Nursing Care Plans

Nursing Priorities Control pain. Prevent/manage complications. Maintain quality of life as possible. Plans in place to meet patient’s/family’s last wishes (e.g., care setting, Advance Directives, will, funeral). 1. Ineffective Family Coping Nursing Diagnosis Ineffective Family Coping Risk for Compromised or Disabled Caregiver Role Strain May be related to Inadequate or incorrect information or understanding by a primary person; unrealistic expectations Temporary preoccupation by significant person who is trying to manage emotional conflicts and personal suffering and is unable to perceive or to act effectively with regard to patient’s needs; does not have enough resources to provide the care needed Temporary family disorganization and role changes; feel that caregiving interferes with other important roles in their lives Patient providing little support in turn for the primary person Prolonged disease/disability progression that exhausts the supportive capacity of significant persons Significant person with chronically unexpressed feelings of guilt, anxiety, hostility, despair Highly ambivalent family relationships; feel stress or nervousness in their relationship with the care receiver Possibly evidenced by Patient expressing/confirming a concern or complaint about SO’s response to patient’s health problem, despair about family reactions/lack of involvement; history of poor relationship between caregiver and care receiver Neglectful relationships with other family members Inability to complete caregiving tasks; altered caregiver health status SO describing preoccupation about personal reactions; displaying intolerance, abandonment, rejection; caregiver not developmentally ready for caregiver role SO attempting assistive/supportive behaviors with less than satisfactory results; withdrawing or entering into limited or temporary personal communication with patient; displaying protective behavior disproportionate (too little or too much) to patient’s abilities or need for autonomy Apprehension about future regarding care receiver’s health and the caregiver’s ability to provide care Desired Outcomes Identify resources within themselves to deal with situation. Visit regularly and participate positively in care of patient, within limits of abilities. Express more realistic understanding and expectations of patient. Provide opportunity for patient to deal with situation in own way. Nursing Interventions Rationale Assess level of anxiety present in family and/or SO. Anxiety level needs to be dealt with before problem solving can begin. Individuals may be so preoccupied with own reactions to situation that they are unable to respond to another’s needs. Establish rapport and acknowledge difficulty of the situation for the family. May assist SO to accept what is happening and be willing to share problems with staff. Determine the level of impairment of perceptual, cognitive, and/or physical abilities. Evaluate illness and current behaviors that are interfering with the care of the patient. Information about family problems will be helpful in determining options and developing an appropriate plan of care.