Nursing Consideration for the Patient Taking Anxiolytics

Josephine Notter RN

Some patients suffer from anxiety, an unpleasant experience. This is an emotional state defi ned by psychological and physiological responses to the anticipation of real or imagined danger. Physical signs and symptoms can include increased heart rate, altered respiration, sweating, trembling and fatigue. Psychological factors include feelings of powerlessness, apprehension, and potential danger. As clinicians, we are trained to assess and implement interventions to decrease the stress and anxiety of our patients to enhance their quality of life.

The list of interventions utilized for success with our patients is endless. Comfort measures,  conversation, 1:1, group activities, personal care needs, removal from stimulation or noise, exercise,
food, and even medications are used to help decrease anxiety. Medications are not our fi rst line of treatment. These medications may help the current situation but have the potential to cause adverse effects in the elderly such as somnulence, unsteady gait, confusion and altered cognition. These side
effects can further put our patients in danger of falls, broken bones and accidents.

Implementation of non-pharmalogical interventions happens throughout the day from many different staff members. Care plans reflect how we manage our patients’ needs and deliver care in an holistic individualized manner. Documentation is required to paint an accurate picture of what is truly occurring, what has been implemented, what didn’t work, and what alternatives are available.
Without proper documentation of all our efforts to decrease stress and anxiety for our patients, it looks as if nothing is done to enhance their quality of life. Rather a picture of giving a pill is clearly recorded on the MAR as if it was the first intervention for treatment. In many situations this is not the case.

Remember, next time you go to give that PRN anxiolytic, ask yourself:
  • Have we tried other alternative?
  • What else can I try?
  • Is there a care plan in place?
  • Am I following the care plan?
  • Have attempts at non-pharmacological interventions been documented?
  • These simple questions may help to provide documentation and interventions that are successful for our patients. Remember, if it isn’t charted, it didn’t happen!

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