1. Treatment of Clients Experiencing Anxiety
A Collaborative Approach to Care
February 24, 2018 * Tex-CHIP Training Series

2. Medical Management of Symptoms

3. Understanding Provider Role in Treating Anxiety
PRIMARY ROLE is providing “Primary Care”
What does that mean?
Standards specific to RN: Utilize a systematic approach to provide individualized, goal-directed, nursing care by:
- Performing comprehensive nursing assessments
- Making nursing dx that serve as basis for strategy of care
- Develop plan of care based on assessment and nursing dx
- Implement and
- Evaluate responses to nursing interventions
All within the context of SAFETY!

4. Considerations when Interacting with Clients
Creating the environment that is calm/safe
What contributes to that in a Primary care setting?
IF benzodiazipines are being used as an anxiolytic (anti-anxiety agent), it is important to know HOW it is prescribed and HOW it is actually being used. “PRN vs. Scheduled.”

5. Goals & Related Interventions (examples)
The patient will demonstrate calmer behaviors
resuming normal rate of speech
able to interact and ask questions
able to focus on the situation
vital signs will return to normal ranges
Interventions:
Maintain a calm manner while interacting with the patient.
Acknowledge awareness of patient’s anxiety
Teach Self-Soothing techniques

6. Measuring Outcomes/ Success
In Primary Care, it will depend on underlying sources.
Is this a temporary, situational state or???
If the individual is in therapy, are they using newly learned coping strategies or self-management skills?
Are they able to engage in all aspects of their care?
Is the individual able to understand the connection with their physical processes and the brain? Examples with limbic system – flight or fight and change in B/P or escalation of anxiety and increased cortisol which can cause a disruption in the metabolic system etc.

7. Communication from Counselors
SBAR
Imminent Safety Concerns
Education/Information
In PC setting, nurses are often “generalists”
What is working in the moment
Identify triggers to anxiety
Are there things that need reinforced
– specific skills or coping strategies
Keeping in mind the connection of anxiety to suicide risk – safe environment and consideration for means restriction