Nurse's Pocket Guide

• Allow client to react in own way without judgment. Provide
support and diversion, as indicated.
• Help client to set limits on acting-out behaviors and learn
ways to express emotions in an acceptable manner. Promotes
internal locus of control, enabling client to maintain selfconcept
and feel more positive about self.
• Address use of ineffective/dangerous coping mechanisms
(e.g., substance use/abuse, self/other-directed violence) and
refer for counseling as indicated.
• Collaborate in treatment of underlying conditions (e.g., physical
injury, depression, anger management).
NURSING PRIORITY NO. 3. To promote wellness (Teaching/
Discharge Considerations):
• Use client’s locus of control to develop individual plan of care
(e.g., for client with internal control, encourage client to
take control of own care and for those with external control,
begin with small tasks and add as tolerated).
• Incorporate strengths/assets and past coping strategies that
were successful for client. Reinforces that client is able to deal
with difficult situations.
• Provide information about stress and exhaustion phase,
which occurs when person is experiencing chronic/unresolved
stress. Release of cortisol can contribute to reduction
in immune function, resulting in physical illness, mental
disability, and life dysfunction.
• Review stress management/coping skills that client can use:
Practice behaviors that may help reduce negative consequences—change
thinking by focusing on positives,
reframing thoughts, changing lifestyle.
Take a step back, simplify life; learn to say “no” to reduce
sense of being overwhelmed.
Learn to control and redirect anger.
Develop and practice positive self-esteem skills.
Rest, sleep, and exercise to recuperate and rejuvenate self.
Participate in self-help actions (e.g., deep breathing, find time
to be alone, get involved in recreation or desired activity,
plan something fun/develop humor) to actively relax.
Eat right; avoid junk food, excessive caffeine, alcohol, and
nicotine to support general health.
Develop spiritual self (e.g., meditate/pray, block negative
thoughts, learn to give and take, speak and listen, forgive
and move on).
Interact socially, reach out, nurture self and others to reduce
loneliness/sense of isolation.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 661
STRESS OVERLOAD