Angelite Nurses: 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:

(_) Assist patient to identify the stressors.

(_) Explore feelings about situation with patient.

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

(_) Other:________________
________________________
________________________
________________________

__________________________
Patient/Significant other signature

__________________________
RN signature

Angelite Nurses