I ne ffe ct i v eCopi ng I ne ffe c t i v eCop i n g: I nabi l i t yt of or m av al i dappr ai s al oft hes t r es sor s ,i nadequat ec hoi c esofpr ac t i c edr es pons es ,
and/ ori nabi l i t yt ous eav ai l abl er e sour c es .
Nur si ngDi agnosi s
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I neff ec t i v eCopi ng
Ma yber e l a t e dt o
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Si t uat i onal c r i s es ,v ul ner abi l i t y ,c ogni t i v eper c ept ual c hanges
Possi bl yevi dencedby
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I n ap pr o pr i a t eus eofd ef en s eme ch an i s ms ms
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I nabi l i t yt oc ope/ di ffic ul t yas k i ngf orhel p
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Ch an gei nus ua lc o mmu mm ni c at i o np at t er n s
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I nabi l i t yt omeetbas i cneeds / r ol eex pec t at i ons
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Di ffic ul t ypr obl em s ol v i ng
Desi r edOu Out come mes
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Ver bal i z eac cept anc eofs el fi ns i t uat i on.
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T a l k / c ommun i c at ewi t hSO a bou ts i t ua t i o nan dc h ang est h ath av eoc c u r r e d.
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Ver bal i z eawar enes sofo wnc opi ngabi l i t i es .
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Meetps y c hol ogi c al needsase vi denc edbyappr opr i at eex pr es s i onoff eel i ngs , i dent i fi cat i onofopt i ons ,andus eofr es our c es . Nursing Interventions
Rationale
Assess extent of altered perception and related degree of disability. Determine Functional Independence Measure score.
Determination of individual factors aids in developing plan of care/choice of interventions and discharge expectations.
Identify meaning of the dysfunction and change to patient. Note ability to understand un derstand events, provide realistic appraisal of the situation.
Independence is highly valued in American American culture but is not as significant in some cultures. ome patients accept and manage altered function effectively !ith little ad"ustment, !hereas others may have considerable difficulty recogni#ing and ad"ust to deficits. In order to provide meaningful
Nursing Interventions
Rationale
support and appropriate problem$solving, healthcare providers need to understand the meaning of the stro%e/limitations to patient.
Determine outside stressors& family, !or%, future healthcare needs.
'elps identify specific needs, provides opportunity to offer information and begin problem$solving. (onsideration of social factors, in addition to functional status, is important in determining appropriate discharge destination.
)rovide psychological support and set realistic short$term goals. Involve the patient*s + in plan of care !hen possible and explain his deficits and strengths.
o increase the patient*s sense of confidence and can help in compliance to therapeutic regimen.
-ncourage patient to express feelings, including hostility or anger, denial, depression, sense of disconnectedness.
Demonstrates acceptance of patient in recogni#ing and beginning to deal !ith these feelings.
Note !hether patient refers to affected side as it or denies affected side and says it is dead.
uggests re"ection of body part and negative feelings about body image and abilities, indicating need for intervention and emotional support.
Ac%no!ledge statement of feelings about betrayal of body0 remain matter$of$fact about reality that patient can still use unaffected side and learn to control affected side. 1se !ords 2!ea%, affected, right$left3 that incorporate that side as part of the !hole body.
'elps patient see that the nurse accepts both sides as part of the !hole individual. Allo!s patient to feel hopeful and begin to accept current situation.
Identify previous methods of dealing !ith life problems. Determine presence of support systems.
)rovides opportunity to use behaviors previously effective, build on past successes, and mobili#e resources.
-mphasi#e small gains either in recovery of function or independence.
(onsolidates gains, helps reduce feelings of anger and helplessness, and conveys sense of progress.
upport behaviors and efforts such as increased interest/participation in rehabilitation activities.
uggest possible adaptation to changes and understanding about o!n role in future lifestyle.
Monitor for sleep disturbance, increased difficulty concentrating, statements of inability to cope, lethargy, !ithdra!al.
May indicate onset of depression 2common after effect of stro%e3, !hich may re4uire further evaluation and intervention.
5efer for neuropsychological evaluation and/or May facilitate adaptation to role changes that counseling if indicated. are necessary for a sense of feeling/being a productive person. Note& Depression is common in stro%e survivors and may be a
Nursing Interventions
Rationale
direct result of the brain damage and/or an emotional reaction to sudden$onset disability.
