HOPELESSNESS

ASSESSMENT DIAGNOSIS PLANNING INTERVENTIONS RATIONALE EVALUATION

SUBJECTIVE: Hopelessness related to After 1 week of nursing Independent:  Hopelessness is After 1 week of nursing
“I can’t seem to do deteriorating interventions, patient  Monitor and document directly associated interventions, goal met.
anything,” as physiological condition will be able to: potential for suicide. with suicidal Patient was able to
verbalized by the  Participate in care Provide a safe behavior and also identify feelings of
patient environment so client with a variety of hopelessness (regarding
 Verbalize feelings
cannot harm self. other dysfunctional present situation),
OBJECTIVE: and make positive
statements personal demonstrate more
 Decreased appetite  Assess the client for and
characteristics. effective
point out reasons for
 Increased sleep  Maintains Hopelessness is an communication skills
living.
appropriate accurate indicator and verbalizes feelings,
 Lack of initiative appetite for age  Assess for impaired of suicidal risk. A participates in different
 Lack of and physical health problem-solving ability safe environment activities such as self-
involvement in care and dysfunctional reassures the client. care, and resume
 Sleep appropriate
attitude. appropriate rest
 Passive amount of time for  Interventions that
pattern as well as diet.
age and physical  Evaluate client by increase the
health realistically assessing awareness of
the predicament or reasons for living
threat. may decrease
hopelessness and
 Determine appropriate decrease risk for
approaches based on suicide
the underlying
condition or situation  Impaired problem-
that is contributing to solving ability and
feelings of dysfunctional
hopelessness. Either attitude have been
encourage a positive shown to correlate
mental attitude with hopelessness
(discourage negative
 Understanding the
thoughts) or brace
etiologic basis of
client for negative
the client's
outcomes
hopelessness is
 Assist client with important in order
looking at alternatives
 and setting goals that to intervene
are important to him or
 Truthful
her.
information is
 Spend one-on-one time generally preferred
with client. Use by families; surprise
empathy; try to information
understand what a regarding a change
client is saying, and in status may cause
communicate this the family to worry
understanding to the that information is
client. being withheld from
them (Johnson,
 Encourage expression
Roberts, 1996). A
of feelings, and
person awaiting a
acknowledge
transplant may
acceptance of them
need to express
 Give client time to only hope or
initiate interactions. optimism, whereas
After an appropriate a person with an
amount of time is injury with long-
allowed, approach term effects, such
client in an accepting as a spinal-cord
and nonjudgmental injury, may need to
manner. prepare for possible
negative outcomes
 Review client's and slow progress
strengths with client.
Have client list own  Mutual goal setting
strengths on a note ensures that goals
card and carry this list are attainable and
for future reference. helps to restore a
cognitive-temporal
 Encourage family and sense of hope
significant others to
express care, hope, and  Experiencing
love for client. warmth, empathy,
genuineness, and
 unconditional
positive regard can
inspire hope

 Active listening is a
tool used by nurses
to enable them to
listen to all ideas
and feelings
without judgment.
Active listening may
help clients to
express themselves

 Clients who have

feelings of
hopelessness need
extra time to
initiate
relationships and
sometimes are not
able to.
Approaching the
client in an
unhurried,
nonjudgmental
manner allows the
client to feel secure
and provides an
atmosphere
conducive to
venting fears and
asking questions

 Having individual
worth affirmed
inspires hope.
Listing strengths
 provides
reinforcement of
positive self-regard.

 Helping the family

to provide client
reinforcement, to
understand the
client's feelings, and
to be physically
present and
involved in care are
strategies that
enable the family to
alter the client's
hope state
ALTERED NUTRITION
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIONS RATIONALE EVALUATION
OBJECTIVE: Imbalanced
nutrition less than After nursing 1. Encourage patient 1. An ongoing After nursing
Verbalization of body requirements intervention, the to seek relationship interventions, the
inability to cope related to patient will be able to information that establishes trust, patient was able to
* Inability to make UNWILLINGNESS TO increases coping reduces the feeling of
decisions EAT AS EVIDENCED BY Patient identifies own skills isolation, and may
* Inability to ask for STARVATION, WEIGHT maladaptive coping facilitate coping
help LOSS, AND ANOREXIA behaviors. 1. Patient
* Destructive behavior * Patient identifies 2. Provide 2. Verbalization of identifies own
toward self available resources opportunities to actual or perceived maladaptive
* Inappropriate use of and support systems. express concerns, threats can help coping
defense mechanism * Patient describes fears, feelings, and reduce anxiety behaviors.
lack of appetite and initiates expectations * Patient
* Headaches alternative coping 3. Convey feelings of 3. to avoid losing the identifies
* Chronic depression strategies. acceptance and trust of patient available
* Emotional tension understanding. resources and
* Insomnia Avoid false support
reassurances systems.
4. Encourage patient 4. Fostering * Patient
to identify own awareness can describes and
strengths and expedite use of these initiates
abilities. During strengths alternative
crises, patients coping
may not be able to strategies.
recognize their 2.
strengths

5. Establish a 5. An ongoing
working relationship
relationship with establishes trust,
patient through reduces the feeling of
continuity of care. isolation, and may
 facilitate coping

6. Encourage patient 6. Patients who are

to seek not coping well may
information that need more guidance
increases coping initially
skills
7. Provide 7. Patients who are
information the coping ineffectively
patient wants and have reduced ability
needs. Do not to assimilate
provide more than information
patient can handle
8. encourage patient 8. This helps patient
to set realistic gain control over the
goals situation. Guiding the
patient to view the
situation in smaller
parts may make the
problem more
manageable.

9. Point out signs of 9. Patients who are

positive progress coping ineffectively
or change may not be able to
assess progress.
10. Encourage patient 10. Unexpressed
to communicate feelings can increase
feelings with stress.
significant others
11. Point out 11. This helps patient
maladaptive focus on more
behaviors appropriate strategies