Nursing Care Plan for Elective Termination

Therapeutic abortion may be done to safeguard the woman’s health, or a voluntary abortion may be a woman’s reproductive decision.

NURSING PRIORITIES
1. Evaluate biopsychosocial status.
2. Promote/augment coping strategies.
3. Provide emotional support.
4. Prevent postprocedural complications.
5. Provide appropriate instruction/information.

DISCHARGE GOALS
1. Free of complications following procedure
2. Coping effectively with situation
3. Specific therapeutic needs and concerns understood

Nursing diagnosis: Risk for Decisional Conflict may be related to unclear personal values/beliefs, lack of experience or interference with decision making, lack of relevant sources of information or information from multiple or divergent sources, support system deficit.

Desired Outcomes
1. Acknowledge feelings of anxiety/distress related to making difficult decision.
2. Verbalize confidence in the decision to terminate the pregnancy.
3. Meet psychological needs as evidenced by appropriate expression of feelings, identification of options, and use of resources.
4. Display relaxed manner and/or calm demeanor, free of physical signs of distress.

Nursing care plan intervention with rationale:
1. Ascertain circumstances of conception and response of family/significant other. Encourage client to talk about the issues and process used to problem-solve and make decision regarding termination.
Rationale: Allows the nurse to determine whether the client/couple has explored alternatives. The decision to terminate a pregnancy may have been based on an inability to problem-solve or a lack of support and resources.

2. Note expressions of indecision and dependence on others.
Rationale: May indicate ambivalence about decision and need for further information and discussion.

3. Assist client to look at alternatives and use problem-solving process to validate decision. Involve significant others as appropriate.
Rationale: Helps client to reinforce reasons for decision and to be comfortable that this is the course she wants to pursue.

4. Provide explanations about the procedure desired by the client, pre-procedural and post-procedural tests, examinations, and follow-up.
Rationale: Lack of knowledge about the procedures, reproduction, or self-care may contribute to the client’s/family’s inability to cope positively with this event, which may be behaviorally manifested by the client canceling appointments or verbalizing ambivalence. By eliminating fear of the unknown and by reinforcing reasons for and appropriateness of decision, ongoing verbalization can foster positive decision making.

5. Evaluate the influence of family and significant other(s) on the client.
Rationale: Conflict can arise within the client herself as well as within the family. Allows the nurse to encourage positive forces or provide support where it is lacking.

6. Remain with the client during examinations and the procedure. Provide both physical and emotional support.
Rationale: Physical presence of nurse can help client feel accepted and reduce stress.

7. Act as a liaison and lend support to significant other(s).
Rationale: Helps reduce stress and encourages significant other(s) to be supportive of the client.

8. Review safe options available based on gestation.
Rationale: Assists client in making informed decision.

9. Obtain/review informed consent.
Rationale: Depends on agency guidelines. No procedure should be performed unless the client freely consents to it.

10. Refer for additional counseling or resources, if needed.
Some clients may be more affected by the decision and may require additional support and/or education or genetic counseling.