Impaired Adjustment

Impaired Adjustment

(_)Actual (_) Potential

Related To:
[Check those that apply]
(_) Illness
(_) Other:_____________________________
____________________________________
____________________________________

As evidenced by:
[Check those that apply]
Major:
(
Must be present)
(_) Verbalization of non-acceptance of health status change.
(_) Inability to be involved in problem solving or goal setting.
Minor:
(
May be present)
(_) Lack of movement toward independence.
(_) Extended period of shock, disbelief, or anger regarding health status change.
(_) Lack of future oriented thinking.

Date &
Sign.
Plan and Outcome
[Check those that apply]
Target
Date:
Nursing Interventions
[Check those that apply]
Date
Achieved:
The patient will:

(_) Identify the temporary and long term demands of the situation.

(_) Differentiate coping behavior that is effective vs. ineffective.

(_) Other:

(_) Asses the patient's:
  • pre-morbid lifestyle
  • pre-morbid coping style
  • amount and type of resources available
  • extent of current disruption on life style
  • current level of stress
  • current coping methods and their effectiveness

(_) Assist patient to identify the stressors.

(_) Explore feelings about situation with patient.

(_) Identify factors that interfere with or delay effective adjustment:

  • unmanageable level of stress
  • ineffective problem solving
  • inadequate or unavailable resources
  • significant other(s)
  • inadequate coping mechanisms
  • explore effective coping mechanisms

(_) Other:________________
________________________
________________________
________________________

__________________________
Patient/Significant other signature

__________________________
RN signature

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