Care Plan Help - Is Anxiety r/t hallucinations appropriate to use?

[TexasGirl24]

I am working on a care plan for a 44 y/o client with down syndrome who came in with hallucinations. He has nothing else wrong with him. When he hallucinates, he is so afraid that he tries to "run away from the ghosts and cries hysterically. His B/P and Pulse are elevated as well. I wasn't sure if I could use Anxiety r/t HALLUCINATIONS, b/c I wasn't sure if our etiology could be a medical diagnosis....assuming that hallucinations are a medical diagnosis? Any help would be greatly appreciated!!! Thanks :)

[Daytonite, BSN, RN]

when you are new at diagnosing you need to look at the taxonomy (the information about the diagnosis that includes its definition, related factors and defining characteristics/symptoms). if you do not have a care plan or nursing diagnosis book with this information you will find it for this diagnosis on these web pages:

• anxiety
  
• http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=03
  

if you have a copy of taber's cyclopedic medical dictionary you will also find this information in the appendix of the dictionary.

anxiety is a feeling of dread or impending danger. your related factor needs to be something that causes that. usually, it is a crisis, change, threat or a conflict of some sort. the cause of the anxiety is more likely the stress or fear brought on by the hallucinations. the fear, elevated b/p and pulse are symptoms of anxiety, but not the hallucinations.

hallucinations are visual, tactile, auditory, gustatory or olfactory false perceptions of one's environment. they do not fit with the related factors listed for this diagnosis. hallucinations are evidence of acute confusion or disturbed thought processes.

• acute confusion
  
• disturbed thought processes
  
• http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=53 - disturbed thought processes
  
  

[RochesterRN-BSN, BSN, RN]

Yes...as hallucinations are a symptom not an actual disease or disorder. They can be caused by several medical conditions, meds or as part of a psychiatric diagnosis........44 is a little on the old side for first time hallucinations r/t a new onset of a psych Dx. Its is possible that it could be a more medical pathology.

Keep in mind that a 44 YO with Down's is not same as a healthy 44YO, they have a lot of medical problems outside of the developmental cognitive things you may see......so why may be more sensitive to things then others. This is something you may want to research.

[TexasGirl24]

Daytonite & psychRNinNY: Thank you both for helping me out! You're responses helped me quite a bit and are greatly appreciated! :)