Disturbed Body Image NCP

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Cebu Normal University College of Nursing

NURSING CARE PLAN IN PSYCHIATRY AS A NURSING SPECIALTY
Name of student: _______________________________________________ Date of Exposure: ___March 4-8, 2013________ Yr. & Section: __________III-A_____________________________________ Area of exposure: ___Seven Sisters Servants of Mary Home of Elderly___ Client Initials: __________________________________________________ Date of Submission: ___March 8, 2013________ Diagnosis: _________________________________________________________________________________________________________________________ Doctor: ___________________________________________________________________________________________________________________________ PHASE OF NURSE-CLIENT RELATIONSHIP: Working Phase PROBLEM/CUES: SUBJECTIVE:
- “Naai puti2x sa ako mata dong. Wa pa man unta ni sauna." as verbalized - "Naai burot ako tiil. Arthirits daw ni." as verbalized - “ Naay bugon-bugon akng dunggan” as verbalized Disturbed Body Image related to significance of body part or functioning with regard to age.

NURSING DIAGNOSIS

OUTCOME NURSING STRATEGIES CRITERIA SHORT TERM INDEPENDENT NURSING FUNCTION (10): Physical GOAL:
After 8 hours of nursing intervention, client will be able to: -Verbalize understanding of body changes - Seek information and actively pursue growth I: Discuss pathophysiology present and/or situation affecting the members of the community R: Allows understanding of the current situation S: Doenges, 2010 I: Assist in correcting underlying problems R: To promote optimal adaptation S: Doenges, 2010 I: Determine ethnic background and cultural and religious perceptions or considerations R: May influence how individual deals with the situation S: Doenges, 2010 I: Encourage to look at/touch affected part R: To begin to incorporate changes into body image S: Doenges, 2010 Psychological I: Determine whether condition is permanent with no expectation for resolution. R: There is always something that can be done to enhance acceptance, and it is important to hold out the possibility of living a good life

EVALUATION Day 1: Orientation Phase
After 8 hours of nursing intervention, client was able to: - Verbalize understanding of body changes -“Paita aning maniguwang na ta” as verbalized

Day 2: Working Phase
After 8 hours of nursing intervention, client was able to: - Seek information “Unsay naa sa pagkatiguwang nganong naingani ni siya?” as verbalized.

OBJECTIVE:
- Change in ability to estimate spatial relationship of body to the environment noted - Change in social involvement noted -Low frustration tolerance noted - Constant monitoring of the affected body part noted

LONG GOAL:

TERM

Day 3: Working Phase
After 8 hours of nursing intervention, client was able to: - Verbalize acceptance of situation -“Dawaton na lang ta ni kay

After 40 hours of nursing intervention, client will be able to: - Verbalize relief of anxiety and adaptation to actual/altered body

THEORETICAL BASIS: “The image of physical self,
or body image, is how a person perceives the size appearance, and functioning of the body and its parts. Body image has both cognitive and affective aspects. The cognitive is the knowledge of the material body; the affective includes the sensations of the body such as pain, pleasure, fatigue, and physical movement. Body image is the sum of these attitudes, conscious and conscious, that a person has toward his or her body. The person who has a disturbance in body image may hide or not look at or touch a body part that has significant changes in structure. Some individuals may also express feelings of helplessness, hopelessness, and vulnerability, and may exhibit self-destructive behaviors such as over- or under-eating or suicide attempts.” (Kozier, et. al., 2007)

image - Verbalize acceptance of situation -Acknowledge self as an individual who has responsibility for self.

S: Doenges, 2010 I: Evaluate client’s level of knowledge of and anxiety related to situation. Observe emotional changes. R: May indicate acceptance or non-acceptance of the situation S: Doenges, 2010 I: Note signs of grieving or indicators of severe or prolonged depression R: To evaluate need for counseling and/or medications S: Doenges, 2010 I: Note withdrawn behavior or use of denial. R: May be normal response to situation or may be indicative of mental illness (e.g. schizophrenia) S: Doenges, 2010 Therapeutic Communication I: Visit client frequently and acknowledge the individual as someone who is worthwhile R: Provides opportunities for listening to concerns and questions. S: Doenges, 2010 I: Encourage verbalization and of role-play of anticipated conflicts R: To enhance handling of potential situations S: Doenges, 2010 I: Listen to client’s comments and responses to the situation R: Different situations are upsetting to different people, depending on individual coping skills and past experiences. S: Doenges, 2010 Spiritual I: Encourage client to continue spiritual/religious activities like praying. R: Promote spiritual wellness S: Doenges, 2010

mao man ning gihatag sa ginoo” as verbalized

Day 4: Phase

Terminating

After 8 hours of nursing intervention, client was able to: - Acknowledge self as an individual who has responsibility for self. - “Ako lay kuha ana” as verbalized.

DEPENDENT NURSING FUNCTION (1):
I: Monitor drug regimen if prescribed. R: Anti-depressants may be prescribed if signs of severe depression are present S: Doenges, 2010

COLLABORATIVE NURSING FUNCTION(1):
I: Refer client to counseling for help adjusting to body image. R: Counseling is important for a client who is trying to create a new body ideal or work through a grief process S: Doenges, 2010

BIBIOGRAPHY:

* Doenges,M.E; Moorshouse,M.M; Murr.A.C. 2010. Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales .10th edition. F.A. Davis
Company. Philadelphia, Pennsylvania page 625 – 647. * Kozier, B.; Erb, G. L.;Berman, A.; Snyder, S.J..2007. Kozier and Erb’s Fundamentals of Nursing: Concepts, Process, and Practice. 8th edition. Pearson Education South Asia Pte Ltd. Page 808. * Seeley, R,R,; Stephens, T.D.; Philip, T. 2007. Essential’s of Anatomy and Physiology. 6th edition. McGraw Hill(Singapore) page. 150 * Smeltzer, S.C.; Bare, B.G.; Hinkle, J.L.; Cheever, K.H.2010. Brunner and Suddarth’s Textbook of Medical-Surgical Nursing. 12th edition. Lippincott Williams and Wilkins. Page 1309. * Varcarolis, E.M.2007.Manual of Psychiatric Nursing Care Palns: Diagnoses, Clinical Tools and Psyschopharmacology.3rd edition.Elsevier(Singapore) Pte Ltd. Pages 109-112

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