Nursing Care Plan

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Medical Diagnoses: Stress overload related to multiple co-existing stressors

Nursing DX/Clinical Problem

Client Goals/Desired Outcomes/Objectives

Nursing Interventions/Actions/Orders

*I

Evaluation

Goals

Interventions

Stress overload related to multiple co-existing stressors as evidenced by patient statements, “My husband used to beat me,” and “My daughter cusses me but I don’t care.  I cuss her back.”


Short Term:

Patient will review the amounts and types of stressors in daily living as measured by patient identification of two stressors, identifying amount and type by [date] at 3:00 pm.

     

     

     

Long Term:

Client will reduce stress levels through use of relaxation techniques and other strategies as measured by patient statement of implementation of at least one alternative method of reducing stress by [date] at 3:00 pm.



-Listen actively to descriptions of stressors and the stress response.  Having an opportunity to speak about stressors is helpful in dealing with stress overload.  Listening engenders trust and trust is the first step in the process of helping clients to reduce the psychological distress of stress overload (Ackley & Ladwig).   

-Categorize stressors as modifiable or nonmodifiable.  Removing or minimizing some stressors, changing responses to stressors, and modifying the long-term effects of stress are all actions that can assist those with diabetes and stress (Ackley & Ladwig).   

-Encourage social support for older adults.  Stressors in highly valued roles affect physical health only when there is insufficient emotional support from social networks (Ackley & Ladwig).    

-Explore possible therapeutic approaches such as cognitive behavior therapy, biofeedback, neurofeedback, pharmacologic agents, and complimentary and alternative therapies.  These types of therapies decrease the sympathetic nervous system response to stress.  Neurofeedback promotes optimum functioning of the central nervous system, induces relaxation, and supports healthy balance, flexibility, and resilience.  Adults who had experienced hospitalizations of at least 5 days said that spirituality strengthened their coping ability (Ackley & Ladwig).   

     

     

     

     

     

     

     

     

     

     

Goal met.  Patient identified two stressors and patient identified amount and type of stressors on [date].

    

 

 

 

 

 

Goal is set to be measured on [date] at 3:00 pm.  Client has made progress.  Client has requested that she receive students from the School for therapeutic communication sessions for the fall semester on [date].

-Active listening is used to assess descriptions of stressors and the stress response, every Tuesday afternoon.

- Stressors are categorized as modifiable or non-modifiable, every Tuesday afternoon.

     

     

     

     

-Social support has been encouraged, every Tuesday afternoon. 

-Possible therapeutic approaches and complimentary and alternative therapies were explored on [date].



Assessment

Subjective Data:

-Patient statement “My husband used to beat me.”

- Patient statement “My daughter cusses me but I don’t care.  I cuss her back.”

Objective Data:

-Patient appears aggravated on assessment.

- Patient cries during visit while talking about her children.

-Patient expresses anger and strong emotion while talking about past abuse and uncomfortable situations.

 

Ackley, B.J., & Ladwig, G.B. (2008). Nursing Diagnoses handbook: An evidence-based guide to planning care (8th ed.). St. Louis, MI: Mosby Elsevier




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