[Low self-esteem][Underdeveloped ego]Abuse of chemical agents[Inappropriate use of defense mechanisms]Inability to meet basic needs●[Alteration in societal participation]Inability to meet role expectationsDefi[Chronic depression][Chronic anxiety]adequate choices of practiced responses, and/or inability to use available resources. Possible Etiologies (“related to”)[Inadequate support systems][Inadequate coping skills]^94 [Possible hereditary factor][Dysfunctional family system][Negative role modeling][Personal vulnerability] Defi[Low frustration tolerance]^ INEFFECTIVE COPING ning Characteristics (“evidenced by”) nition:●^ ALTERATIONS IN PSYCHOSOCIAL ADAPTATION Inability to form a valid appraisal of the stressors, in-
2506_Ch04_071-104.indd Sec1:94 2506 Ch 04 071 - 104 .indas a method of coping with stress.[Need for immediate gratifi[Manipulative behavior] Goals/ObjectivesShort-term Goal 2. Set limits on manipulative behavior. Be sure that client Interventions with 1. Establish trusting relationship with client (be honest; keep Long-term GoalClient will be able to verbalize adaptive coping mechanisms to use, instead of substance abuse, in response to stress.Client will express true feelings associated with use of substances d Ses for violating the limits set. Ensure that all staff main-tain consistency with this intervention. knows what is acceptable, what is not, and the consequenc-nurse-client relationship is built on trust.appointments; be available to spend time). ec 1 : 94 Selected Rationales cation] Client is unable to The therapeutic 10/1/10 9:34:02 AM 10 / 1 / 10 9 : 34 : 02 AM
