Nursing Care Plan - ESSAYS ON BIPOLAR DISORDER THAT USE FOR RESEARCH PDF

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ESSAYS ON BIPOLAR DISORDER THAT USE FOR RESEARCH...

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NURSING CARE PLAN NO. 5 NEED/PROBLEM/NURSING DIAGNOSIS:

RATIONALE:

1. Liable Affect/Alteration in Affect Why? 1. Depression 2. psychosis 3. personality disorder 4. anger 5. guilt 6. frustration 7. decreased self-esteem 8. ineffective individual coping 9. anxiety 10. psycho-social stressors 11. environmental stressors 12. loneliness 13. helplessness 14. inappropriate expressions of feelings 15. pregnancy 16. birth of child 17. hormonal imbalance

GOAL: 1. To minimise moods swings 2. Promote and maintain appropriate affect 3. Promote and maintain positive self image.

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NURSING CARE PLAN NO. 5

STRATEGY:

RATIONALE:

1. Assess level of mood/affect to obtain baseline data. 2. Assess the cause if the liability i.e. Is the moods swing a reaction to something, someone. 3. Isolate the cause of the liability i.e. Remove stimuli from patient or patient from stimuli.

Establishment of a cause for a labile affect will lead to successful nursing intervention in trying to assist patient to stabilise their mood. Removing the cause of the liability will enable the patient to maintain a constant affect.

STRATEGIES 4. Encourage patient to ventilate feelings by being approachable, honest, caring, warm. This also establishes and maintains a therapeutic relationship.

This assists patient to identify prominent feelings. The nurse being approachable etc will encourage the patient to talk to her/him. The establishment of a therapeutic relationship increases the likelihood that the patient will develop trust in you. A therapeutic relationship will facilitate the initiation of patient interaction with you.

5. Acknowledge, but do not agree with unrealistic or negative expectations and thoughts. 6. Encourage patient to make statements that are positive about self. 7. Listen carefully and nonjudgementally to expression of feelings. 8. Show respect for patient.

Conveys to patient that you understand how they feel but that you do not agree with them.

Alters patients negativism about self. This aids your patient in feeling safe and not judged when they are expressing feelings. Conveys to the patient that s/he has worth and value. Patients with labile affect (especially due to depression) often feel worthless and of no value.

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NURSING CARE PLAN NO. 5 RATIONALE: 9. Encourage patient to identify and verbalise feelings as they are experienced. To identify suicide rise, plans, previous attempt.

This aids the patient to clarify what is factual information rather than perceived ideas and notions.

10. Provide structure in the environment with opportunity to participate in meaningful activities.

This keeps the patient busy and prevents preoccupation with self.

11. Encourage patient to assume responsibility for own feelings.

Prevents dependence on others.

12. Show acceptance through touch (within limits acceptable to patient).

Demonstrates warmth and caring and promotes feelings of self worth.

13. Provide encouragement and opportunity for regular exercise.

14. Reinforce assumption of responsibility for ADLs.

Increases energy level and fitness, prevents preoccupation with self.

Encourages patient to take responsibility for ADL’s, helps patient to maintain self respect, and esteem and encourages independence. It also promotes general health and well being.

15. Encourage recognition of negative thoughts and beliefs.

Allows clarification of misconceptions by supplying accurate information.

16. Assist patient in distinguishing between thoughts and feelings.

Helps the patient clarify what is fact and what is feeling so that distorted facts (perceptions) can be questioned and feelings can be identified.

17. Teach patient to replace self criticisms and negative thoughts with positive self-affirmations.

This helps the patient to be kind and gentle to self.

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NURSING CARE PLAN NO. 5

18. Divert attention from preoccupations with painful feelings. 19. Help patient recognise illogical conclusions drawn from negative thoughts and painful feelings. 20. Encourage patient to indulge in pleasant sensations (listening to music, massage). 21. Assist patient to focus in on the present. 22. Help the patient identify personal strengths, assets and accomplishments. 23. Focus attention on daily progress and recognise all performance gains. 24. Assist patient to set small achievable goals that are directly relevant to patients needs and to develop plans of action. 25. Discuss with the patient situations, events or changes that seem to be associated with the labile affect. 26. Make decisions for the patient when necessary.

This prevents the patient from ruminating.

Promotes realistic thinking.

Prevents the patient from making inappropriate decisions because of impaired judgement associated with labile affect.

27. Encourage recognition if what patient can control.

Presents the patient from making inappropriate decisions.

28. Provide group therapy.

Assist patients in interacting with others, to listen and empathise with other problems, and to receive support and encouragement from others.

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NURSING CARE PLAN NO. 5

29. Discuss with patient consequences of the various behaviours they exhibit.

Helps patient recognise effects of their behaviour on others and learn more satisfying ways to relate to people.

30. Assist patient in recognising that other people will not always be there and willing to meet their needs.

Presents reality.

31. Teach patient healthy ways to deal with criticism from others

Prevents patient from accepting criticism at face value and therefore reinforcing a negative view of themselves.

32. Provide opportunities for patient to be creative.

Helps patient express feelings through creativity and expands their cognitive abilities.

33. Help client direct attention outside themselves and their immediate concerns.

Prevent self absorption.

34. Dispense appropriate medications and administer to patient ensuring they do not default. 35. Encourage family visits and involvement. 36. Report and record all findings.

Mood stabilising medications will alleviate labile affect. Ensuring the patient does not default, make sure that the patient receives the correct medication.

CRITERIA: 1. Mood swings minimised as evidenced by affect stable and consistent. 2. Self esteem increased as evidenced by: • Client stresses they feel better • Maintains eye contact • Erect posture • •

Good personal hygiene Tidy appearance

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