Ineffective Coping | Nursing Care Plan for Inflammatory Bowel Disease

Nursing diagnosis: ineffective Coping related to Multiple stressors, repeated over period of time; situational crisis, Unpredictable nature of disease process, Personal vulnerability; inadequate coping method; lack of support systems, Severe pain, Lack of sleep, rest

Possibly evidenced by
Verbalization of inability to cope, discouragement, anxiety
Preoccupation with physical self, chronic worry, emotional tension, poor self-esteem
Depression and dependency

Desired Outcomes/Evaluation Criteria—Client Will
Coping
Assess the current situation accurately.
Identify ineffective coping behaviors and consequences.
Acknowledge own coping abilities.
Demonstrate necessary lifestyle changes to limit or prevent recurrent episodes.

Nursing intervention with rationale:
1. Assess client’s/SO’s understanding and previous methods of dealing with disease process.
Rationale: Enables the nurse to deal more realistically with current problems. Anxiety and other problems may have interfered with previous health teaching and client learning.Enables the nurse to deal more realistically with current problems.

2. Determine outside stressors, such as family, relationships, and social or work environment.
Rationale: Stress can alter autonomic nervous response, affecting the immune system and contributing to exacerbation of disease. Even the goal of independence in the dependent client can be an added stressor.

3. Provide opportunity for client to discuss how illness has affected relationships, including sexual concerns.
Rationale: Stressors of illness affect all areas of life, and client may have difficulty coping with feelings of fatigue and pain in relation to relationship and sexual needs.

4. Help client identify individually effective coping skills.
Rationale: Use of previously successful behaviors can help client deal with current situation and plan for the future.

5. Encourage use of stress management skills, such as relaxation techniques, visualization, guided imagery, and deep-breathing exercises.
Rationale: Refocuses attention, promotes relaxation, and enhances coping abilities.

6. Include client/SO in team conferences to develop individualized program.
Rationale: Promotes continuity of care and enables client/SO to feel a part of the plan, imparting a sense of control and increasing cooperation with therapeutic regimen.

7. Administer medications as indicated, for example, anti-anxiety agents, such as lorazepam (Ativan) and alprazolam (Xanax).
Rationale: Aids in psychological and physical rest. Conserves energy and may strengthen coping abilities.

8. Refer to resources, as indicated, such as local support group, social worker, psychiatric clinical nurse specialist, or spiritual advisor.
Rationale: Additional support and counseling can assist client/SO in dealing with specific stress or problem areas.

9. Provide emotional support: Active-listen in a nonjudgmental manner.
Rationale: Aids in communication and understanding client’s viewpoint. Adds to client’s feelings of self-worth.

10. Maintain nonjudgmental body language when caring for client.
Rationale: Prevents reinforcing client’s feelings of being a burden, for example, frequent need to empty bedpan or commode.