Nursing Care Plan for Ineffective Coping

Sample of Nursing Care Plan for Ineffective Coping

Nursing Diagnosis: Ineffective Coping

Definition of Ineffective Coping

  • Inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources

Related Factors of Ineffective Coping | Nursing Care Plan for Ineffective Coping

  • Situational/maturational crises

  • High degree of threat

  • Inadequate opportunity to prepare for stressor; disturbance in pattern of appraisal of threat

  • Inadequate level of confidence in ability to cope/perception of control; uncertainty

  • Inadequate resources available; inadequate social support created by characteristics of relationships

  • Disturbance in pattern of tension release; inability to conserve adaptive energies

  • Gender differences in coping strategies

  • [Work overload, no vacations, too many deadlines; little or no exercise]

  • [Impairment of nervous system; cognitive/sensory/perceptual impairment, memory loss]

  • [Severe/chronic pain]

Defining Characteristics of Ineffective Coping | Nursing Care Plan for Ineffective Coping


  • Verbalization of inability to cope or inability to ask for help

  • Sleep disturbance; fatigue

  • Abuse of chemical agents

  • [Reports of muscular/emotional tension, lack of appetite]


  • Lack of goal-directed behavior/resolution of problem, including inability to attend to and difficulty with organizing information; [lack of assertive behavior]

  • Use of forms of coping that impede adaptive behavior [including inappropriate use of defense mechanisms, verbal manipulation]

  • Inadequate problem solving

  • Inability to meet role expectations/basic needs

  • Decreased use of social supports

  • Poor concentration

  • Change in usual communication patterns

  • High illness rate [including high blood pressure, ulcers, irritable bowel, frequent headaches/neckaches]

  • Risk taking

  • Destructive behavior toward self or others [including overeating, excessive smoking/drinking, overuse of prescribed/OTC medications, illicit drug use]

  • [Behavioral changes (e.g., impatience, frustration, irritability, discouragement)]

Desired Outcomes/Evaluation Criteria—Client Will:

  • Assess the current situation accurately.

  • Identify ineffective coping behaviors and consequences.

  • Verbalize awareness of own coping abilities.

  • Verbalize feelings congruent with behavior.

  • Meet psychologic needs as evidenced by appropriate expression of feelings, identification of options, and use of resources.

Nursing Interventions for Ineffective Coping | Nursing Care Plan for Ineffective Coping

NURSING PRIORITY NO. 1. To determine degree of impairment:

  • Evaluate ability to understand events, provide realistic appraisal of situation.

  • Identify developmental level of functioning. (People tend to regress to a lower developmental stage during illness/crisis.)

  • Assess current functional capacity and note how it is affecting the individual’s coping ability.

  • Determine alcohol intake, drug use, smoking habits, sleeping and eating patterns.

  • Ascertain impact of illness on sexual needs/relationship.

  • Assess level of anxiety and coping on an ongoing basis.

  • Note speech and communication patterns.

  • Observe and describe behavior in objective terms. Validate observations.

Nursing Interventions for Ineffective Coping | Nursing Care Plan for Ineffective Coping

NURSING PRIORITY NO. 2. To assess coping abilities and skills:

  • Ascertain client’s understanding of current situation and its impact.

  • Active-listen and identify client’s perceptions of what is happening.

  • Evaluate client’s decision-making ability.

  • Determine previous methods of dealing with life problems to identify successful techniques that can be used in current situation.

Nursing Interventions for Ineffective Coping | Nursing Care Plan for Ineffective Coping

NURSING PRIORITY NO. 3. To assist client to deal with current situation:

  • Call client by name. Ascertain how client prefers to be addressed. Using client’s name enhances sense of self and promotes individuality/self-esteem.

  • Encourage communication with staff/SO(s).

  • Use reality orientation (e.g., clocks, calendars, bulletin boards) and make frequent references to time, place as indicated. Place needed/familiar objects within sight for visual cues.

