PRESENTING PROBLEMS / BEHAVIORS (continued) Current Affect:  Appropriate  Blunted  Flat  Inappropriate  Current Affect Comments: (Elaborate on current affect). What Upsets Client / Behavioral Triggers:  Authority conflicts  Being ignored  Being touched    Boredom Certain time of year Darkness  Delay of request  Delusions  Hearing voices    Invasion of privacy Loss of property Noise    Other people talking about me Pain / Discomfort Personal space /  Provoked / Teased  Task demand  Other (specify) Behavioral Triggers Comments: (Include client responses. Include special examples if known). Behaviors When Triggered:    Bite Cry Curse    Destroy property Fight Get away  Hit people  Hit things  Isolates self    Kicks people Kicks things Pacing  Self-Injurious behavior  Spits  Throws    Throws things Yells Other (specify) Triggered Behavior Comments: (Include specific examples if known). What Have You Tried That Helps You Calm Down or Cope?    Drugs / Alcohol Journaling Listen to music  Meditation / Deep breathing  Pray  Self-Injurious    Smoke Talk about it Walk / Exercise  Other (specify) Coping Comments: (Include effectiveness of coping skills). 12
PRESENTING PROBLEMS / BEHAVIORS (continued) Current Affect:  Appropriate  Blunted  Flat  Inappropriate  Current Affect Comments: (Elaborate on current affect). What Upsets Client / Behavioral Triggers:  Authority conflicts  Boredom  Delay of request  Invasion of privacy  Other people talking about me  Provoked / Teased  Being ignored  Certain time of year  Delusions  Loss of property  Pain / Discomfort  Task demand  Being touched  Darkness  Hearing voices  Noise  Personal space /  Other (specify) Behavioral Triggers Comments: (Include client responses. Include special examples if known). Behaviors When Triggered:  Bite  Destroy property  Hit people  Kicks people  Self-Injurious behavior  Throws things  Cry  Fight  Hit things  Kicks things  Spits  Yells  Curse  Get away  Isolates self  Pacing  Throws  Other (specify) Triggered Behavior Comments: (Include specific examples if known). What Have You Tried That Helps You Calm Down or Cope?  Drugs / Alcohol  Meditation / Deep breathing  Smoke  Other (specify)  Journaling  Pray  Talk about it  Listen to music  Self-Injurious  Walk / Exercise Coping Comments: (Include effectiveness of coping skills). 12
54575%20(1-11)%20cws%20nursing%20initial%20assessment.docx