Nurse's Pocket Guide

• Explore the expressions of emotions signifying impaired
adjustment by client/SO(s) (e.g., overwhelming anxiety, fear,
anger, worry, passive and/or active denial).
• Note child’s interaction with parent/caregiver (development
of coping behaviors is limited at this age, and primary
caregivers provide support for the child and serve as role
models).
• Determine whether child displays problems with school performance,
withdraws from family/peers, or demonstrates
aggressive behavior toward others/self.
NURSING PRIORITY NO. 2.To identify the causative/contributing
factors relating to the change in health behavior:
• Listen to client’s perception of the factors leading to the present
dilemma, noting onset, duration, presence/absence of
physical complaints, and social withdrawal.
• Review previous life situations and role changes with client to
determine coping skills used.
• Determine lack of/inability to use available resources.
• Review available documentation and resources to determine
actual life experiences (e.g., medical records, statements by
SO[s], consultants’ notes). In situations of great stress, physical
and/or emotional, the client may not accurately assess
occurrences leading to the present situation.
NURSING PRIORITY NO. 3.To assist client in coping/dealing with
impairment:
• Organize a team conference (including client and ancillary
services) to focus on contributing factors effecting adjustment
and plan for management of the situation.
• Acknowledge client’s efforts to adjust: “Have done your best.”
Lessens feelings of blame/guilt and defensive response.
• Share information with adolescent’s peers as indicated when
illness/injury affects body image (peers are primary support
for this age group).
• Explain disease process/causative factors and prognosis, as
appropriate, and promote questioning to enhance understanding.
• Provide an open environment encouraging communication
so that expression of feelings concerning impaired function
can be dealt with realistically and openly.
• Use therapeutic communication skills (active-listening,
acknowledgment, silence, I-statements).
• Discuss/evaluate resources that have been useful to the client
in adapting to changes in other life situations (e.g., vocational
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 113
risk-prone health BEHAVIOR