral therapy for generalized anxiety. Dialogues in clinical neuroscience, 19(2), 203. https://dx.doi.org/10.31887%2FDCNS.2017.19.2%2Flborza 
• DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized anxiety disorder. Annals of internal medicine, 170(7), ITC49-ITC64. https://doi.org/10.7326/AITC201904020 
• Kandola, A., Vancampfort, D., Herring, M., Rebar, A., Hallgren, M., Firth, J., & Stubbs, B. (2018). Moving to beat anxiety: epidemiology and therapeutic issues with physical activity for anxiety. Current psychiatry reports, 20(8), 1-9. https://doi.org/10.1007/s11920-018-0923-x 
• Maron, E., & Nutt, D. (2017). Biological markers of generalized anxiety disorder. Dialogues in clinical neuroscience, 19(2), 147. https://dx.doi.org/10.31887%2FDCNS.2017.19.2%2Fdnutt 
• Postorino, V., Kerns, C. M., Vivanti, G., Bradshaw, J., Siracusano, M., & Mazzone, L. (2017). Anxiety disorders and obsessive-compulsive disorder in individuals with autism spectrum disorder. Current psychiatry reports, 19(12), 1-8. https://doi.org/10.1007/s11920-017-0846-y