Fear/Anxiety | Nursing Care Plan for Lung Cancer

Nursing diagnosis: anxiety related to situational crises; threat to or change in health status; perceived threat of death

Possibly evidenced by

Withdrawal

Apprehension

Anger

Increased pain, sympathetic stimulation

Expressions of denial, shock, guilt, insomnia

Desired Outcomes/Evaluation Criteria—Client Will

Fear Self-Control [or] Anxiety Self-Control

Acknowledge and discuss fears and concerns.

Demonstrate appropriate range of feelings and appear relaxed and resting appropriately.

Verbalize accurate knowledge of situation.

Report beginning use of individually appropriate coping strategies.

Nursing intervention with rationale:

1. Evaluate client and significant other (SO) level of understanding of diagnosis.

Rationale: Client and SO are hearing and assimilating new information that includes changes in self-image and lifestyle. Understanding perceptions of those involved sets the tone for individualizing care and provides information necessary for choosing appropriate interventions.

2. Acknowledge reality of client’s fears and concerns and encourage expression of feelings.

Rationale: Support may enable client to begin exploring and dealing with the reality of cancer and its treatment. Client may need time to identify feelings and even more time to begin to

express them.

3. Provide opportunity for questions and answer them honestly. Be sure that client and care providers have the same understanding of terms used.

Rationale: Establishes trust and reduces misperceptions or misinterpretation of information.

4. Accept, but do not reinforce, client’s denial of the situation.

Rationale: When extreme denial or anxiety is interfering with progress of recovery, the issues facing client need to be explained and resolutions explored.

5. Note comments and behaviors indicative of beginning acceptance or use of effective strategies to deal with situation.

Rationale: Fear and anxiety will diminish as client begins to accept and deal positively with reality. Indicator of client’s readiness to accept responsibility for participation in recovery and to

“resume life.”

6. Involve client and SO in care planning. Provide time to prepare for events and treatments.

Rationale: May help restore some feeling of control and independence to client who feels powerless in dealing with diagnosis and treatment.

7. Provide for client’s physical comfort.

Rationale: It is difficult to deal with emotional issues when experiencing extreme or persistent physical discomfort.