Nursing Diagnoses for the Bi Polar, Manic patient

  1. Can anyone give me some idea for a few nursing diagnoses for the manic patient I can use in my case study or maybe help with the ones I've already come up with?

    Risk for injury related to inablility to sleep

    Risk for violence: other-directed related to delusional thinking secondary to Post Traumatic Stress Disorder

    any ideas?

    Thanks in advance!
  2. 1 Comments

  3. by   Daytonite
    you have no actual problems listed. when care planning you need to assess the patient first to determine what their abnormal data (symptoms) are. if the patient is bipolar and in a manic phase, there are symptoms of it. what are they? these symptoms are evidence of the nursing diagnoses you will use.
    • excessive and constant physical activity (impaired social interaction)
    • poor judgment
    • lack of sleep/rest
    • poor food intake; too distracted to eat; groom, etc (imbalanced nutrition, self-care deficits)
    • they are loud, use profanity excessively, aggressive, overly demanding
    • intrusive
    • taunting
    • are unable to control their behavior (ineffective coping)
    • go into rages/anger easily
    • manipulative (defensive coping)
    • have grandiose thoughts (disturbed thought processes)
    • jump from topic to topic when speaking (impaired verbal communication) - bipolar disorders

    follow the steps of the nursing process in sequence as they occur when care planning:
    • assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
      • a physical assessment of the patient
      • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
      • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
      • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.
      • - medical disease information/treatment/procedures/test reference websites
    • determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
      • it helps to have a book with nursing diagnosis reference information in it. there are a number of ways to acquire this information.
      • your instructors might have given it to you.
      • you can purchase it directly from nanda. nanda-i nursing diagnoses: definitions & classification 2007-2008 published by nanda international. cost is $24.95
      • many authors of care plan and nursing diagnosis books include the nanda nursing diagnosis information. this information will usually be found immediately below the title of a nursing diagnosis.
      • the nanda taxonomy and a medical disease cross reference is in the appendix of both taber's cyclopedic medical dictionary and mosby's medical, nursing, & allied health dictionary
      • there are also two websites that have information for about 75 of the most commonly used nursing diagnoses that you can access for free:
    • planning (write measurable goals/outcomes and nursing interventions)
      • goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. they have the following overall effect on the problem:
        • improve the problem or remedy/cure it
        • stabilize it
        • support its deterioration
      • interventions are of four types
        • assess/monitor/evaluate/observe (to evaluate the patient's condition)
          • note: be clear that this is assessment as an intervention and not assessment done as part of the initial data collection during step 1.
        • care/perform/provide/assist (performing actual patient care)
        • teach/educate/instruct/supervise (educating patient or caregiver)
        • manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)
    • implementation (initiate the care plan)
    • evaluation (determine if goals/outcomes have been met)