Psychiatric Mental Health Nursing by Videbeck

474 Unit 4 NURSINGPRACTICE FORPSYCHIATRICDISORDERS

continued from page 473

Alerting the client to situations surrounding the

complaint helps him or her to see the relatedness

of stress and physical symptoms.

Learning nonchemical pain relief techniques will

shift the focus of coping away from physical

means and increase the client’s sense of control.

Optimal physical wellness is especially important

with clients using physical symptoms as a coping

strategy.

The focus is on feelings of fear, not fear of physi-

cal problems.

The client may have helpless feelings but may not

recognize this independently.

Continued, regular interest in the client facilitates

the relationship. It also can desensitize the client

regarding discussion of feelings and emotional

issues.

The client may have difficulty identifying and ex-

pressing feelings directly. Your encouragement and

support may help the client to develop these skills.

Direct expression of feelings will minimize the

need to use physical symptoms to express them.

The client can gain confidence dealing with

stress.

The client needs to know that appropriate expres-

sions of anger or other negative emotions are ac-

ceptable and that he or she can feel better physi-

cally as a result of these expressions.

Observe and record the circumstances surround-

ing the occurrence or exacerbation of complaints;

talk about your observations with the client.

Help the client to identify and use nonchemical

methods of pain relief such as relaxation

techniques.

Teach the client more healthful daily living habits

with regard to diet, sleep, comfort measures, stress

management techniques, daily fluid intake, daily

exercise, decreased stimuli, rest, possible connec-

tion between caffeine and anxiety symptoms, and

so forth. See Care Plan 35: Sleep Disorders.

Encourage the client to discuss his or her feelings

about the fears rather than the fears themselves.

Help the client to explore his or her feelings of

lack of control over stress and life events.

Talk with the client at least once per shift; focus

on the identification and expression of the client’s

feelings.

Encourage the client to ventilate feelings by talking

or crying, through physical activities, and so forth.

Encourage the client to identify and express feel-

ings directly in interpersonal relationships or

stressful situations, especially feelings with

which the client is uncomfortable (such as anger

or resentment).

Notice the client’s interactions with others (other

clients, staff members, visitors, significant others,

yourself), and give positive feedback for self-

assertion and the direct expression of feelings,

especially anger, resentment, and other so-called

negative emotions.

Adapted from Schultz, J. M. & Videbeck, S. L. (2002). Lippincott’s Manual of Psychiatric Nursing Care Plans (6th ed.). Philadelphia:

Lippincott Williams & Wilkins.