Steps a Nurse Should Take When Observing a Mental Health Client with Anxiety Disorder
Trauma, particularly the combat and sexual abuse, and other mental stresses often cause anxiety disorders that may cause considerable fear and worry. These feelings may escalate into panic attacks or other physical symptoms.
When you're a nurse, panic level anxiety can be a tough one to deal with. You know your client is having trouble managing their mental health, but it's not always easy to know what to do.
So, what should you do when observing a client with panic-level anxiety? You need to note every interaction with other people and give them medication as directed. These are just but a few things you could do when taking care of such a client.
So, read on to learn more about how you should handle a client with panic-level anxiety.
How to Differentiate Between Types of Anxiety Disorders
The first step is to know whether you are really handling a patient with a panic level of anxiety. Here are the different types of anxiety disorders and their differences:
- Social Anxiety Disorder - Social anxiety disorder is when you experience extreme, irrational fear of social or performance situations that can cause you to avoid those situations and experiences.
- Obsessive-Compulsive Disorder (OCD) - Obsessive-compulsive disorder is a type of anxiety disorder characterized by intrusive thoughts (obsessions) and excessive rituals or actions (compulsions). It is marked by an inability to control the behavior.
- Panic Disorder - Panic attacks are episodes of intense fear or discomfort that occur suddenly and without warning, usually with chest pain or difficulty breathing, followed by a sensation of being about to faint or lose control.
- Specific Phobias - These are fears that cause distress—you might be afraid of heights, spiders, animals with certain features (like snakes), or even places like enclosed spaces or elevators.
- Posttraumatic stress disorder - This type of anxiety disorder can develop after a traumatic event, such as a natural disaster or violence. The symptoms often include flashbacks, nightmares, and intrusive thoughts about the event. These symptoms can last for months or years after the trauma.
- Acute stress disorder - This is another type of anxiety disorder that develops within hours or days of experiencing an extremely stressful event. Symptoms include feeling nervous, irritable, and easily startled. These symptoms usually disappear within a few weeks of the trauma.
- Agoraphobia - Agoraphobia is an intense fear of being in public places where many people gather, such as shopping malls or busy streets. People with agoraphobia may feel anxious when they have to go out in public places because they fear that they will have a panic attack.
Signs and Symptoms of a Client Having a Panic Level of Anxiety
Here are the signs and symptoms to check for in a client with this disorder:
- Breathing quickly or shallowly
- Feeling lightheaded, dizzy, or faint
- Feeling chest pain
- Chest pain
- Chest tightness (like a band around your chest)
- Having a racing heart
- Having trouble sleeping or sleeping too much
- Being irritable or short-tempered
- Choking sensation
- Feeling of unreality
- Fear that they will die or go mad
- Impending doom senses
Steps a Nurse Should Take When Observing a Mental Health Client with Anxiety Disorder
Some nurses may find caring for someone experiencing a panic-level anxiety disorder challenging. This can result in severe consequences for the person experiencing anxiety or the healthcare team working with them.
Luckily, you can prevent these by accurately handling the client. Here are some tips when a nurse in a mental health facility observes a client who is experiencing a panic level of anxiety:
1. Be Calm and Do Not Threaten Them
You must remain calm and collected when observing a client with an anxiety disorder. The best way to do this is by keeping your tone low and standard, as though the situation were not so serious.
If someone is anxious, they will often try to hide it, so the best way to get them to open up about their anxiety is simply to act as though it is no big deal.
You should also not threaten or make them feel bad about their condition. This can cause them to become defensive and even more secretive about their feelings. If you do this, you will only be able to see what they want others to see—but not what they feel inside themselves.
The best way to go about observing someone with an anxiety disorder is to keep your distance from them. Be looking over their shoulder occasionally if you need to ask questions or check their vitals or other important information.
2. Assure Them That They Are Safe
Assuring a person he is safe is an essential first step in helping them feel more comfortable. You can do this by explaining that they are in a safe space and that you are there with them. You can also remind them of the things they control, like their thoughts and feelings.
It's also important to reassure clients that they don't need to be afraid of anything or anyone around them.
This doesn't mean that you should ignore potential threats. Instead, it means you should approach the situation calmly and rationally so as not to alarm your client further.
