help with psychosocial diagnoses

[namita]

hello every one,

I am having problem with psychosocial diagnosis. The patient has DepressiveDisorder , reported suicide ideation and multiple plan to kill; also has Polysubstance dependence and reported that has been taking opiate and benzodiazepine more than prescribed "to feel better". also has Osteogenesis Imperfecta a congenital connective tissue disorder of bone also called "brittle bone disease' and has to go 21 surgeries in hip and legs. I came up with these diagnoses:

Psychosocial:

1)risk for self directed violence r/t suicide ideation and plan aeb pateint verbalizing multiple plans to "kill" himself

( My instructor told us to use r/t and AEB for 'risk for' diagnosis too. STRANGE isn't it)

2) ineffective coping r/t inadequate coping skills and inadequate ability to cope with stress aeb substance dependence and patient stating "I can't take it anymore"

For above diagnosis can I use "situational crisis" as related factor?

3)social isolation r/t ??? aeb not participating in group activities and eating alone and not going in cafetaria, and homebound,

Can I use fear of rejection coz patient gets panic attack whenever he has to go out of his house so he stays home bound and states "I can't go out side and have any fun." NEED HELP

4)chronic Low self esteem r/t negative view of self aeb patient stating "I am tired of always feeling bad."

Phyical diagnosis;

1)Impaired physical immobility r/t:uhoh3: musculoskeletol impairement in lower extremities secondary to genetic bone disorder(not allowed to use medical diagnosis of 'osteogenesis imperfecta')aeb low muscle tone in extremities and inability to ambulate effectively without crutches

NEED HELP in related factor for above diagnosis

2) risk Risk for Imbalanced Nutrition: Less than Body Requirements r/t physiologic response to stress AEB reported loss of appetite by patient

[~PedsRN~, BSN, RN]

How about plain old anxiety?