Question

A 35-year-old single white female and mother of two presents with the chief complaint of worrying. She is a full-time salaried manager at a thriving and growing IT Company. She complains of persistent, constant, and uncontrollable worrying and indicates no matter what she does she is unable to sit still and relax. She is becoming irritable, feels nervous, and is consumed with the awful fear that she will lose her job, vehicle, home, and be unable to provide for you children. The client indicates that these thoughts and feelings occur nearly every day and have been persisting for the 4 weeks.

1. Provide an SBAR report summarizing the case; include symptoms of anxiety or risk factors related to anxiety.

2. Identify at least three complete (2 or 3 step) nursing diagnosis that would apply to the case.

3. Identify three nursing interventions that would be appropriate.

4. Discuss how the nurse would recognize that treatment was effective/evaluation of the patient's response to intervention.

Answer 1

1. SBAR REPORT

SBAR is an acronym for Situation, Background, Assessment, Recommendation.

It is a technique that can be used to facilitate prompt and appropriate communication in healthcare settings among professions such as physician and nursing

UNIT:    DATE:

S - Situation	Patient Name : mrs. X Room Number: 1234 Diagnosis:Anxiety Isolation: Nil Physician : Mr. Y Attending: Mr. R Consults: Mr. S
B- Background	Family history & Socioeconomic history: Bread winner of the family lives single with two children full time salaried manager at a thriving and growing IT company
A- Assessment	Cheif complaints : persistent, constant and uncontrollable worrying unable to sit still and relax becoming irritable feels nervous fear that she will loss her all posessions symptoms feels everyday and persisting for the 4 weeks Past Medical History : No relevant history
R- Recommendation	Mindfulness Relaxation technique Correct breathing techniques Dietary adjustments Exercise Learning to be assertive Cognitive therapy Structured problem solving Medication Support groups

2 & 3. NURSING DIAGNOSIS WITH INTERVENTIONS

Nursing Diagnosis	Nursing Interventions
1. Anxiety related to lack of knowledge, regarding symptoms, progression of condition and treatment regimen as evidenced by restlessness, feeling of discomfort	recognize the anxiety encourage the client to talk about feelings and concerns Provide creative outlet promote relaxation techniques, such as breathing exercises or guided imagery Administer antianxiety medications as prescribed
2. Fear related to perceived threat as evidenced by apprehension or helplessness	encourage problem solving Encourage gross motor exercise Always be with the client
3. Deficient knowledge related to the progression of the condition, helplessness as evidenced by asking frequent doubts	Provide a clear, simple statement Use always low pitched voice with clear explanations to the client Use calm manner in dealing with client

4. EVALUATION

The patient responds by

• relaxation technique with a decreased anxiety
• reduce own anxiety level
• be free from anxiety attacks
• increased knowledge to control feeling of fear
• deals situations with a positive attitude
• increased coping mechanism