Anxiety | Nursing Care Plan for Herniated Nucleus Pulposus (HNP)

Nursing diagnosis: Anxiety related to situational crisis, threat to or change in health status, socioeconomic status, role functioning, recurrent disorder with continuing pain, inadequate relaxation, little or no exercise, inadequate coping methods

Possibly evidenced by
Apprehension, uncertainty, helplessness
Expressed concerns regarding changes in life events
Verbalization of inability to cope
Muscular tension, general irritability, restlessness; insomnia, fatigue
Inability to meet role expectations

Desired Outcomes/Evaluation Criteria—Client Will
Anxiety Self-Control
Appear relaxed and report anxiety is reduced to a manageable level.
Identify ineffective coping behaviors and consequences.
Assess the current situation accurately.
Demonstrate effective problem-solving skills.
Develop plan for necessary lifestyle changes.

Nursing intervention with rationale
1. Assess level of anxiety. Determine previous coping strategies. Help client identify strategies to address current perceived or actual problems.
Rationale: Aids in identifying strengths and skills that may help client deal with current situation and enable others to provide appropriate assistance.

2. Provide accurate information and honest answers.
Rationale: Honest answers and accurate information facilitate development of rapport. These enable the client to use own experiences and knowledge to make decisions.

3. Provide opportunity for expression of concerns, such as possible permanent nerve damage, paralysis, effect on sexual ability, changes in employment, finances, and altered role responsibilities.
Rationale: Open communication promotes client realization of short- and long-term implications of current condition and can promote coping with situation.

4. Assess presence of secondary gains that may impede recovery.
Rationale: Client may unconsciously experience positive reinforcement, such as attention, control of others, and relief from responsibilities. These need to be recognized and addressed positively to promote recovery.

5. Note behaviors of SO that promote “sick role” for client.
Rationale: By relieving the client from roles and responsibilities or not allowing the client to perform optimal level of function, the SO may unconsciously enable client to remain dependent.

6. Refer to appropriate support groups, social services, financial or vocational counseling, and marital therapy or psychotherapy, as appropriate.
Rationale: These services provide support for promoting coping and adaptation to life changes.