Nursing diagnosis: Ineffective coping

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Nursing diagnosis: Ineffective coping

Patient: 48 year old male admitted for alcohol dependence. Medical history includes anxiety, bipolar, PTSD, and hypertension. Pt had one suicide attempt in 2001. K+ at 3.2 upon admission. Pt claims his dependence on alcohol began when he was in the Air Force. He lives with an alcoholic partner who depends on him for housing. He was considering going to live with his mother after rehab.
Nursing Diagnosis:
Ineffective coping related to inadequate social support created by characteristics of relationships as evidenced by alcohol dependence, use of forms of coping that impede adaptive behavior, smoking approximately one pack a day, report of sleep disturbance, and uncertainty about living arrangements.
Short term goals:
1) Client will describe previous stressors and coping behaviors, measured by verbalization of at least two stressful circumstances, and how he coped with them and the consequences, by the end of his stay.
2) Client will use behaviors to decrease stress as measured by verbalization of those behaviors by the end of his stay.
Long term goal:
Client will demonstrate ability to cope effectively to stressors by using two new coping strategies by the end of his 90 day participation in AA.
Nursing Interventions:
1) Observe for contributing factors of ineffective coping lack of problem solving skills, lack of coping strategies, lack of support, and lack of medical care.
Rationale: Ineffective coping strategies predict greater distress.
2) Use therapeutic communication techniques including active listening, silence, and empathy to allow the patient to express emotions.
Rationale: Clinicians’ use of therapeutic communication techniques benefits the well-being of clients and reduces psychosocial problems.
3) Encourage patient to describe previous coping strategies used for stressors, and provide instruction regarding alternative coping strategies including using physical activity, and deep



References: Ackley, B. J., & Ladwig, G. B. (2010). Nursing diagnosis handbook: An evidence-based guide to planning care. Maryland Heights, MO: Mosby.

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