Friday, September 6, 2013

Anxiety related to Laparotomy

Nursing Care Plan for Laparotomy - Nursing Diagnosis : Anxiety


A laparotomy is a surgical incision (cut) into the abdominal cavity. This operation is performed to examine the abdominal organs and aid diagnosis of any problems, including abdominal pain. In many cases, the problem – once identified – can be fixed during the laparotomy. In other cases, a second operation is required. Another name for laparotomy is abdominal exploration.

Anxiety

A vague, uneasy feeling of discomfort or dread accompanied by an autonomic response, with the source often nonspecific or unknown to the individual; a feeling of apprehension caused by anticipation of danger. It is an altering signal that warns of impending danger and enables the individual to take measures to deal with threat.

Defining Characteristics:

Behavioral

  • Diminished productivity;
  • scanning and vigilance;
  • poor eye contact;
  • restlessness;
  • glancing about;
  • extraneous movement (e.g., foot shuffling, hand/arm movements);
  • expressed concerns resulting from change in life events;
  • insomnia;
  • fidgeting

Affective
  • Regretful;
  • irritability;
  • anguish;
  • scared;
  • jittery;
  • overexcited;
  • painful and persistent increased helplessness;
  • rattled;
  • uncertainty;
  • increased wariness;
  • focus on self;
  • feelings of inadequacy;
  • fearful;
  • distressed;
  • apprehension;
  • anxious

Physiological
  • Voice quivering

Objective
  • Trembling/hand tremors; insomnia

Subjective
  • Shakiness; worried; regretful


Nursing Diagnosis for Laparotomy : Anxiety related to surgical procedure, preoperative procedures.

Outcomes:
  • Patients will demonstrate the ability focus on new knowledge and skills.
  • Identification of symptoms as an indicator of anxiety itself.
  • Showed no aggressive behavior.
  • Communicating and handling negative feelings appropriately.
  • Relaxed and comfortable in the move.

Interventions and Rational :
1. Monitor patient's signs and symptoms of anxiety while nursing assessment.
R /: Assessment of patients with anxiety conditions carefully allows nurses to make nursing priorities.

2. Focus discussion on stressors that affect the condition of the patient.
R /: Focus discussion facilitates the ability of the patient to express fears and feelings are felt and build a therapeutic relationship.

3. Discuss the patient's perception will be a surgical procedure, the fear associated with the operation.
R /: Discussion will make the patient's perception and fear to express themselves and explore self-knowledge.

4. Provide information procedure before surgery, the patient's illness and surgery preparation
R /: Measures to increase knowledge and anxiety reduction.

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