3. Give Your Client a Non-Stimulating Space
When observing a mental health client with an anxiety disorder, you need to ensure that they are in an environment that is not stressful or stimulating.
This can be done by giving them a friendly, quiet workplace. Such as a room where the walls are painted a soothing color, and there are no windows or clocks—just soft lighting.
This is important because it will help them relax their muscles and allow their body to rest while still feeling anxious. It also helps bring down their heart rate, so they don't feel so much stress when you're talking to them.
4. Give Medications as Directed
When observing a mental health client, paying attention to their medication is essential. This is especially true of anxiety disorder patients. Their medications can be complicated and may require some adjustment on your part.
The first step in giving medication as directed is to ensure that your patient is taking it. If they aren't, they may need to return to the doctor or chemist. Ask them to adjust the dose or clarify the instructions.
Once you've confirmed that your client is taking their prescribed medication, it's time to discuss any adjustments needed. The discussion will ensure they feel comfortable taking them every day. You should also ensure they know precisely when to take their medication.
Tell them how long after taking it they can expect an effect. This will help them feel more confident about managing their anxiety disorder with medication. It will allow them to know when things are going well so that they can celebrate progress!
5. Recognize the Triggers
Whenever you observe a mental health client with an anxiety disorder, you must recognize the precipitating factors of the condition.
The precipitating factors of an anxiety disorder can be defined as any external events or circumstances that make a person more prone to anxiety.
6. Encourage Them to Talk About Their Feelings
Another big step in helping a client with an anxiety disorder is understanding the problem thoroughly. It's essential to give them the space and time they need to express their feelings without feeling like you're judging them for it.
This can be done by simply listening to your client's words without interrupting. It's also important to let them know that you understand where they're coming from and why their emotions might seem overwhelming.
The essential thing is that they feel understood, supported, and safe in discussing their issues with you. They can also talk to any other medical professional to help them address their fears or triggers.
What You Should Assess When Taking Care of a Client with a Panic Level of Anxiety
When taking care of such patients, there are assessments that you must do as a nurse. They include the following:
1. Their History
When taking care of a client with a panic level of anxiety, you'll want to ensure that you know their stress history. You need to learn about this to treat the client accordingly.
Talk with them about how they've dealt with their anxiety in the past. Know what they did to manage it. Ask questions like these: "What did you do when your anxiety got too intense? Did you seek out professional help? What did they say?"
If your client has successfully dealt with their anxiety on their own, then there is no need for additional treatment from a nurse. However, if they've come to you for help managing their symptoms, they need help from professionals.
2. Appearance and Behavior
When a nurse is taking care of a patient with a panic level of anxiety, it's essential to assess the appearance and behavior of the client.
The first thing to assess is their appearance. Check if-
- They are sweating
- They seem agitated or nervous
- They are pacing back and forth
- They are having trouble breathing
These are all signs that could indicate that your client is panicking.
The next thing you should look for is how your client behaves. This can be done by looking at the individual's body language and facial expressions.
3. Assess their Mood or Affect
Assessing a client's mood is vital in taking care of them. Moods can be affected by many things, including their environment, past experiences, medications, and more. It's essential to refer to the client's medical history when assessing their mood so that you can keep track of any changes that may be happening.
It's also essential to assess how your client feels about what has happened or is happening. If they're feeling anxious or worried, it could lead to even more anxiety.
4. Assess their Thought Process
Evaluating your client's thought process, especially if they have anxiety, is essential. Stress can make it difficult for a person to think clearly, which could lead them to make mistakes and hurt themselves or others.
A client's opinions should be evaluated in terms of whether they are rational, irrational, or even delusional.
For instance, a client may say, "I feel like I'm going to die." That would be irrational thinking because they have no reason to believe that will happen. On the other hand, if they say something like, "I am going to kill myself today," this would be delusional thinking because there is no rational basis for it.
A nurse should take proper steps when observing a mental health client with an anxiety disorder. Any wrong move may bring a dire situation that makes it hard to recover the situation.
Remember that respecting a person's autonomy is a core value of nursing. You are here to help your patients, but not at the expense of their dignity and self-care. So, when you observe a mental health client, you must know how to serve the person without compromising their autonomy.