250
Unit 3
Applying concepts from the nursing process
Nursing interventions
3. Encourage active participation of
patient or family in care and treatment
decisions.
4. Visit family frequently to establish and
maintain relationships and physical
closeness.
5. Encourage ventilation of negative
feelings, including projected anger and
hostility, within acceptable limits.
6. Allow for periods of crying and
expression of sadness.
7. Involve pastoral care as desired by the
patient and family.
8. Advise professional counselling as
indicated for patient or family to
alleviate pathological grieving.
9. Allow for progression through the
grieving process at the individual pace
of the patient and family.
Rationale
3. Active participation maintains patient
independence and control.
4. Frequent contacts promote trust and
security and reduce feelings of fear
and isolation.
5. This allows for emotional expression
without loss of self-esteem.
6. These feelings are necessary for
separation and detachment to occur.
7. This facilitates the grief process and
spiritual care.
8. This facilitates the grief process.
9. Grief work is variable. Not every
person uses every phase of the grief
process and the time spent in dealing
with each phase varies with every
person. To complete grief work, this
variability must be allowed.
Expected outcomes
• The patient and family identify
resources available to aid coping
strategies during grieving.
• The patient and family use resources
and supports appropriately.
• The patient and family discuss the
future openly with each other.
• The patient and family discuss
concerns and feelings openly with
each other.
• The patient and family use
non-verbal expressions of concern
for each other.
Plan of Nurs ing Care
Care of patient with cancer
(
continued
)
CHART
11-4
Nursing interventions
1. Assess patient’s feelings about body
image and level of self-esteem.
2. Identify potential threats to patient’s
self-esteem (e.g. altered appearance,
decreased sexual function, hair loss,
decreased energy, role changes).
Validate concerns with patient.
3. Encourage continued participation in
activities and decision making.
4. Encourage patient to verbalise
concerns.
5. Individualise care for the patient.
6. Assist patient in self-care when
fatigue, lethargy, nausea, vomiting
and other symptoms prevent
independence.
7. Assist patient in selecting and using
cosmetics, scarves, hair pieces and
clothing that increase their sense of
attractiveness.
8. Encourage patient and partner to
share concerns about altered sexuality
and sexual function and to explore
alternatives to their usual sexual
expression.
9. Refer to collaborative specialist as
needed.
Rationale
1. Provides baseline assessment for
evaluating changes and assessing
effectiveness of interventions.
2. Anticipates changes and permits
patient to identify importance of these
areas.
3. Encourages and permits continued
control of events and self.
4. Identifying concerns is an important
step in coping with them.
5. Prevents or reduces depersonalisation
and emphasises patient’s self-worth.
6. Physical well-being improves
self-esteem.
7. Promotes positive body image.
8. Provides opportunity for expressing
concern, affection and acceptance.
9. Interdisciplinary collaboration essential
in meeting patient needs.
Expected outcomes
• Identifies concerns of importance.
• Takes active role in activities.
• Maintains previous role in decision
making.
• Verbalises feelings and reactions to
losses or threatened losses.
• Participates in self-care activities.
• Permits others to assist in care
when the patient is unable to be
independent.
• Exhibits interest in appearance and
uses aids (cosmetics, scarves, etc.)
appropriately.
• Participates with others in
conversations and social events and
activities.
• Verbalises concern about sexual
partner and/or significant others.
• Explores alternative ways of
expressing concern and affection.
Nursing problem:
Disturbed body image and situational low self-esteem related to changes in appearance, function and
roles
Goal:
Improved body image and self-esteem
