Situational Low Self-Esteem

NURSING CARE PLAN Name of Patient: Age: Clustered Cues January 30, 2012 12:00 PM “I am still hoping that I can teach again and help my wife in supporting our family.” “Although it is so hard for me to quit the job that I always loved, I have to quit … Since I have to quit my job and stop having my own income, it’s quite a shame for me that I will need to be dependent to my wife with financial

Nursing Diagnosis Situational low selfesteem related to social role changes

Attending Physician: Impression/Diagnosis:

Ward/Bed Number: Rationale (Scientific Basis) Development of a negative perception of selfworth in response to a current situation (quits his job because of his condition). Although many cancers can be cured and the survival rate in some cancers is good, psychological, social, sexual, and physical dysfunction caused by both the diagnosis and treatment exerts a deleterious impact on the quality of most patients’ lives. Cancer treatment

Objectives of Care The patient will be able to verbalize understanding of individual factors that precipitated the current situation, express positive self-appraisal, demonstrate behaviors to restore positive self-esteem, and participate in treatment regimen to correct factors that precipitated the crisis.

Nursing Interventions INDEPENDENT: 1. Assess degree of threat/percepti on of client in regard to crisis. 2. Discuss with client and SO how the diagnosis and treatment are affecting the client’s personal life and home and work activities. 3. Review anticipated side effects associated with a particular treatment, including possible effects on sexual activity and sense of

Rationale (Scientific Basis) 1. Some people view a major situation as manageable, while another person may be overly concerned about a minor problem. 2. Aids in defining concerns to begin problemsolving process. 3. Anticipatory guidance can help client and SO begin the process of adaptation to new state and to prepare for some side effects. 4. May help reduce

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Safe and Quality Nursing Care Core Competency 2: Provides sound decision making in the care of individuals/grou ps considering their beliefs and values. Identifies the problem; and gathers data related to the problem. Safe and Quality Nursing Care Core Competency 7.2: Formulates a Plan of Care in collaboration with patients and other members of the health team Includes patient and his family in care planning.

Evaluation On-going 

Planned to join a support group

“I understand the restrictions that I should impose on myself but I will really try to be less of a burden and still contribute help to my family.”

terms.” “ I feel less of a man because I have to quit my job and not be the breadwinner of my family. I love my family so much that I don’t want to see them suffer. Even though I can function well, but I have restrictions that’s why I had to quit; and I don’t know if I could still find another job.”

inevitably means a considerable disruption to a patient’s life. Some manage to continue working through their radiotherapy and chemotherapy, but others require lengthy periods of hospitalization with its associated effects on social, family, sexual, and occupational functioning. After initial therapy, even this has been successful, the months and years of follow-up visits and tests can continue to make it difficult for patients to ever see themselves again in the same way as they did prior to diagnosis. Source:  Oxford Handbook of Oncology by: Cassidy et al

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attractiveness or desirability. Encourage discussion of and problemsolve concerns about effects of cancer or cancer treatments on a role as homemaker, wage earner, or parent. Evaluate support structures available to and used by client and SO. Provide emotional support for client and SO during diagnostic tests and treatment phase. Use touch during interactions, if acceptable to client, maintain eye contact. Refer client and SO to supportive group

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problems that interfere with acceptance of treatment or aggravate progression of disease. Helps with planning for care while hospitalized and after discharge. Although some clients adjust to cancer effects or side effects of therapy, many need additional support during this period. Affirmation of individuality and acceptance is important in reducing client’s feelings of insecurity and self-doubt. Group support is usually very beneficial for both client and SO.

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Safe and Quality Nursing Care Core Competency 7.3: Implements planned nursing care to achieve identified outcomes. Explains interventions to patients and family before carrying them out.

4. Communication Core competency 1: Establishes rapport with patients, significant others and members of the health team.  Creates trust and confidence; spends time with the client to facilitate conversation that allows client to express concerns. 5.

Safe and Quality Nursing Care Core Competency 7.2: Formulates a plan of care in collaboration with patients and other members of the health team.  Includes patient and his family in

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Nurse’s Pocket Guide by Doenges et al.

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care planning Encourage the patient to speak about what is relevant to his condition.

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Safe and Quality Nursing Care Core Competency 4: Sets priorities in nursing care based on patients’ needs  Determines appropriate nursing care to be provided

Communication Core Competency 4: Responds to needs of individuals, family, group and community  Provides reassurance through therapeutic, touch, warmth and comforting words of encouragement. 7. Communication Core Competency 4: Responds to needs of individuals, family, group and community.  Provides reassurance

through therapeutic, touch, warmth, and comforting words of encouragement. 8. Collaboration and Teamwork Core Competency 2:Collaborates plan of care with other members of the health team  Refers patient to allied health team partners.

Student’s Name:_____________________ Clinical Instructor:___________________