- Anxiety related to Loss of a loved one or situational crisis as evidenced by panic attacks and feelings of worry
- Fear Related to Perceived danger and threat as evidenced by reports of apprehension and Increased alertness or avoidance and Jitteriness
- Ineffective Coping related to Situational crisis and lack of confidence in the ability to cope as evidenced by Inability to perform daily tasks and Reoccurrence of intrusive thoughts
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: -Feeling nervous -Verbalizing a sense of impending danger -Difficulty controlling one’s worrying Objective Data: -Restlessness and tense appearance -Tachycardia -Tachypnea -Hyperventilation -Diaphoresis -Trembling/tremors -Weakness or tiredness -Difficulty concentrating -Difficulty sleeping -GI distress | Anxiety related to Loss of a loved one or situational crisis as evidenced by panic attacks and feelings of worry | Patient will exercise control over their anxiety as evidenced by reports of feeling relaxed Patient will implement two strategies to reduce anxiety Patient will demonstrate reduced anxiety as evidenced by heart rate and blood pressure within normal limits | 1. Encourage therapeutic communication. Display empathy and positivity allowing the patient to express their anxiety. Encourage the patient to openly express their emotions. Use silence and active listening to portray a patient attitude. Do not deny or minimize their anxiety. 2. Encourage relaxation techniques. Relaxation techniques include deep breathing, yoga, and meditation. Encourage the patient to try implementing different methods when they are feeling anxious. In the hospital setting, the nurse can promote a calm environment through dim lighting and soft music. 3. Evaluate the patient’s support systems. Patients with PTSD need to know they aren’t alone. Determine what kind of personal support the patient has at home. Encourage support groups along with their home support system. 4. Administer medications as ordered. The patient’s anxiety may be at a level where they are experiencing panic. Benzodiazepines are the most common class of medications administered to reduce anxiety. | Patient exercised control over their anxiety as evidenced by reports of feeling relaxed Patient implemented two strategies to reduce anxiety Patient demonstrated reduced anxiety as evidenced by heart rate and blood pressure within normal limits |
| Subjective data: Verbalizes feeling fear Objective data: -Increased alertness or avoidance -Jitteriness -Nausea or vomiting -Increased perspiration -Dilated pupils | Fear Related to Perceived danger and threat as evidenced by reports of apprehension and Increased alertness or avoidance and Jitteriness | Patient will openly discuss fear and what is invoking the sense of fear Patient will be able to use effective coping behaviors to resume normal life activities Patient will acknowledge that they are safe and cannot be harmed | 1. Reassure safety. This may likely be the first step, especially if the patient is in a state of panic. Ensure the patient is in a calm and safe environment and reassure them repeatedly that they are safe. Allow time for them to become accustomed to the environment, giving them periods of rest. 2. Discuss the reality of the situation. Inquire about what the patient’s fear is. Acknowledging what can and can’t be changed can help the patient feel in control. 3. Encourage healthy coping strategies. After evaluating whether the patient’s coping strategies are healthy or not, encourage implementing positive strategies. Some healthy ways to cope during a fearful situation include positive self-talk, listening to music, and relaxation techniques. Encourage them to try various methods and see which is most helpful. 4. Be sensitive to the patient’s feelings. Reassure the patient that feelings of fear after a traumatic event are normal and valid. Empathize with their feelings instead of giving them false reassurances. Showing compassion promotes trust. | Patient openly discussed fear and what is invoking the sense of fear Patient used effective coping behaviours to resume normal life activities Patient acknowledged that they are safe and cannot be harmed |
| Subjective data: -Verbalizes an inability to cope and handle stressors -Complaints of secondary concerns from lack of coping (sleep disturbances, fatigue, lack of appetite) Objective data: -Not caring for basic needs -Insufficient skills to meet goals, problem-solve or reach resolutions -Behaviors that impede progress (defensive speech, making excuses, manipulation) -Inability to handle life responsibilities and activities of daily living -Use of drugs, alcohol, or medication as coping mechanisms -Multiple acute illnesses or chronic pain -Depression | Ineffective Coping related to Situational crisis and lack of confidence in the ability to cope as evidenced by Inability to perform daily tasks and Reoccurrence of intrusive thoughts | Patient will identify maladaptive coping behaviors Patient will participate in self-care activities: cooking healthy meals, exercising, proper sleep, etc. Patient will display a desire for effective coping as evidenced by asking for help and reaching out to a support person/group | 1. Empathetic listening. Acknowledge the patient’s feelings and show understanding. This creates a supportive environment in which the patient will be more willing to open up about how they’re feeling and how they cope. 2. Arrange for professional support. Referring the patient to a therapist or counselor may be warranted. Ask the patient how they feel about this and reiterate that it’s not a negative, but a positive step. A mental health professional trained in PTSD can offer different treatments for effective coping. 3. Encourage positive self-talk and self-care. A traumatic event may harm the patient’s confidence. Encourage positive statements and mantras. Institute self-care opportunities by allowing the patient to make decisions and do things for themselves. Show the patient they are capable of taking control. 4. Recommend a support group. Speaking with other individuals who understand the trauma the patient has experienced can be beneficial in coping and recovering. | Patient identified maladaptive coping behaviours Patient participated in self-care activities: cooking healthy meals, exercising, proper sleep, etc. Patient displayed a desire for effective coping as evidenced by asking for help and reaching out to a support person/group |