Anxiety Disorders and Panic Disorders Nursing Care Guide – Nurseslabs

Anxiety disorders involve disorders that contain characteristics of excessive fear and anxiety and linked behavioral disturbances. There are several types of anxiety disorders including generalized anxiety disorder, agoraphobia, separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder or social phobia, panic disorder, substance/medication-induced anxiety disorder, and anxiety disorder due to another medical condition. Review this study guide and learn more about anxiety disorders, its nursing care management, interventions, and assessment.

The characteristic features of this group of disorders are symptoms of anxiety and avoidance behavior. Anxiety disorders are categorized in the following manner:

Obsessive-compulsive disorder (included in the obsessive-compulsive and related disorders), posttraumatic stress disorder (included in the trauma and stress-related disorders), and acute stress disorder, are no longer considered anxiety disorders as they were in the previous version of the DSM. Nonetheless, these disorders are closely linked to anxiety disorders and the sequential order of these chapters in the DSM-5 reflects this close connection.

The brain circuits and regions associated with anxiety disorders are beginning to be understood with the development of functional and structural imaging.

Statistics and Incidences

Anxiety disorders are the most common type of psychiatric disorders in the Unites States.

Predisposing factors to anxiety disorder include the following:

Clinical Manifestations

Signs and symptoms of anxiety disorders may include the following:

Assessment and Diagnostic Findings

For presentations with a higher index of suspicion for other medical causes of anxiety, more detailed evaluations may be indicated to identify or exclude underlying medical disorders.

Medical Management

Treatment usually consists of a combination of pharmacotherapy and/or psychotherapy.

Pharmacologic Management

Antidepressant agents are the drugs of choice in the treatment of anxiety disorders, particularly the newer agents that have a safer adverse effect profile and higher ease of use than the older tricyclic antidepressants.

Nursing Management

Nursing management of a patient with anxiety disorder include the following:

Nursing Assessment

Nursing assessment of a patient with anxiety disorder include:

Nursing Diagnosis

Based on the assessment data, the major nursing diagnosis are:

Nursing Care Planning and Goals

The major nursing care planning goals for patients with Anxiety Disorders are:

SEE ALSO: 7 Anxiety and Panic Disorders Nursing Care Plans

Nursing Interventions

The nursing interventions for anxiety disorders are:

The outcome criteria for Anxiety Disorders include:

Documentation Guidelines

Documentation guidelines include the following:

Practice Quiz: Anxiety Disorders

Nursing practice questions for Anxiety Disorders. For more practice questions, visit our .

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Practice Quiz: Anxiety Disorders

Congratulations – you have completed Practice Quiz: Anxiety Disorders. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%
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Question 1
After seeking help at an outpatient mental health clinic, Ruby who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for Ruby?
Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle.
Question 1 Explanation: 
Option C: The client with PTSD needs encouragement to examine and understand the meaning of the traumatic event and consequent losses. Otherwise, symptoms may worsen and the client may become depressed or engage in self-destructive behavior such as substance abuse. Option B: A special diet isn’t indicated unless the client also has an eating disorder or a nutritional problem. Option C: The client must explore the meaning of the event and won’t heal without this, no matter how much time passes. Behavioral techniques, such as relaxation therapy, may help decrease the client’s anxiety and induce sleep. Option D: The physician may prescribe antianxiety agents or antidepressants cautiously to avoid dependence; sleep medication is rarely appropriate.
Question 2
Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse is aware that the teaching instructions for newly prescribed buspirone should include which of the following?
A warning that immediate sedation can occur with a resultant drop in pulse.
Question 2 Explanation: 
Option C: The client should be informed that the drug’s therapeutic effect might not be reached for 14 to 30 days. The client must be instructed to continue taking the drug as directed. Option A: Blood level checks aren’t necessary. Options B and D: NMS hasn’t been reported with this drug, but tachycardia is frequently reported.
Question 3
Patient Clint with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include:
Depression and weight loss
Question 3 Explanation: 
Option A: Phobias cause severe anxiety (such as a panic attack) that is out of proportion to the threat of the feared object or situation. Physical signs and symptoms of phobias include profuse sweating, poor motor control, tachycardia, and elevated blood pressure. Option B: Withdrawal and failure to distinguish reality from fantasy occur in schizophrenia. Options C and D: Insomnia, an inability to concentrate, and weight loss are common in depression.
Question 4
Which medications have been found to help reduce or eliminate panic attacks?
Question 4 Explanation: 
Option D: Tricyclic and monoamine oxidase (MAO) inhibitor antidepressants have been found to be effective in treating clients with panic attacks. Why these drugs help control panic attacks isn’t clearly understood. Option A: Anticholinergic agents, which are smooth-muscle relaxants, relieve physical symptoms of anxiety but don’t relieve the anxiety itself. Option B: Mood stabilizers aren’t indicated because panic attacks are rarely associated with mood changes. Option C: Antipsychotic drugs are inappropriate because clients who experience panic attacks aren’t psychotic.
Question 5
The nurse is assessing a client who has just been admitted to the emergency department. Which signs would suggest an overdose of an antianxiety agent?
Combativeness, sweating, and confusion
Question 5 Explanation: 
Option B: Signs of antianxiety agent overdose include emotional lability, euphoria, and impaired memory. Option A: Hallucinogen overdose can produce suspiciousness, dilated pupils, and increased blood pressure. Option C: Amphetamine overdose can result in agitation, hyperactivity, and grandiose ideation. Option D: Phencyclidine overdose can cause combativeness, sweating, and confusion.
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Practice Mode: This is an interactive version of the Text Mode. All questions are given in a single page and correct answers, rationales or explanations (if any) are immediately shown after you have selected an answer. No time limit for this exam.

