Subjective

∙ Client states the XXXXX

family lived through a hurricane and lost their home as a result

∙ Family relocated to xxxxx 6 months ago

Objective

∙ Could include increased urination or diarrhea, shortness of breath, increased HR, sweating, etc.

Problem

Anxiety

Long Term:

By a week from the date of care, XXXXXX, the client will identify, verbalize, and demonstrate techniques to control anxiety (Ackley & Ladwig, 2008).

∙ Assess the client's level of anxiety and physical reactions to anxiety (tachycardia, tachypnea, nonverbal expressions of anxiety). Consider using The Face Anxiety Scale. (It is important to assess the client’s baseline anxiety level to determine if any progress has been made to control anxiety) (Ackley & Ladwig, 2008).

∙ Encourage the client to use positive self-talk such as, “I can do this one step at a time,” “Right now I need to breathing” (Cognitive therapy changes behaviors by changing thoughts. It is important to use positive self talk instead of negative self talk) (Ackley & Ladwig, 2008).

∙ Provide backrubs or aromatherapy for the client to decrease anxiety (Massage and aromatherapy can help to decrease tension in the body, thus decreasing anxiety) (Ackley & Ladwig, 2008).

∙ A successfully met goal would be evident by the client being able to identify, verbalize, and demonstrate 4 techniques to control anxiety. An unsuccessfully met goal would occur if the client can not do this by xxxx4, 2xxxx.

∙ If the client’s level of anxiety decreases throughout the week this intervention has been successfully used. If it does not decrease throughout the week this intervention has not been successfully used.

∙ If the client verbalizes having used positive self talk throughout the week to control anxiety this intervention has been successfully used. If the client does not use positive self talk or does not feel the self talk is decreasing anxiety levels then the intervention was not successful.

∙ If the client verbalizes feeling additional support and a further decrease in anxiety levels as the result of back rubs or aromatherapy the intervention has been successful. If the touch is not therapeutic to the client or aromatherapy does not decrease anxiety levels, the intervention has not been successful.

R/T

Change in environment, situational crisis, and stress

AEB

Concerns due to change in life events, living through a natural disaster, and relocating (Ackley & Ladwig, 2008).

Short Term:

By the end of the date of care, xxxxx, the client will identify and verbalize symptoms of anxiety (Ackley & Ladwig, 2008).

∙ If the situational response is rational, use empathy to encourage the client to interpret the anxiety symptoms as normal (Validating client feelings promotes self esteem, which can increase quality of life) (Ackley & Ladwig, 2008).

∙ Guided imagery can be used to decrease anxiety (Guided imagery can help to decrease tension in the body and mind, thus decreasing anxiety) (Ackley & Ladwig, 2008).

∙ Use therapeutic touch and healing touch techniques (Touch can be therapeutic and further encourage open discussion) (Ackley & Ladwig, 2008).

∙ A successfully met goal is shown when the client can verbalize her symptoms of anxiety. An unsuccessfully met goal is if the client can not identify her symptoms of anxiety by the end of the date of care.

∙ If the client verbalizes an increase in self esteem as a result of therapeutic validation and conversation this intervention has been successful. If the client does not feel an increase in self esteem this intervention has not been successful.

∙ If the client verbalizes a decrease in anxiety following guided imagery this intervention has been successful. If the client does not feel a decrease in anxiety after guided imagery this intervention has not been successful.

∙ If the client verbalizes feeling additional support as the result of therapeutic touch the intervention has been successful. If the touch is not therapeutic to the client the intervention has not been successful.