A new client in the medical-surgical unit complains of difficulty sleeping and is scheduled for an exploratory laparotomy in the morning. The nursing diagnosis is Sleep Pattern Disturbance: Insomnia related to fear of impending surgery. Which step is most appropriate in planning care for this diagnosis?

Provide an opportunity for the patient to talk about concerns

Explanation:

More often than not, details regarding incoming surgeries are unaddressed without any ill intention, but just because the physician is not aware of some of the patient's worries.

In fact a recent study carried on by listening to a series of audio recordings of patient-physician visits provided an insight that also showed that some behaviors in the pre-op consultation lead to the patient not disclosing all of his/her concern. For example, physicians often redirect patients at the beginning of the visit, giving patients less than 30 seconds to express their concerns.

By including the patient in the decision making process, showing empathy, giving clinical recommendations, going through the surgery's agenda with the patient, and giving the patient time and patience to talk about concerns, the pre-op fear will be reduced and even the post-op treatment has more chances of being completed to the letter.