Practice Quiz: Anxiety Disorders

Congratulations – you have completed Practice Quiz: Anxiety Disorders. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
After seeking help at an outpatient mental health clinic, Ruby who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for Ruby?
Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle.
Question 1 Explanation: 
Option C: The client with PTSD needs encouragement to examine and understand the meaning of the traumatic event and consequent losses. Otherwise, symptoms may worsen and the client may become depressed or engage in self-destructive behavior such as substance abuse. Option B: A special diet isn’t indicated unless the client also has an eating disorder or a nutritional problem. Option C: The client must explore the meaning of the event and won’t heal without this, no matter how much time passes. Behavioral techniques, such as relaxation therapy, may help decrease the client’s anxiety and induce sleep. Option D: The physician may prescribe antianxiety agents or antidepressants cautiously to avoid dependence; sleep medication is rarely appropriate.
Question 2
Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse is aware that the teaching instructions for newly prescribed buspirone should include which of the following?
A warning that immediate sedation can occur with a resultant drop in pulse.
Question 2 Explanation: 
Option C: The client should be informed that the drug’s therapeutic effect might not be reached for 14 to 30 days. The client must be instructed to continue taking the drug as directed. Option A: Blood level checks aren’t necessary. Options B and D: NMS hasn’t been reported with this drug, but tachycardia is frequently reported.
Question 3
Patient Clint with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include:
Depression and weight loss
Question 3 Explanation: 
Option A: Phobias cause severe anxiety (such as a panic attack) that is out of proportion to the threat of the feared object or situation. Physical signs and symptoms of phobias include profuse sweating, poor motor control, tachycardia, and elevated blood pressure. Option B: Withdrawal and failure to distinguish reality from fantasy occur in schizophrenia. Options C and D: Insomnia, an inability to concentrate, and weight loss are common in depression.
Question 4
Which medications have been found to help reduce or eliminate panic attacks?
Question 4 Explanation: 
Option D: Tricyclic and monoamine oxidase (MAO) inhibitor antidepressants have been found to be effective in treating clients with panic attacks. Why these drugs help control panic attacks isn’t clearly understood. Option A: Anticholinergic agents, which are smooth-muscle relaxants, relieve physical symptoms of anxiety but don’t relieve the anxiety itself. Option B: Mood stabilizers aren’t indicated because panic attacks are rarely associated with mood changes. Option C: Antipsychotic drugs are inappropriate because clients who experience panic attacks aren’t psychotic.
Question 5
The nurse is assessing a client who has just been admitted to the emergency department. Which signs would suggest an overdose of an antianxiety agent?
Combativeness, sweating, and confusion
Question 5 Explanation: 
Option B: Signs of antianxiety agent overdose include emotional lability, euphoria, and impaired memory. Option A: Hallucinogen overdose can produce suspiciousness, dilated pupils, and increased blood pressure. Option C: Amphetamine overdose can result in agitation, hyperactivity, and grandiose ideation. Option D: Phencyclidine overdose can cause combativeness, sweating, and confusion.
Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results
There are 5 questions to complete.
You have not finished your quiz. If you leave this page, your progress will be lost.
Questions Not Attempted
Total Questions on Quiz

Text Mode: All questions and answers are given on a single page for reading and answering at your own pace. Be sure to grab a pen and paper to write down your answers.

1. After seeking help at an outpatient mental health clinic, Ruby who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for Ruby?

A. Allowing the client time to heal.
B. Recommending a high-protein, low-fat diet.
C. Exploring the meaning of the traumatic event with the client.
D. Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle.

1. Answer: C Exploring the meaning of the traumatic event with the client.

2. Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse is aware that the teaching instructions for newly prescribed buspirone should include which of the following?

A. A reminder of the need to schedule blood work in 1 week to check blood levels of the drug.
B. A warning about the incidence of neuroleptic malignant syndrome (NMS).
C. A warning about the drugs delayed therapeutic effect, which is from 14 to 30 days.
D. A warning that immediate sedation can occur with a resultant drop in pulse.

2. Answer: C. A warning about the drugs delayed therapeutic effect, which is from 14 to 30 days.

3. Patient Clint with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include:

A. Severe anxiety and fear
B. Withdrawal and failure to distinguish reality from fantasy
C. Insomnia and an inability to concentrate
D. Depression and weight loss

3. Answer: A. Severe anxiety and fear.

4. Which medications have been found to help reduce or eliminate panic attacks?

A. Anticholinergics
B. Mood stabilizers
C. Antipsychotics
D. Antidepressants

4. Answer: D. Antidepressants.

5. The nurse is assessing a client who has just been admitted to the emergency department. Which signs would suggest an overdose of an antianxiety agent?

A. Suspiciousness, dilated pupils, and increased blood pressure
B. Emotional lability, euphoria, and impaired memory
C. Agitation, hyperactivity, and grandiose ideation
D. Combativeness, sweating, and confusion

5. Answer: B. Emotional lability, euphoria, and impaired memory.

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