HOPELESSNESS

ASSESSMENT DIAGNOSIS PLANNING INTERVENTIONS RATIONALE EVALUATION

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