Document Code No.

CHS/BSN-CURR -RLEFORM-002j
Revision No. Effective Date Page No.
00 02.24.2023 1 of 3

NURSING CARE PLAN

Identified Problem: Loss of a 22-week fetus

Nursing Diagnosis: Risk for maladaptive grieving related to complex emotions and circumstances surrounding the loss of the fetus.
Definition: May refer to NANDA in determining when and when not to use each nursing diagnostic Defining Characteristics:
category, both the definition and defining characteristics should be compared with the client’s set of data
(cues) to make sure that the correct diagnoses are chosen for the client. None
Susceptible to a disorder that occurs after the death of significant other, in which the experience
of distress accompanying bereavement fail to follow sociocultural expectation.

CUES OBJECTIVES INTERVENTIONS RATIONALE EVALUATION

Subjective: Short term: 1. Identify loss that has occurred and meaning to 1. These situations can sometimes cause SHORT-TERM:
After 4 hours of nursing client. Note circumstances of death, such as sudden the individual to become stuck in grief
No subjective cues and unable to move forward with life.
intervention, the patient will or traumatic. PARTIALLY MET:
be able to verbally 2. Education about relaxation techniques
After 4 hours of
acknowledge their feelings of 2.Educate the patient on simple relaxation empowers the patient to manage their nursing intervention,
sadness and loss. techniques, such as deep breathing or guided emotional distress. Deep breathing and patient was able to
imagery. guided imagery can help reduce anxiety partially
and stress, which are common during the acknowledge her
3. Ascertain the response of family/SO(s) to the grieving process. feelings of sadness
client's situation. and loss.
3. Dysfunctional patterns of
communication, such as avoidance,
Objective: Long term: 4. Assess client's ability to manage activities of daily preaching, and giving advice, can block
living and period of time since loss has occurred. effective communication and isolate
No objective cues After 3 days of nursing family members. LONG TERM:
intervention, the patient will 5. Use therapeutic communication techniques to
participate in at least one encourage the patient to share their emotions. 4. Responses of family/SO(s) affect how GOAL MET:
Risk Factors: relaxation or coping activity. client deals with situation. After 3 days of
- Difficulty dealing with nursing intervention,
6. Encourage expression of anger, fear, and anxiety. 5. Therapeutic communication
concurrent crises the patient
techniques, such as active listening, participated in at least
- excessive emotional 7. Assist family/SO(s) to understand and be tolerant open-ended questions, and reflection, one relaxation or
disturbance of client's feelings and behavior. facilitate the patient's expression of their
- High attachment anxiety; low coping activity,
emotions. These techniques help build
attachment avoidance trust and rapport, allowing the patient to
indicating the
- inadequate social support. feel comfortable discussing their grief. initiation of emotional
self-care.
 Document Code No.
CHS/BSN-CURR -RLEFORM-002j
Revision No. Effective Date Page No.
00 02.24.2023 2 of 3

8. Refer to other resources. Provide additional help, 6. These feelings are part of the
when needed. grieving process; to accomplish the
work of grieving, they need to be
expressed and accepted.
9. Refer to mental health providers for specific
diagnostic studies and intervention in issues 7. Family members inadvertently
associated with debilitating grief. hamper client's progress through grief
by expressing their feelings in anger for
10. Permit verbalization of anger with client behavior they deem
acknowledgement of feelings and setting of limits unacceptable rather than recognizing
regarding destructive behavior. the basis is grief.

8. To resolve situation/continue grief

work.

9. To address and assess any

underlying mental health conditions,
such as complicated grief disorder or
major depressive disorder, which may
require specialized treatment and
therapeutic interventions for effective
resolution.

10. Enhances client safety and

promotes resolution of the grief process.
 Document Code No.
CHS/BSN-CURR -RLEFORM-002j
Revision No. Effective Date Page No.
00 02.24.2023 3 of 3

EVALUATION TOOL: NURSING CARE PLAN RUBRIC

UNACCEPTABLE SATISFACTORY EXCEPTIONAL
REMARKS
(1) (3) (5)
Nursing Diagnosis Main Problem is not listed or identified; Identified problem but not the priority Main Problem is listed or identified
need of the patient; with correct related factor
Risk factors/ Subjective and Assessment data are not listed or inadequate to Correct assessment data but lacking Listed all pertinent assessment
Objective Cues support nursing diagnosis important factors to support nursing data more than enough to support
diagnosis the nursing diagnosis
STO and LTO Objectives do not solve/target the identified problem STO and LTO are not SMART STO and LTO are SMART
Nursing Intervention Intervention/s are not appropriate for the patient and Correct Intervention/s but lacking (5-8 Intervention/s (>8 interventions)
does not solve the main problem (<5 interventions) interventions) are correct and appropriate for the
patient.
Evaluation/ Expected Outcome Evaluation or expected outcomes do not measure Evaluation or expected outcomes Evaluation or expected outcomes
the STO and LTO. measure LTO but not the STO. measure and target the STO and
LTO.
Total ___/25