- Anxiety related to recurrence of syncope episodes and risk of injury/falls as evidenced by expresses anxiety about life event changes and insecurity
- Deficient Knowledge Related to Inadequate information and inadequate participation in care planning as evidenced by Inaccurate follow-through of instructions and recurring syncopal episodes
- Risk for Adult Falls Related to Fainting and Impaired postural balance as evidenced by history of falls and syncopal Episodes
| 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 -Tachypnoea -Hyperventilation -Diaphoresis -Trembling/tremors -Weakness or tiredness -Difficulty concentrating -Difficulty sleeping -GI distress | Anxiety related to recurrence of syncope episodes and risk of injury/falls as evidenced by expresses anxiety about life event changes and insecurity | Patient will demonstrate techniques that help reduce anxiety. Patient will report a reduced sense of anxiety and control over syncope. | 1. Allow the patient to verbalize feelings and emotions. Establish trust and build a rapport so the patient feels comfortable discussing their anxiety. 2. Explain all procedures and interventions. Investigating syncope can provide answers to prevent further occurrences. Prepare the client for tests such as stress tests, tilt table tests, and wearing a Holter monitor. 3. Help the patient feel in control. Losing consciousness can be frightening, especially if the patient sustained an injury from a past episode. Help the patient gain control of syncope by arming them with information about the types, triggers, and treatments. 4. Educate on recognizing symptoms. Not all patients will have pre-syncopal symptoms, but instruct the patient that if they feel dizzy, light-headed, diaphoretic, or nauseous, that fainting could occur and they should prepare by sitting down or alerting someone. | Patient demonstrated techniques that help reduce anxiety. Patient reported reduced sense of anxiety and control over syncope. |
| Subjective data: Verbalizes poor understanding Seeks additional information Objective data: -Inaccurate demonstration or teach-back of instructions -Inability to recall instructions -Exhibiting aggression or irritability regarding teaching follow-up -Poor adherence to recommended treatment or worsening medical condition | Deficient Knowledge Related to Inadequate information and inadequate participation in care planning as evidenced by Inaccurate follow-through of instructions and recurring syncopal episodes | Patient will verbalize understanding of the disease process and appropriate interventions. Patient will participate in tests to further investigate syncope. | 1. Take precautions with medications. Diuretics and antihypertensives can cause dehydration or worsen orthostatic hypotension. Ensure the patient understands the side effects of their medications. 2. Teach to prevent vasovagal responses. Since vasovagal syncope is the most common type of syncope, educate the patient on avoiding triggers such as the sight of blood, standing up too quickly, standing too long, and intense fear or stress. 3. Document syncopal episodes to learn more. If syncope is recurring, have the patient or family member document events surrounding the episode, where it occurred, the time of day, how long it lasted, and how the patient felt afterward. This information can identify triggers or underlying conditions. 4. Follow-up with providers. Instruct the patient to adhere to discharge instructions such as following up with a cardiologist if syncope is suspected to be related to a cardiac event. | Patient verbalized understanding of the disease process and appropriate interventions. Patient participated in tests to further investigate syncope. |
| Subjective data: Verbalizes fear of fall Objective data: -Risk for fall -Vulnerable age group -Syncopal episode -Fainting -Impaired postural balance -Hypotension | Risk for Adult Falls Related to Fainting and Impaired postural balance as evidenced by history of falls and syncopal Episodes | Patient will remain free from falls and other related injuries. Patient will demonstrate interventions that can help reduce the risk of falls. | 1. Instruct the patient to wear an identification band. Wearing an identification wristband is vital for patients at risk for falling due to syncope, as these wristbands can make it easier for healthcare practitioners to provide appropriate aid quickly. 2. Instruct on changing positions slowly. Hypotension is a common cause of syncope. When the patient moves from lying to sitting or sitting to standing, ensure they do so slowly, allowing the body to adjust to the change in blood pressure. 3. Educate the patient and family about syncope. Offer education to help the patient and family understand triggers or underlying causes of syncope and initiate appropriate interventions to reduce the risk of injuries and falls at home. 4. Initiate fall precaution interventions. Fall precautions like bed alarms, keeping the bed in the lowest position, and utilizing assistive devices can help reduce falls during a syncopal episode. 5. Remove potential environmental hazards. Environmental hazards, including clutter, floor coverings, and cords, can predispose patients with syncope to potential injuries and falls. | Patient remained free from falls and other related injuries. Patient demonstrated interventions that can help reduce the risk of falls. |