related to unfamiliar environment; lack of understanding of diagnosis, diagnostic tests, and treatments; financial concerns; and feelings of confinement.

Desired Outcome
The client will experience a reduction in fear and anxiety as evidenced by:
  1. verbalization of feeling less anxious
  2. usual sleep pattern
  3. relaxed facial expression and body movements
  4. stable vital signs
  5. usual perceptual ability and interactions with others.
Nursing Actions and Selected Purposes/Rationales
  1. Assess client for signs and symptoms of fear and anxiety (e.g. verbalization of feeling anxious, insomnia, tenseness, shakiness, restlessness, diaphoresis, tachycardia, elevated blood pressure, self-focused behaviors).
  2. Implement measures to reduce fear and anxiety:
    1. orient client to environment, equipment, and routines; explain the purpose for and operation of a kinetic bed if indicated
    2. introduce client to staff who will be participating in care; if possible, maintain consistency in staff assigned to his/her care
    3. assure client that staff members are nearby; respond to call signal as soon as possible
    4. keep door and curtains open as much as possible to reduce feeling of confinement
    5. maintain a calm, supportive, confident manner when interacting with client
    6. encourage verbalization of fear and anxiety; provide feedback
    7. reinforce physician's explanations and clarify misconceptions client has about the diagnosis, treatment plan, and prognosis
    8. explain all diagnostic tests
    9. provide a calm, restful environment
    10. instruct client in relaxation techniques and encourage participation in diversional activities
    11. assist client to identify specific stressors and ways to cope with them
    12. initiate social service referral and/or assist client to identify and contact appropriate community resources if indicated
    13. provide information based on current needs of client at a level he/she can understand; encourage questions and clarification of information provided
    14. encourage significant others to project a caring, concerned attitude without obvious anxiousness
    15. include significant others in orientation and teaching sessions and encourage their continued support of the client
    16. administer prescribed antianxiety agents if indicated.
  3. Consult appropriate health care provider if above actions fail to control fear and anxiety.