Cues

Nursing Diagnosis Fear related to known progression of pathologic condition as evidenced by verbal reports of panic.

Rationale

Goals and objectives After 30 minutes of nursing intervention, the patient should: Discuss her fears Identify her own coping response Recognize effective and ineffective coping patterns.

Interventions

Ratioale

Evaluation

Subjective: E anong mangyayari dun sa nakapa nila sa kaliwa (breast)? Magagawan bay un ng paraan? As stated by the patient. Objective: Increase wariness Impulsiveness Increased perspiration Pupil dilatation Changes in voice pitch Hand/ arm movements Worried facial expression

Upon palpation of left breast (Admission), a mass of less than 1cm was palpated and was considered as benign. It is an indication of another form of breast cancer or it could be a product of the right breast cancer cells metastasis. Fear is triggered by the stimulation of the amygdala then travels in to the brain structures which results to the manifestation of signs and symptoms.

Reduce or eliminate contributing factors (Environmental factors, voice)

Factors (Environment, voice) causes stress to the patient so minimizing the contributing factors, decrease the risk of intensifying fear thus promoting relaxation and improve body functions of the patient. This provides social support that is needed by the patient. A person who experiences fear is always at risk of harming herself or himself so staying with the patient decreases the risk for possible injury or harm. Its the duty of the nurses to decrease the fear or anxiety felt by the patient and usually, verbal communication is the key to fulfill this role. Also, this enhances the relationship between the nurse and the patient because active listening signifies the willingness to help; and through their conversation, ideas will be improved and misconceptions will be corrected.

After 30 minutes of nursing intervention, the patient was able to: Discuss her fears Identify her own coping response Recognize effective and ineffective coping patterns.

Stay with the patient until fear subsides or have someone else to be there.

Encourage expression of feeling and be available for active listening

-Goal met

Discuss the normalcy of fear

During the conversation, patients tend to focus on themselves and their concern. As nurses, discussing the normalcy of fear somehow provides a relief to the patient thereby decreasing fear and anxiety of the patient. Also, by doing so, it allows awareness of the reality of situation. Fear is part of the neurological activity of the brain and also it acts as the minds reaction to stimuli. Not all of our bodys activity is controllable or voluntary (hand movements etc.) and fear is one of those uncontrollable. Like the pumping action of the heart, transmission of impulses from one focus to another is uncontrollable. By being aware of this, the patient can strengthen his/ her control and will decrease fear and anxiety. Demonstrating methods to the patient allows effective learning for the patient. Proper execution of methods is needed to solve fear as well as its manifestations. This also

Promote patients control and also help patient accept things that are uncontrollable (e.g. fear)

Demonstrate methods that can increase patients level of comfort

encourages the patient to assess if the she/ he can perform the methods accurately. Instruct in using relaxation/ visualization and guided imagery. Fear is always present in patients confined in the hospital so moral support and relaxation techniques are the only ones which can decrease it. This instruction can promote wellness and it serves as a way of assisting patients because as patient gains knowledge, sense of control is becoming strong and the likeliness of fear management is high.