Situation: Patient is newly diagnosed with Breast Cancer

Nursing Care Plan

Date/ Cues Nee Nursing Diagnosis Objectives Nursing Evaluation

Time d of Care Interventions
9/26/202 Subjective: C Anxiety r/t threat to or change After 8 hours 1. Identify Goal met:
0 The patient O in health of nursing and
7AM- verbalized,  P intervention, acknowled After 8 hours
3PM “I am so worried. I Rationale: Cancer is a life- the patient ge of nursing
I can’t think N changing disease. Patients with will be able patient’s intervention,
straight G this condition may experience to: perception the patient
” / anxiety due to fear of death, pain, of threat was relax
S being left alone, and future • The patient and and anxiety
Objectives T treatments, which might cause will report an situation. reduced as
Vital Signs: R apprehension and affect an increase in Encourage evidenced
T: 36.5 C E individual’s ability to function psychologic expression by:
P: 80 S properly. With these, it is al and s of, and (-)
R: 20 S essential to address anxiety to physiologic do not nervousness
BP: 120/80 prevent further complications.  comfort. deny (-)
02 SAT: 98% T Reference:(n.d.). Retrieved feelings of, preoccupatio
 Nervousness O September 29, 2020, from • The anger, n
 Helplessness L https://www.psychiatry.org/patient patient will grief, -was able to
 Poor Eye E s-families/anxiety-disorders/what- verbalize her sadness, perform
Contact R are-anxiety-disorders own anxiety fear. anxiety-
 Preoccupatio A and coping R: Patient may reducing
n N patterns. fear death skills such as
 Distress C and/or be deep
 Level of E • The patient anxious about breathing
anxiety: Mild will be able immediate exercise
P to report a environment.
A reduction of Ongoing And
T anxiety anxiety (related verbalized “
T experienced to concerns Thanks for
E to a about impact of helping me. I
R manageable cancer on am so much
N level. future lifestyle, calmer than
matters left before”
• The patient unattended or
will be able unresolved, and
to identify effects of illness
health ways on family) may
to deal with be present in
and express varying degrees
anxiety. for some time
. and may be
manifested by
symptoms of
depression.

2. Accept
client’s
defenses,
do not
confront,
argue and
debate.
R:
Confrontation
can promote
anger and
increase use of
denial, reducing
cooperation and
possibly
 impeding
recovery.

3. Observe
for verbal
and
nonverbal
signs of
anxiety
(restlessne
ss,
changes in
vital signs),
and stay
with
patient.
Intervene if
patient
displays
destructive
behavior.
R: Patient may
not express
concern
directly, but
words and
actions may
convey sense
of agitation,
aggression, and
hostility.
Intervention can
 help patient
regain control of
own behavior.

4. Orient
patient
and/or SO
to routine
procedures
and
expected
activities.
Promote
participatio
n when
possible.
R: Predictability
and information
can decrease
anxiety for
patient.

5. Provide
rest
periods
and/or
uninterrupt
ed sleep ti
me, quiet
surroundin
gs, with
patient
controlling
 type,
amount of
external
stimuli.
R: Conserves
energy and
enhances
coping abilities.

6. Encourage
patient and
SO to
communic
ate with
one
another,
sharing
questions
and
concerns.
R: Sharing
information
elicits support
and comfort
and can relieve
tension of
unexpressed
worries.

7. Assist the
patient in
developing
new
 anxiety-
reducing
skills (e.g.,
relaxation,
deep
breathing,
positive
visualizatio
n, and
reassuring
self-
statements
).
R: Discovering
new coping
methods
provides the
patient with a
variety of ways
to manage
anxiety.

8. Note
ineffective
coping
(poor
social
interaction
s,
helplessne
ss, giving
up
 everyday
functions
and usual
sources of
gratificatio
n).
R: Identifies
individual
problems and
provides
support for
patient and SO
in using
effective coping
skills.

9. Include SO
as
indicated
or patient
desires
when
major deci
sions are
to be
made.
R: Provides a
support system
for patient and
allows SO to
be involved
appropriately.
http://downloads.lww.com/wolterskluwer_vitalstream_com/sample-content/9780781764254_videbeck/videbeckch13.pdf
https://nurseslabs.com/anxiety/#:~:text=Peplau%20described%204%20levels%20of,will%20be%20within%20normal
%20ranges.