Part II:
Nursing Care Plan
Nursing Diagnosis
(Dx, related to, & as evidenced by)
Ineffective coping related to inadequate
coping skills and weak ego as evidenced
by use of substances as coping
mechanisms.
Expected Outcomes
(Short term (8-48 hr.) reasonable
expectations stated in measurable,
behavioral terms, i.e., action verbs)
1. Pt will be able to verbalize
adaptive coping
mechanisms to use, instead
of substance abuse, when
responding to stress within
two days.
2. Pt will demonstrate adaptive
coping mechanisms to use
within five days.
3. Pt will report/display
decreased physical
symptoms of stress within
five days.
Nursing Interventions/Rationale Outcome Evaluation
List all interventions for each nsg. dx (include (Patient outcome noted as met or
patient/family teaching) unmet/responses described)
1. Observe pt for contributing factors of
ineffective coping to help establish a plan for
teaching.
2. Use therapeutic communication techniques to
encourage the pt to express emotions such as
anger and guilt in order to help pt verbalize fears
and set goals.
(Ackley, B., Ladwig, G. 2008)
3. Teach pt alternative coping strategies to help pt
establish a plan for how to cope with stress.
1. Encourage pt to describe previous stressors and
the coping mechanisms used in order to identify
and eliminate ineffective coping mechanisms.
(Ackley, B., Ladwig, G. 2008)
2. Assist pt to set realistic goals and identify
personal skills and knowledge to provide positive
factors in successful adaptation. (Ackley, B.,
Ladwig, G. 2008)
3. Explore options available to the pt at home to
assist with stress rather than resorting to
substance use, then practice those techniques in
order to prepare the pt for coping in his home
environment. (Townsend, M.,2008)
1. Encourage the client to make choices and
participate in discharge planning in order to
increase the pt’s responsibility for his own
actions. (Ackley, B., Ladwig, G. 2008)
2. Provide mentally and physically stimulating
activities to provide an alternative way to relieve
stress.
3. Encourage pt to attend groups and use external
social support groups to help build positive social
relationships and reinforce effective coping.
(Ackley, B., Ladwig, G. 2008)