Ineffective
Individual Coping
(_)Actual (_)
Potential
(_) Illenss:____________________________ ____________________________________ (_) Other:_____________________________ ____________________________________ |
Major: (Must be present) |
(_) Change in usual communication patterns (in acute). (_) Verbalization of inability to cope. (_) Inappropriate use of defense mechanisms. |
Minor: (May be present) |
(_) Anxiety (_) Reported life stress. (_) Inability to problem-solve. (_) Alteration in social participation. (_) Destructive behavior toward self or others. (_) High incidence of accidents. (_) Frequent illnesses. (_) Verbalization of inability to ask for help. (_) Verbal manipulation. (_) Inability to meet basic needs. |
Date & Sign. |
Plan and Outcome [Check those that apply] |
Target Date: |
Nursing Interventions [Check those that apply] |
Date
Achieved: |
The patient will: (_) (_) Identify (_) Identify coping (_) Utilize effective
(_) Other:
|
(_) Encourage verbalization of feelings, perceptions, and fears. (_) (_) Encourage (_) Assist with (_) Consult with:
(_) Identify problems (_) |
__________________________
Patient/Significant other signature
__________________________
RN signature