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Discussion

Nursing Dx.

I have a question, I'm working on a care plan for a patient with suicidal ideation. I have one dx already(Risk for Suicide r/t psychosis) Does anyone have any suggestions to a second dx?

Thanks

Tiffany

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I'm not sure that's a nursing dx - I think it would be Risk for Self-Directed Violence. Also try, Ineffective Coping

Mike

  • Experts

any diagnosis has to be based on the assessment information you have gathered about the patient. that is what makes their care structured to them. suicidal ideation is the medical diagnosis. nursing diagnoses are based upon the patient's responses to their medical problems and other things happening to them. medical diagnoses, as well, are always based upon the symptoms a patient is having. a doctor must go through the same process of examination and sorting through data before determining the person's problem (diagnosis) just as nurses do. for nursing diagnosing, the symptoms we look for are not only the same ones the doctors focus on, but also include patients responses to their diseases and conditions as well as their ability to perform their adls. every nursing diagnosis has a list of signs and symptoms (nanda calls them defining characteristics) and before you assign any nursing diagnosis to a patient you should check to make sure that they have one of more of the symptoms listed under a nursing diagnosis. you should also double check the definition of the nursing diagnosis to make sure it is indeed the correct problem that the patient has.

you need to use the nursing process to guide you in this. first, go back and re-examine the assessment data you have on this patient. assessment consists of:

  • a health history (review of systems)
  • performing a physical exam
  • assessing their adls (at minimum: bathing, dressing, mobility, eating, toileting, and grooming)
  • reviewing the pathophysiology, signs and symptoms and complications of their medical condition
  • reviewing the signs, symptoms and side effects of the medications/treatments that have been ordered and that the patient is taking

your next step is to sort out all the abnormal data. it is the abnormal data that are the signs and symptoms of the nursing problems (nursing diagnoses). determine what nursing diagnostic names to attach to them. the third step is to begin planning care by writing goals and nursing interventions.

on the nursing student forums of allnurses is a thread where there are examples showing how to do this: https://allnurses.com/general-nursing-student/help-care-plans-286986.html- help with care plans. if you still are having difficulty doing this first step, ask, or search allnurses as i am positive there has been a care plan question regarding suicide that i have answered in the past.

  • Experts

this is part of the patient assessment. . .

if the patient is psychotic (
risk for suicide r/t
psychosis
), then there are symptoms of psychosis present. what are they? break this disease down into its component signs and symptoms. what symptoms is the patient exhibiting? delusions? hallucinations? loss of contact with reality? erroneous reactions to reality? antisocial behavior? false concepts? the risk for suicide is merely one symptom of this psychosis and the reason for hospitalization (for the person's safety). however, other symptoms are going to be present and need addressing as well. see

  • Experts

so you don't have to do the searching, here are previous threads on care planning regarding suicide that i think would be of interest for you to read. one contains nursing interventions that i recently copied from a mental health textbook that you may find helpful:

i want you to understand how important it is to do the preliminary assessment work before diagnosing. diagnosing is not guesswork and is based on solid principles and logical thinking.

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