Nurse's Pocket Guide

Moderate
Dependence on others that may result in irritability
Inability to seek information regarding care
Passivity
Nonparticipation in care/decision making when opportunities
are provided; does not monitor progress
Does not defend self-care practices when challenged
Severe
Apathy [withdrawal, resignation, crying]
Desired Outcomes/Evaluation
Criteria—Client Will:
• Express sense of control over the present situation and future
outcome.
• Make choices related to and be involved in care.
• Identify areas over which individual has control.
• Acknowledge reality that some areas are beyond individual’s
control.
Actions/Interventions
NURSING PRIORITY NO.1.To assess causative/contributing factors:
• Identify situational circumstances (e.g., strange environment,
immobility, diagnosis of terminal/chronic illness, lack of support
system, lack of knowledge about situation).
• Determine client’s perception/knowledge of condition and
treatment plan.
• Ascertain client response to treatment regimen. Does client
see reason(s) and understand it is in the client’s best interest
or is client compliant and helpless?
• Identify client locus of control: internal (expressions of
responsibility for self and ability to control outcomes—“I
didn’t quit smoking”) or external (expressions of lack of control
over self and environment—“Nothing ever works out”;
“What bad luck to get lung cancer”).
• Note cultural factors/religious beliefs that may contribute to
how client is handling the situation.
• Assess degree of mastery client has exhibited in life. Passive
individual may have more difficulty being assertive and
standing up for rights.
• Determine if there has been a change in relationships with
SO(s). Conflict in the family, loss of a family member, or
divorce can contribute to feelings of powerlessness and lack
of ability to manage situation.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 541
POWERLESSNESS