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Help please with care plans

Posted

Could someone please help me with 5 interventions for the following (2) nursing diagnosis for a 90 y/o woman at a nursing home.

Social isolation r/t depression AEB client does not socialize nor participate in activities. The physician had to D/C her AROM due to non-participation.

Goal: Resident will participate in group activities for 30 minutes on my 7AM- 2:30 PM shift

Ineffective coping r/t anxiety AEB trembling of one or both upper extremities during physical assessments causing interference with independent management of ADL.

GOAL: Resident will be relaxed & free from tremors for 30 minutes while I perform my physical assessments.

ALL ADVISE IS WELCOMED. THANKS A LOT!!!!

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

you've got major problems with the construction of your diagnoses. until you correct them you can't even begin to work on your goals and nursing interventions.

social isolation r/t depression aeb client does not socialize nor participate in activities. the physician had to d/c her arom due to non-participation.

depression
is not a related factor (cause) of social isolation but a result, or symptom, of it. the reason for the isolation needs to be because the client misbehaves in groups, is so hideous to look at that others shun them, is too ill to attend groups, doesn't act their age, or doesn't act appropriately.
client does not socialize nor participate in activities
is merely a restatement of the diagnosis and really has not elaborated, or given any evidence, of the client's symptoms. why, specifically, is it that the client doesn't participate in activities? are activities offered but the resident
refuses
to go or is taken but
asks to leave
?

the physician had to d/c her arom due to non-participation
indicates that the physician evaluated the patient's response to a treatment he had ordered and changed his plan of care when she failed to meet a goal he had set for her.

goal: resident will participate in group activities for 30 minutes on my 7am- 2:30 pm shift

the goal lies in how you approach the problem. since the problem hasn't really been identified, a goal can't really be formulated yet either.

ineffective coping r/t anxiety aeb trembling of one or both upper extremities during physical assessments causing interference with independent management of adl.

if anxiety is at play here, then use the nursing diagnosis of
anxiety
. anxiety cannot be a related factor for
ineffective coping
. trembling is a symptom of the nursing diagnosis of
anxiety
which addresses the physical symptoms of stress and coping, but not of
ineffective coping
which addresses the psychosocial and behavior symptoms of stress and coping. the related factors for
ineffective coping
need to be thing(s) that is(are) a threat or impediment to coping. trembling is
not
a symptom of
ineffective coping
.

goal: resident will be relaxed & free from tremors for 30 minutes while i perform my physical assessments.

since tremors are not a symptom of
ineffective coping
, then this goal is not appropriate to this diagnosis.

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