Mr. Lopez, 51 years old,
CEO of local smartphone company. Mr. Lopez is a vegetarian and active in
dissemination of information about positive benefits of being a vegetarian. He
went to various seminars as a speaker to spread what he knew was right and will
help others to be healthy and prolonged life. He wrote books about wonderful
effects of vegetables and the dangerous effects of meat to human body. Though
many people oppose what he believes, he has numerous followers and companion
for his revolutionary act. Unfortunately, Mr. Lopez is experiencing stomachache
for the past 12 days and the pain keeps escalating. Mr. Lopez was worried
so he went to the hospital for a check-up and found out that he had a colon
cancer by means of several test results. Below is a sample of nursing care plan
about ineffective denial of Mr. Lopez.
Assessment:
Subjective: "I don't have cancer, the test was wrong, I'm a vegetarian, I can't have cancer." As verbalized by the patient.
Objectives:
- Delays seeking or
refuses health care attention
- Does not perceive
personal relevance of symptoms or danger
- Uses home remedies for self-treatment to relieve symptoms
- Does not admit fear of death
- Cannot admit the effects of the disease on life pattern
- Displaces the fear of effects of the condition
- Displays inappropriate affect
Diagnosis:
Ineffective denial
related to inability to tolerate consciously the consequences secondary to
cancer.
Planning:
The patient will use
alternative coping mechanism in response to cancer instead of denial as
evidenced by the acknowledgement of the illness and use problem-focused coping
skills.
Interventions:
- Initiate a therapeutic
relationship to Mr. Lopez. Assess effectiveness of his
denial. Avoid confronting to Mr. Lopez that he is using
denial. Approach Mr. Lopez directly, matter-of-factly,
and non-judgmentally.
- Encourage Mr. Lopez to share his perceptions of the situation like fears
or anxieties. Focus on the feelings shared. Use reflection to
encourage more sharing.
- Attempt to elicit from Mr. Lopez a description of his problem. Assist
him to gain an intellectual understanding that this is an illness, not a
moral problem. Provide opportunities to perform successfully;
gradually increase his responsibility. Provide opportunities to
share his fears and anxieties. Assist in lowering anxiety level (see Anxiety for additional interventions).
- Avoid confronting person on use of denial. Carefully explore Mr. Lopez's
interpretation of the situation. Reflect self-reported cues used to
minimize the situation like "a little,” or “only”. Identify his
recent detrimental behavior and discuss the effects of his behavior on health. Emphasize Mr.
Lopez's strengths and past successful coping. Provide him positive
reinforcement for any expressions of insight. Do not accept his
rationalization or projection. Be polite, caring, but firm. It is important to help the
person you care for keep a sense of control. A cancer diagnosis may make him
feel little control over life. Start by asking if you can help with a specific
task or decision instead of doing it on your own. Mr. Lopez may no longer be able to
actively participate in activities he enjoys. So look for other ways to
encourage involvement.
- Provide self-help
manuals or other pamphlets.
Evaluation:
The patient used
alternative coping mechanism in response to cancer instead of denial and
acknowledged the illness and used problem-focused coping skills.
For more samples of nursing care plan you are free to check it
out in our NCP LIST page.
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