1. Nursing C A R E P L A N GRIEF
ASSESSMENT DATA
EXPECTED OUTCOMES
Nursing
Diagnosis (or Planning)
Cognitive Responses
• Questioning and trying to
make sense
of the loss
• Experiencing
disillusionment
• Attempting to make sense
of the loss
Emotional Responses
• Feeling numb
• Experiencing sorrow,
loneliness
• Crying, sobbing
• Having vacillating
emotions including
anger
• Experiencing hopelessness
• Feeling helpless, powerless
Behavioral Responses
• Experiencing great
restlessness;
searching for the deceased
• Seeking and avoiding
places and activities
once shared with the lost
one
• Functioning
“automatically”
Physiologic Responses
• Headaches
• Insomnia
• Lack of energy
➤ Grieving
A normal response
in the human
experience of loss.
Prep by: Dr. James Malce Alo, RN,MAN,MAPsycho.PhD.
The client will
• Identify the loss and its
meaning for self (adequate
perception)
• Express feelings, verbally
and nonverbally
• Establish and maintain
adequate nutrition, hydration,
and elimination (adequate
coping)
• Establish and maintain an
adequate balance of rest,
sleep, and activity (adequate
coping)
• Establish and maintain an
adequate support system
• Verbalize knowledge of the
grief process
• Demonstrate initial
integration of loss into his or
her life (adequate coping)
• Verbalize realistic future
plans integrating loss
(adequate perception)
EVALUATION
IMPLEMENTATION
Nursing Interventions *denotes
collaborative interventions
After establishing rapport with
the client, bring up the loss in a
supportive manner; if the client
refuses to discuss it, withdraw
and state your intention to return.
(“I can understand that you
may not want to talk with me
about this now. I will come to
talk with you again at 11:00.
Maybe we can talk about it
then.”) Return at the stated time,
then continue to be as supportive
as possible rather than
confronting the client.
Talk with the client realistically
about his or her loss; discuss
concrete changes that the client
must now begin to make as a
result of the loss.
Encourage the expression of
feelings in ways the client is
comfortable—for example,
talking, writing, drawing, crying,
wailing, or yelling. Convey your
acceptance of these feelings and
means of expression. Offer the
client verbal support for attempts
to express feelings.
RATIONALE
Your presence demonstrates
interest and caring. Telling
the client you will return
conveys your support. The
client may need emotional
support to face and express
uncomfortable or painful
feelings. Confronting the
client or pushing him or her
to express feelings may
increase anxiety and lead to
further denial or avoidance.
Discussing the loss on this
level may help to make it
more real for the client.
Expression of feelings can
help the client to identify,
accept, and work through
his or her feelings even if
these are painful or
otherwise uncomfortable for
the client.
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