mg1982. . .you need to review some of the information that is contained in these threads:
the process of writing any care plan or nursing diagnosis begins with collecting assessment data and grouping it into nursing diagnoses. i'm assuming this is a case scenario and not a real person. you are therefore restricted by the information you have been given. the facts you have are the following:
- 24 year old male heroin addict
- clean for 30 days
- fired from his job because of stealing money
- said he wanted to quit (his job? what is it he wants to quit?)
- just found out that his girlfriend was pregnant
they bring up several questions in my mind.
first of all, you need to go and look up the signs and symptoms as well as the treatment for heroin addiction and withdrawal. although the patient has been drug-free and has gone through physical detox, he's not out of the woods yet. so, you need to find that information about the long-term treatment and effects of drug addiction and withdrawal. i'd give them to you, but i really am not that familiar with all of them.
next, you say he was fired from his job for stealing money. that puts him in the criminal justice system. so, he is going to have to deal with that. it also indicates that he probably has financial problems of some sort. if this were a real person, i would have spoken with him about his feelings and anticipation about what was going to happen to him as a result of his crime. most people are usually pretty shook up about the idea of possibly going to prison.
then, you say he wanted to quit. quit what? the job? he's already been fired from his job. the only thing left that i could think of was that maybe he wants to quit life which means he might be thinking about suicide. that might be a very feasible likelihood with a recently detoxed heroin addict who is now facing criminal charges and a pregnant girlfriend. these are situational life crises. if he doesn't have the skills to cope with these situations then a number of things are likely to happen. he could start reusing heroin again. this is why i recommend that you look at the signs and symptoms of heroin detox and withdrawal. i do know that suicide is a common problem with the addicted crowd (i used to work on a alcohol detox unit). so, i think that suicide might be a very likely possibility to consider here. sometimes when people are considering offing themselves, their initial pleas for help are very vaguely disguised. is is possible that he may have just dropped a bomb like this on you and you missed it? if so, then you've got a more serious problem here which is a threat of him doing harm to himself.
the problem with the girlfriend being pregnant is a problem, to be sure, but is low in priority to the others. i wouldn't start pulling out family related nursing diagnoses because in this day and age he may not be the father of that baby. it could also be his reason to live, as well as to die.
my suggestions for nursing diagnoses, in order of priority, are:
- hopelessness r/t potential loss of freedom aeb being caught stealing money from his job and learning his girlfriend is pregnant
- ineffective coping r/t situational crisis aeb inappropriate solving of financial problems by stealing money
- risk for suicide r/t being a young adult male with a history of heroin abuse and statement that he "wants to quit"
hope this helps you understand more of the critical thinking that needs to go into the nursing process.
welcome to allnurses!