ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

S :”.” Fear r/t unwanted Short term: Independent: Short term:

result of operation Within 8 hours of nursing After 8 hours of nursing
O: interventions, the patient 1. Assess source 1. Fear is a normal interventions, the patient was
 narrowed focus will be able to verbalize of fear with response to actual or able to verbalize known fear.
 apprehension; known fear. client. perceived danger and
 increased helps mobilize GOAL MET
tension Long term: protective defenses.
 fatigue Within 2 days of nursing 2. Have the client Long term:
 diarrhea interventions the patient draw the object 2. Because human figure After 2 days of nursing
 pallor will be able to Identifies, of their fear. drawings are reliable interventions, the patient was
 for verbalizes, and This is a tools for assessing able to Identifies, verbalizes, and
demonstrates those reliable anxiety and fears in demonstrates those coping
cholecystectomy
coping behaviors that assessment tool children, practitioners behaviors that reduce own fear
reduce own fear for children. should incorporate
these drawings as part GOAL MET
of their routine
assessments of fearful
children
3. Discuss
situation with 3. The first step in
client and help helping the client deal
distinguish with fear is to collect
between real information about the
and imagined situation and its effect
threats to well- on the client and
being. significant others

4. Correcting mistaken
4. If irrational beliefs reduces anxiety
fears based on
incorrect
information are
present, 5. Reassure clients that
provide seeking help is both a
 accurate sign of strength and a
information. step toward resolution
of the problem
5. If client's fear
is a reasonable
response, 6. Fear is a normal
empathize with response to actual or
client. Avoid perceived danger; if
false the threat is removed,
reassurances the response will stop
and be truthful.

6. If possible,
remove the 7. Self-discovery
source of the enhances feelings of
client's fear control.
with accurate
and appropriate 8. 66% believe touch is
amounts of comforting and
information. healing and view
distal touches (on the
7. If possible, hand and shoulder) as
help the client comforting
confront the
fear.

8. Stay with 9. Deficient knowledge

clients when or unfamiliarity is one
they express factor associated with
fear; provide fear (Johnson, 1972;
verbal and Garvin, Huston,
nonverbal Baker, 1992; Whitney,
(touch and hug 1992).
with
permission)
reassurances of
 safety if safety 10. Methods of coping
is within with anxiety that have
control. previously been
successful are likely to
9. Explain all be helpful again
activities, (Clunn, Payne, 1982).
procedures (in
advance when
possible), and 11. The dependent
issues that variable, anxiety, was
involve the measured before back
client; use massage, immediately
nonmedical following, and 10
terms; calm, minutes later on four
slow speech; consecutive evenings.
and verify
client's 12. The results obtained
understanding. indicated that massage
had significant effect
10. Explore coping on nonverbal
skills used reactions, especially
previously by those related to
client to deal muscular relaxation.
with fear;
reinforce these 13. Anxiety was reduced
skills and significantly in a TT
explore other group but was
outlets. unchanged in a TT
placebo group
11. Provide
backrubs for 14. Relaxation improves
clients to ability to cope. The
decrease nurse needs to pace
anxiety activities, especially to
older adults to
 conserve the patient’s
energy.
12. Provide
massage before
procedures to
decrease
anxiety

13. Use therapeutic

touch (TT) and
healing touch
techniques.

14. Allow the

patient to have
rest periods.

Collaborative

1. Refer for cognitive 1. behavioral group

behavioral group sessions had
therapy. significantly better
results with regard to
fear avoidance beliefs
than the comparison
group.