Nurse's Pocket Guide

Defining Characteristics
SUBJECTIVE
Expresses difficulty in functioning/problems with decision
making
Expresses a feeling of pressure/tension/increased feelings of
impatience/anger
Reports negative impact from stress (e.g., physical symptoms,
psychological distress, feeling of “being sick” or of “going to
get sick”)
Reports situational stress as excessive (e.g., rates stress level as a
seven or above on a 10-point scale)
OBJECTIVE
Demonstrates increased feelings of impatience/anger
Desired Outcomes/Evaluation
Criteria—Client Will:
• Assess current situation accurately.
• Identify ineffective stress-management behaviors and consequences.
• Meet psychological needs as evidenced by appropriate expression
of feelings, identification of options and use of resources.
• Verbalize or demonstrate reduced stress reaction.
Actions/Interventions
NURSING PRIORITY NO.1.To identify causative/precipitating factors
and degree of impairment:
• Ascertain what events have occurred (e.g., family violence; death
of loved one; chronic/terminal illness; work place stress/loss of
job; catastrophic natural or man-made event) over remote and
recent past to assist in determining number, duration, and
intensity of events causing perception of overwhelming stress.
• Determine client’s/SO’s understanding of events, noting differences
in viewpoints.
• Note client’s gender, age, and developmental level of functioning.
Women, children, young adults, and divorced and
separated persons tend to have higher stress levels. Multiple
stressors can weaken the immune system and tax physical
and emotional coping mechanisms in persons of any age,
but particulary the elderly.
• Note cultural values/religious beliefs that may affect client’s
expectation for self in dealing with situation and expectations
placed on client by SO(s)/family. For example, in dealing
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 659
STRESS OVERLOAD