P1 · Worry or nervousness
Actual Emotions and mind
Definition
An uneasy feeling with tension, restlessness, fast heartbeat, or trouble focusing.- Illness
- uncertain future
- pain
- hospital stay
- past trauma
- caffeine
- Restlessness
- fast heartbeat
- sweating
- trouble sleeping
- says they are worried
- poor concentration
📋 Scenario
A man waiting for biopsy results cannot sleep and keeps asking questions.
Subjective (S): "I can't stop worrying and I can't sleep."
Objective (O): Heart rate 104/min; restless; sleeps 3 hours; asks the same questions repeatedly; awaiting biopsy results.
Assessment tools for this scenario: CP-MIND Mood & Mind Screen CP-SKIN Skin & Wound Score
Validated scales to consider: PHQ-9, GAD-7, C-SSRS, Braden Scale, TIME wound chart
**CarePath diagnosis:** Worry or nervousness related to illness, as evidenced by restlessness and fast heartbeat.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Stay calm. | A calm nurse helps settle the patient, because anxious people pick up on the tone and pace of those around them and become more tense if staff seem rushed. |
| Listen. | Listening without hurrying lets the patient put worries into words, which often lowers distress and shows the nurse what he fears most. |
| Explain the next steps simply. | Clear, simple information about what happens next reduces fear of the unknown, which is a major driver of worry while waiting for results. |
| Teach slow breathing. | Slow breathing activates the body's relaxation response, which can lower heart rate and muscle tension and help the patient wind down for sleep. |
| Limit stimulants. | Caffeine and other stimulants can raise heart rate and restlessness and disturb sleep, so limiting them avoids adding to the physical signs of worry. |
| Give medicine as ordered. | Prescribed medicine can ease severe worry or help sleep when other measures are not enough, and giving it as ordered keeps dosing safe. |
| Involve family. | Family are familiar and trusted, so their presence offers comfort and support, and they can help reinforce coping and explanations. |
**Expected outcomes**
- Within 24-48 hours: rates worry 3/10 or lower, sleeps 5-6 hours, uses two coping methods, says he feels calmer.
**Linking the data to the diagnosis**
The patient is waiting for biopsy results and says, "I can't stop worrying and I can't sleep." The nurse records a heart rate of 104/min, restlessness, only 3 hours of sleep and the same questions asked repeatedly. These are present now, so this is an actual problem rather than a risk. The plan aims, within 24 to 48 hours, for worry of 3/10 or lower, 5 to 6 hours of sleep, two coping methods and a report that he feels calmer.
CarePath diagnosis
Worry or nervousness related to illness, as evidenced by restlessness and fast heartbeat.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Stay calm. | A calm nurse helps settle the patient, because anxious people pick up on the tone and pace of those around them and become more tense if staff seem rushed. |
| 2. Listen. | Listening without hurrying lets the patient put worries into words, which often lowers distress and shows the nurse what he fears most. |
| 3. Explain the next steps simply. | Clear, simple information about what happens next reduces fear of the unknown, which is a major driver of worry while waiting for results. |
| 4. Teach slow breathing. | Slow breathing activates the body's relaxation response, which can lower heart rate and muscle tension and help the patient wind down for sleep. |
| 5. Limit stimulants. | Caffeine and other stimulants can raise heart rate and restlessness and disturb sleep, so limiting them avoids adding to the physical signs of worry. |
| 6. Give medicine as ordered. | Prescribed medicine can ease severe worry or help sleep when other measures are not enough, and giving it as ordered keeps dosing safe. |
| 7. Involve family. | Family are familiar and trusted, so their presence offers comfort and support, and they can help reinforce coping and explanations. |
Expected outcomes
- Within 24-48 hours: rates worry 3/10 or lower, sleeps 5-6 hours, uses two coping methods, says he feels calmer.
Linking the data to the diagnosis
The patient is waiting for biopsy results and says, "I can't stop worrying and I can't sleep." The nurse records a heart rate of 104/min, restlessness, only 3 hours of sleep and the same questions asked repeatedly. These are present now, so this is an actual problem rather than a risk. The plan aims, within 24 to 48 hours, for worry of 3/10 or lower, 5 to 6 hours of sleep, two coping methods and a report that he feels calmer.