Nursing Care Plan Date Identified: May 14, 2013 Assessment Subjective cue: Maglisod lagi ko sa akong situation

karon. As verbalized by the patient. Objective cues: Poor concentration Withdrawn behavior Sleep disturbances Inadequate problem solving Inability to meet basic needs On suicidal precaution Inability to make decision Sleep disturbance Nursing Diagnosis: Ineffective coping related to situational crisis Planning: Short term: Within 3 days of nursing intervention the client will be able to verbalize thoughts and feelings about her current situation Long term: Within 1 week of nursing intervention the client will be able to initiate alternative coping strategies appropriate to the situation Intervention: (Independent) 1. Assess decision making and problem solving activities Rationale Client may feel that the threat is greater then resources to handle it and feels a loss of control and over solving the threat or problem The client becomes aware of positive qualities and capabilities that have helped the client cope in the past The client becomes more aware of the positive effect of supportive individuals in the clients life, increasing the clients confidence in own coping abilities. Therapeutic modalities can help the client

2. Have the client identify strengths rather than weaknesses 3. Help the client identify who help the client to cope and who support the clients strengths. 4. Assist to learn strategies that

promote more positive thinking 5. Respond to the clients persistent self-deprecation with realistic nonchallenging evidence.

6. Praise the client for adaptive coping, making rational decisions based on accurate judgements, solving own problems, and demonstrating independence. 7. Provide opportunities to express concerns and fears, feelings and expectations. 8. Teach the use of relaxation exercise and diversional activities as a way to cope with stress 9. Discuss and instruct the need for adequate rest and balanced diet to facilitate coping strength 10. Teach family and friends that the client may direct anger toward them but that the client is learning more constructive methods to deal with feelings

replace or substitute irrational selfdeprecating thoughts/images with more rational beliefs. Pointing out contradictions to the clients self-deprecation in a calm, non-challenging way encourages the client to focus on positive aspects of self and minimizes selfdeprecation Genuine praise emphasizes the clients adaptive behaviours and encourages their continuance through positive reinforcement. To unload ideas and greatly affect the personality of the individual. Verbalizations of actual and perceived threats can help reduce anxiety. Diversional activities enable the patient to avoid thinking of unpleasant thoughts and thus avoiding stress. Inadequate diet and fatigue can be a stressor. Family members who are well informed are better able to use their energies to support the client rather than focus on their own reactions.

Evaluation: Short term: Goal met. The patient was able to verbalize thoughts and feelings about her current situation as evidenced by verbalization of Dili jud lalim ang akong sitwasyon sa pagka karon kinahanglan jud nako ni malabang. Date Evaluated: May 17, 2013 Long Term: Goal met. After 4 days of nursing interventions the patient was able to initiate alternative coping strategies appropriate to the situation as evidenced by Kinahanglan jud dili nato iluom ang atong mga problema kinahanglan mangita tau g tao na atong maistoryahan sama sa atong pamilya. Date Evaluated: May 18, 2013