8/18/2019 Nursingcareplangrief Drjma 140219143910 Phpapp01

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Prep by: Dr. James Malce Alo , RN,MAN,MAPsycho.PhD.

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Nursing C A R E P L A N GRIEF ASSESSMENT DATA  Nursing

Diagnosis

EXPECTED OUTCOMES

(or Planning) 

IMPLEMENTATION 

Nursing Interventions *denotescollaborative interventions

RATIONALE

EVALUATION

Cognitive Responses

• Questioning and trying tomake sense

of the loss

• Experiencingdisillusionment

• Attempting to make sense

of the loss

Emotional Responses

• Feeling numb

• Experiencing sorrow,

loneliness

• Crying, sobbing

• Having vacillatingemotions including

anger

• Experiencing hopelessness• Feeling helpless, powerless

Behavioral Responses

• Experiencing great

restlessness;

searching for the deceased

• Seeking and avoiding places and activities

once shared with the lost

one• Functioning

“automatically” 

Physiologic Responses

• Headaches

• Insomnia

• Lack of energy 

➤ Grieving

 A normal responsein the humanexperience of loss. 

The client will

• Identify the loss and itsmeaning for self (adequate

 perception)

• Express feelings, verballyand nonverbally

• Establish and maintain

adequate nutrition, hydration,

and elimination (adequate

coping)

• Establish and maintain an

adequate balance of rest,

sleep, and activity (adequate

coping)• Establish and maintain an

adequate support system

• Verbalize knowledge of thegrief process

• Demonstrate initial

integration of loss into his or

her life (adequate coping)

• Verbalize realistic future

 plans integrating loss(adequate perception) 

After establishing rapport with

the client, bring up the loss in asupportive manner; if the client

refuses to discuss it, withdraw

and state your intention to return.(“I can understand that you

may not want to talk with me

about this now. I will come to

talk with you again at 11:00.

Maybe we can talk about it

then.”) Return at the stated time,

then continue to be as supportive

as possible rather than

confronting the client.

Talk with the client realistically

about his or her loss; discussconcrete changes that the client

must now begin to make as a

result of the loss.

Encourage the expression of

feelings in ways the client iscomfortable — for example,

talking, writing, drawing, crying,

wailing, or yelling. Convey youracceptance of these feelings and

means of expression. Offer the

client verbal support for attempts

to express feelings. 

Your presence demonstrates

interest and caring. Tellingthe client you will return

conveys your support. The

client may need emotionalsupport to face and express

uncomfortable or painful

feelings. Confronting the

client or pushing him or her

to express feelings may

increase anxiety and lead to

further denial or avoidance.

Discussing the loss on this

level may help to make it

more real for the client.

Expression of feelings can

help the client to identify,

accept, and work through

his or her feelings even ifthese are painful or

otherwise uncomfortable for

the client.