Medical Surgical Nursing

Goal:Patient verbalizes feelings consistent with improvement of body image and self-esteem

1. Assess changes in

appearance and the meaning

these changes have for

patient and family.

2. Encourage patient to

verbalize reactions and

feelings about these changes.

3. Assess patient's and family's

previous coping strategies.

4. Assist and encourage patient

to maximize appearance and

explore alternatives to

previous sexual and role

functions.

5. Assist patient in identifying

short-term goals.

6. Encourage and assist patient

in decision making about

care.

7. Identify with patient

resources to provide

additional support

(counselor, spiritual advisor).

8. Assist patient in identifying

previous practices that may

have been harmful to self

(alcohol and drug abuse).

1. Provides information for

assessing impact of changes in

appearance, sexual function,

and role on the patient and

family

2. Enables patient to identify and

express concerns; encourages

patient and significant others to

share these concerns

3. Permits encouragement of those

coping strategies that are

familiar to patient and have

been effective in the past

4. Encourages patient to continue

safe roles and functions while

encouraging exploration of

alternatives

5. Accomplishing these goals

serves as positive reinforcement

and increases self-esteem.

6. Promotes patient's control of

life and improves sense of well-

being and self-esteem

7. Assists patient in identifying

resources and accepting

assistance from others when

indicated

8. Recognition and

acknowledgment of the harmful

effects of these practices are

necessary for identifying a

healthier lifestyle.

 Verbalizes concerns

related to changes in

appearance, life, and

lifestyle

 Shares concerns with

significant others

 Identifies past coping

strategies that have been

effective

 Uses past effective coping

strategies to deal with

changes in appearance,

life, and lifestyle

 Maintains good grooming

and hygiene

 Identifies short-term goals

and strategies to achieve

them

 Takes an active role in

decision making about self

and care

 Identifies resources that

are not harmful

 Verbalizes that some of

previous lifestyle practices

have been harmful

 Uses healthy expressions

of frustration, anger,

anxiety

Nursing Diagnosis: Chronic pain and discomfort related to enlarged tender liver and ascites

Goal: Increased level of comfort

Nursing Interventions Rationale Expected Outcomes