  • Provide for continuity of care with same personnel taking care of the client as often as possible.

  • Explain disease process/procedures/events in a simple, concise manner. Devote time for listening; may help client to express emotions, grasp situation, and feel more in control.

  • Provide for a quiet environment/position equipment out of view as much as possible when anxiety is increased by noisy surroundings.

  • Schedule activities so periods of rest alternate with nursing care. Increase activity slowly.

  • Assist client in use of diversion, recreation, relaxation techniques.

  • Stress positive body responses to medical conditions but do not negate the seriousness of the situation (e.g., stable blood pressure during gastric bleed or improved body posture in depressed client).

  • Encourage client to try new coping behaviors and gradually master situation.

  • Confront client when behavior is inappropriate, pointing out difference between words and actions. Provides external locus of control, enhancing safety.

  • Assist in dealing with change in concept of body image as appropriate. (Refer to ND Body Image, disturbed.)

Nursing Interventions for Ineffective Coping | Nursing Care Plan for Ineffective Coping

NURSING PRIORITY NO. 4. To provide for meeting psychologic needs:

  • Treat the client with courtesy and respect. Converse at client’s level, providing meaningful conversation while performing care. (Enhances therapeutic relationship.) Take advantage of teachable moments.

  • Allow client to react in own way without judgment by staff. Provide support and diversion as indicated.

  • Encourage verbalization of fears and anxieties and expression of feelings of denial, depression, and anger. Let the client know that these are normal reactions.

  • Provide opportunity for expression of sexual concerns.

  • Help client to set limits on acting-out behaviors and learn ways to express emotions in an acceptable manner. (Promotes internal locus of control.)

Nursing Interventions for Ineffective Coping | Nursing Care Plan for Ineffective Coping

NURSING PRIORITY NO. 5. To promote wellness (Teaching/ Discharge Considerations):

  • Give updated/additional information needed about events, cause (if known), and potential course of illness as soon as possible. Knowledge helps reduce anxiety/fear, allows client to deal with reality.

  • Provide and encourage an atmosphere of realistic hope.

  • Give information about purposes and side effects of medications/treatments.

  • Stress importance of follow-up care.

  • Encourage and support client in evaluating lifestyle, occupation, and leisure activities.

  • Assess effects of stressors (e.g., family, social, work environment, or nursing/healthcare management) and ways to deal with them.

  • Provide for gradual implementation and continuation of necessary behavior/lifestyle changes. Enhances commitment to plan.

  • Discuss/review anticipated procedures and client concerns, as well as postoperative expectations when surgery is recommended.

  • Refer to outside resources and/or professional therapy as indicated/ordered.

  • Determine need/desire for religious representative/spiritual counselor and arrange for visit.

  • Provide information, privacy, or consultation as indicated for sexual concerns.

  • Refer to other NDs as indicated (e.g., Pain; Anxiety; Communication, impaired verbal; Violence, [actual/] risk for other-directed and Violence, [actual/] risk for selfdirected).

Documentation Focus | Nursing Care Plan for Ineffective Coping

ASSESSMENT/REASSESSMENT | Nursing Care Plan for Ineffective Coping

  • Baseline findings, degree of impairment, and client’s perceptions of situation.

  • Coping abilities and previous ways of dealing with life problems.

PLANNING | Nursing Care Plan for Ineffective Coping

  • Plan of care/interventions and who is involved in planning.

  • Teaching plan.

IMPLEMENTATION/EVALUATION | Nursing Care Plan for Ineffective Coping

  • Client’s responses to interventions/teaching and actions performed.

  • Medication dose, time, and client’s response.

  • Attainment/progress toward desired outcome(s).

  • Modifications to plan of care.

DISCHARGE PLANNING | Nursing Care Plan for Ineffective Coping

  • Long-term needs and actions to be taken.

  • Support systems available, specific referrals made, and who is responsible for actions to be taken.

This sample of Medical Surgical Nursing: Nursing Care Plan for Ineffective Coping.