Psychosocial problems and care plans

  1. 0
    I am currently looking after a patient with Alzheimer's, Parkinson's, and multiple past CVAs. Patient has expressive aphasia and only responds to loud auditory stimuli. What kinds of psychosocial diagnoses would work here? I was thinking-
    Powerlessness r/t helplessness aeb inability of client to express himself

    But thats the best I can come up with (I'm not even sure that one is right) and I need two. Should I pull out disturbed energy field?
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  4. 0
    Impaired communication, ineffective family/individual coping, self care deficit,
  5. 0
    Ahhh, right communication...duh! Is self care deficit considered psychosocial?
  6. 0
    Do these work?

    1. Disturbed thought processes- Impaired ability to perform activities of daily living r/t dementia a.e.b. impaired ability to perform activities of grooming/hygiene.


    2. Powerlessness r/t chronic illness and dependence on others for activities of daily living a.e.b. inability of client to express himself.
  7. 0
    diagnosing is based upon the symptoms the patient has that will support a diagnosis. (a diagnosis is a label for a problem and the symptoms are evidence of the problem.) expressive aphasia, only responding to loud auditory stimuli and the inability of client to express himself are evidence of a communication problem which is generally considered a safety issue although nanda places communication in a psychosocial category. that does not mean your instructors agree with that. in order to diagnose a psychosocial problem you need evidence of what might be considered abnormal behavior. look at the defining characteristics for powerlessness (they are listed on this webpage: powerlessness. it has to do with self-perception and a physical inability to speak is not exactly the kind of symptom that defines what powerlessness means. since this diagnosis is about a psychological problem your symptoms need to be of a psychological nature. the assessment data you collected in a head to toes assessment isn't going to work here. how does he behave as a result of being unable to express himself?


    a long time ago i listed the nanda breakdown of the psychosocial diagnoses from the taxonomy and posted them on post #145 of this sticky thread: http://allnurses.com/nursing-student...lp-170689.html - desperately need help with careplans. here is the list:


    class: behavior
    • ineffective health maintenance
    • health-seeking behaviors
    • noncompliance
    • effective therapeutic regimen management
    • ineffective therapeutic regimen management
    • ineffective community therapeutic regimen management
    • ineffective family therapeutic regimen management
    • readiness for enhanced therapeutic regimen management
    class: communication
    • impaired verbal communication
    • readiness for enhanced communication
    class: coping
    • risk-prone health behavior
    • decisional conflict
    • ineffective coping
    • ineffective community coping
    • readiness for enhanced community coping
    • defensive coping
    • compromised family coping
    • disabled family coping
    • readiness for enhanced family coping
    • ineffective denial
    • grieving
    • complicated grieving
    • risk for complicated grieving
    • post-trauma syndrome
    • risk for post-trauma syndrome
    • rape-trauma syndrome
    • rape-trauma syndrome: compound reaction
    • rape-trauma syndrome: silent reaction
    • relocation stress syndrome
    • risk for relocation stress syndrome
    • self-mutilation
    • risk for self-mutilation
    • risk for suicide
    • risk for self-directed violence
    • readiness for enhanced coping
    • stress overload
    • readiness for enhanced decision making
    class: emotional
    • anxiety
    • death anxiety
    • fear
    • hopelessness
    • chronic sorrow
    • readiness for enhanced hope
    class: knowledge
    • deficient knowledge (specify)
    • readiness for enhanced knowledge (specify)
    class: roles/relationships
    • risk for impaired parent/child attachment
    • caregiver role strain
    • risk for caregiver role strain
    • parental role conflict
    • dysfunctional family processes: alcoholism
    • interrupted family processes
    • impaired parenting
    • risk for impaired parenting
    • ineffective role performance
    • impaired social interaction
    • social isolation
    • risk for other-directed violence
    • readiness for enhanced family processes
    • readiness for enhanced parenting
    class: self-perception
    • disturbed body image
    • disturbed personal identity
    • risk for loneliness
    • powerlessness
    • risk for powerlessness
    • chronic low self-esteem
    • situational low self-esteem
    • risk for situational low self-esteem
    • readiness for enhanced self-concept
    • readiness for enhanced power
    • risk for compromised human dignity
    some of these (and the taxonomy information for them) can be found on these websites:
    if you have a copy of taber's cyclopedic medical dictionary all the diagnoses, their taxonomy information and a medical diagnosis cross reference is included in its appendix.

    use the defining characteristics that are listed under some of these diagnoses as a guideline for what you need to look for in this patient.
  8. 0
    He doesn't really react at all, that's part of the problem I'm having trying to work through this. My patient doesn't respond to much at all.
  9. 0
    Quote from Goldenatom
    He doesn't really react at all, that's part of the problem I'm having trying to work through this. My patient doesn't respond to much at all.
    So, what is that in terms of assessment? How does the patient make their needs known to you? (I'm trying to help you get to a diagnosis.)
  10. 0
    Well, the patient doesn't really let his needs be known. He's totally dependent for his ADLs. He needs loud auditory stimuli to be roused and falls asleep constantly, even during feedings.
  11. 0
    Quote from Goldenatom
    Well, the patient doesn't really let his needs be known. He's totally dependent for his ADLs. He needs loud auditory stimuli to be roused and falls asleep constantly, even during feedings.
    So, what is that behaviorally? Look at the list I posted for you. Look, specifically at diagnoses listed under Roles & Relationships and Self-Perception. It's there.
  12. 0
    Social isolation? Risk for compromised human dignity?


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