Help with PhsychosocialDx/ Careplan

[hope4ccns]

Hello I am working on a careplan and need 1 more diagnosis. My problem is that I can't figure which is the right one for my patient!

My patient suffers from MS and has had an acute exacerbation causing full body weakness and malaise. I have 3 Dx already but I need 1 more with, goals, 5 interventions, and rationales.

While completing my assessment my patient stated that his wife walked on out on him a few months back and he's still trying to deal with it all. He wouldn't tell me why other than "she'd had enough" He explained to me that that he doesn't have much of a support system and feels alone. He has a roommate who works a lot and leaves for 4 months out of the year. He has a sister that lives an hour away and some friends that are good but "busy with their own lives". He seems to have a reasonable understanding of his disease and what triggers an exacerbation.

I was hoping to find a Dx based on this info.

These are the nursing diagnosis that I'm struggling with

Interrupted family process - looking at the rationales and goal examples it seems that since the wife is completely out of the picture this may not be the right Dx

Risk for loneliness- again looking at the book it does't seem to fit

Hopelessness - I don't fel like he was hopeless just sad

What I would like is risk for depression - which is not a real Dx.

Maybe I'm completely off and it should be innefective coping

I feel like my post makes no sense!

Any advice please help!

Thank you!

[Esme12, ASN, BSN, RN]

Interrupted Family Processes

NANDA-I Definition: Change in family relationships and/or functioning

Interrupted family processes occur as a result of the inability of one or more members of the family to adjust or perform, resulting in family dysfunction and interruption or prevention of development of the family. Family development is closely related to the developmental changes experienced by adult members. Over time, families must adjust to change within the family structure brought on by both expected and unexpected events, including illness or death of a member, and/or changes in social or economic strengths precipitated by divorce, retirement, and loss of employment. The addition of new family members through birth or adoption may require adaptation to new roles and status for existing family members. Health care providers must also be aware of the changing constellation of families: gay couples raising children, single parents with children, older grandparents responsible for grandchildren or foster children, and other situations.

Your answer is in what you posted.......

patient stated that his wife walked on out on him a few months back and he's still trying to deal with it all. He wouldn't tell me why other than "she'd had enough" He explained to me that that he doesn't have much of a support system and feels alone.

[nurseprnRN, BSN, RN]

Esme's got a good one for ya.

You might also take a look at your NANDA-I 2012-2014 pages 393-412, Domain 10, Life Principles. This is where you find things like readiness for enhanced hope, spiritual distress/risk for spiritual distress, and readiness for enhanced spiritual well-being. See if some of their defining characteristics match what you have assessed in him-- if so, you have several good choices.

Also look at Domain 12, Comfort, pages 473-480. Here you'll find the following in Class 3, Social comfort: impaired comfort, readiness for enhanced comfort, and social isolation. Ya think?

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