Fear

Published on Saturday March 10th , 2007

Fear

(_)Actual (_) Potential

**Related To:**
*[Check those that apply]*
(_) Invasive procedures (_) Hospitalization (_) Loss of s/o (_) Pain (_) Anesthesia (_) Surgery (_) Disability/chronic/acute/terminal illness: ____________________________________ (_) Lack of knowledge:_________________ ___________________________________ (_) Other:_____________________________ ____________________________________ ____________________________________

**As evidenced by:**
*[Check those that apply]*
Major: (Must be present)	(_) Feelings of dread, fright, apprehension and/or behaviors of avoidance. (_) Narrowing of focus on danger. (_) Deficits in attention, performance, and control.
Minor: (May be present)	(_) Verbal reports of panic. (_) Obsessions - acts of aggression, escape, hypervigilance, dysfunctional immobility, compulsive mannerisms, increased questioning/verbalization. (_) Visceral-somatic activity: Musculoskeletal (muscle tightness, fatigue), cardiovascular (palpitations, rapid pulse, increased blood pressure), respiratory (shortness of breath, increased rate), gastrointestinal (anorexia, nausea/vomitting, diarrhea), Genitourinary (urinary frequency), skin (flush/pallor, sweating, paresthesia) CNS/perceptual (syncope, insomnia, lack of concentration, irritability, absentmindedness, nightmares, dilated pupils).

Date &
Sign.

Plan and Outcome
[Check those that apply]

Target
Date:

Nursing Interventions
[Check those that apply]

Date
Achieved:

The patient will:

(_) Discuss his/her fears.

(_) Differentiate real from imagined situations.

(_) Identify his/her own coping responses.

(_) Recognize effective and ineffective coping patterns.

(_) Experience increase in psychological and physiological comfort as evidenced by:

(_) Other:

(_) Assess possible contributing factors.

(_) Reduce or eliminate contributing factors by:

Orient to environment using simple explanations.
Speak slowly and calmly.
Avoid surprises and painful stimulus.
Use familiar routine.

(_) Allow personal space.

(_) Remain with person until fear subsides.

(_) Utilize family members and s/o to stay with him/her.

(_) Encourage expression of feelings.

(_) Refocus interaction on areas of capability rather than dysfunction.

(_) Encourage patient to face the fear.

(_) Provide information to reduce distortions.

(_) Age related fears:

Provide child opportunities to express fears.
Acknowledge illness, death, pain as real.
Encourage open, honest sharing.
Discuss with parents the normalcy of fear in children.

(_) Provide or demonstrate methods that increase comfort or relaxation:

Progressive relaxation techniques.
Reading, music, breathing exercises.
Thought stopping, guided fantasy.

(_) Other:________________
________________________
________________________
________________________

__________________________
Patient/Significant other signature

__________________________
RN signature

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