Nursing Diagnosis - Psychosocial

  1. Could someone please tell me what a Psychosocial Nursing Diagnosis is? I'm not sure if I'm headed in the right direction... I was thinking "Anxiety" would fall under that topic... But in the book I have, there's nothing that specifically says Psychosocial and Anxiety falls under Coping/Stress Tolerance...

    Thanks for any help
    Last edit by Joe V on Mar 27, '18
    •  
  2. Visit am0r803 profile page

    About am0r803

    Joined: Nov '07; Posts: 52; Likes: 12

    34 Comments

  3. by   Daytonite
    Psychosocial nursing diagnoses are often used with patients who have diseases like depression, bipolar diseases, anorexia, bulimia, substance abuse, alcohol abuse, have attempted or are thinking of suicide, have death or dying issues, coping and self-esteem issues or behavioral issues. Self-esteem has to do with one's own worth, capability, significance and success in life. Psychosocial also has to do with the positive and negative connections between people or groups of people and the way in which those connections are exhibited (roles we assume). Coping and stress tolerance are included and have to do with how patients deal with life events and life processes.

    Examples of psychosocial nursing diagnoses are:
    • Disturbed Personal Identity
    • Hopelessness
    • Chronic Low Self-Esteem
    • Situational Low Self-Esteem
    • Risk for Situational Low Self-Esteem
    • Social Isolation
    • Caregiver role strain
    • Risk for caregiver Role Strain
    • Impaired Parenting
    • Risk for Impaired Parenting
    • Readiness for Enhanced parenting
    • Interrupted Family Processes
    • Readiness for Enhanced Family Processes
    • Dysfunctional Family Processes: Alcoholism
    • Risk for Impaired Parent/Infant/Child Attachment
    • Effective Breastfeeding
    • Ineffective Breastfeeding
    • Interrupted Breastfeeding
    • Ineffective Role Performance
    • Parental Role Conflict
    • Impaired Social Interaction
    • Fear
    • Anxiety
    • Death Anxiety
    • Chronic Sorrow
    • Ineffective Denial
    • Grieving
    • Complicated Grieving
    • Ineffective Coping
    • Disabled Family Coping
    • Compromised Family Coping
    • Defensive Coping
    • Ineffective Community Coping
    • Readiness for Enhanced Coping (Individual)
    • Readiness for Enhanced Family Coping
    • Readiness for Enhanced Community Coping
    • Risk for Complicated Grieving
    • Stress Overload
    • Risk-prone Health Behavior
  4. by   moncj66
    Hey fellow students, I really have trouble coming up with psychosocial nursing diagnosis for my care plan. I'm currently in OB and had a patient that was physically abused by her partner, who used heavy narcotics & alcohol daily, so now she lives with her grandmother. The baby is healthy and might be given up for adoption. The mother is 40 and has 4 kids already; various ages and jobs. So, I really don't know why should be priority for the child, Not the mother? This careplan is for the infant, not the mother, so its more difficult to come up with things. Ineffective parenting? ANy ideas are GREATLY APPRECIATED!
  5. by   Keri8680
    What about risk for failure to thrive r/t home environment....you can always choose one the baby may be at risk for if you are having trouble trying to figure something out.
  6. by   Daytonite
    remember that a care plan is about the nursing problems of the patient. the baby is the pati ent. forget that the baby is going to be given up for adoption. think about what the nurses are doing for this baby each minute of the day because this baby cannot care for itself, can it? none of the babies in the newborn nursery can. all care plans begin with assessment of the patient and determination of their adls.

    think about what you know about the assessment findings of a normal newborn compared to an adult. what's different? for onething newborns can't regulate their body temperature which is why we don't leave them exposed to the room atmosphere for very long with just a diaper covering them. that's ineffective thermoregulation r/t immature compensation for changes in environmental temperature. [see Newborn Nursing Diagnosisfor information on thermoregulation of temperature in newborns and nursing interventions.] some newborns just have a few difficulties with excessive secretions in the respiratory track (the big hint here is that the nurses will keep a bulb syringe nearby the baby) so ineffective airway clearance can be used. they also have a stump from the umbilical cord hanging off their future belly button. do you? are they treating this cord stump? if it's inflamed or there are umbilical cord problems there is risk for infection, so you can use risk for infection r/t break in skin integrity at umbilical cord site ([color=#3366ff]risk for infection). if the baby has been circumcised that is another reason for a risk of infection. is this baby breastfeeding? if so, use effective breastfeeding. and, some babies just don't start feeding well at first by breast or bottle--it happens. these kids are imbalanced nutrition: less than body requirements r/t poor infant feeding behaviors (imbalanced nutrition: less than body requirements).

    use risk for infection r/t break in skin integrity at umbilical cord site. the risk factor is that if the cord comes off or is traumatically removed instead of falling off on its own it creates an open skin area which is the actual potential for infection as a result of open skin area.

    for ineffective thermoregulation r/t immature compensation for changes in environmental temperature. see Newborn Nursing Diagnosis for information on thermoregulation of temperature in newborns and nursing interventions. it has links to this website:

    http://www.who.int/reproductive-health/publications/msm_97_2_thermal_protection_of_the_newborn/msm_97_2_chapter2.en.html


    you can use imbalanced nutrition: less than body requirements r/t poor feeding behaviors when babies don't start feeding well at first bybottle. just describe their fussiness with feeding, poor intake amount or other little problems that are going on.

    if the baby is under the bililight for hyperbilirubinemia the nursing diagnosis to use is risk for injury r/t phototherapy (risk for injury).
    Last edit by Joe V on Apr 23, '18
  7. by   benjaiiimin
    Hi,

    I am hoping someone can help me here as I am slightly stuck on a psychosocial nursing diagnosis for an assignment.
    A bit of background on the case study:

    22 year old female who has been admitted to A&E following a seizure, witnessed by her fiancee.
    She was diagnosed with idiopathic epilepsy at age 12, but was weaned of dilantin at 19 and has not had a seizure up until this point. She is getting married in 2 weeks and has been very stressed on the lead up to the wedding. She has not disclosed her previous medical history to her fiance before her admission.

    NOW- I am not really sure what this fits into, and havent been able to find many specific supporting resources on this. Although, a lot of my responses to questions is based around fear of rejection, lack of knowledge etc..

    To take a slight stab at it, I would say:

    Nursing Diagnosis
    Anxiety and fear of rejection

    Related to
    Knowledge defecit regarding epilepsy

    As evidenced by
    Stress and not disclosing her condition to her fiance.

    Anyway, I am not sure if I am on the right track with this. Does anyone have any comments/suggestions?

    Thankyou
  8. by   Daytonite
    there are problems with your diagnoses:
    nursing diagnosis
    anxiety and fear of rejection
    "and fear of rejection" is not part of the diagnostic label of anxiety
    related to
    knowledge deficit regarding epilepsy
    if this is the reason you are saying the patient is anxious, then just diagnose deficient knowledge, anxiety.
    as evidenced by
    stress and not disclosing her condition to her fianc.
    stress is not evidence of anxiety. you can see an entire listing of the signs and symptoms of anxiety here (see the defining characteristics: anxiety
    what this patient is doing is quite simply ineffective coping r/t threat of rejection aeb keeping previous medical history of idiopathic epilepsy since age 12 a secret from her fianc.
  9. by   benjaiiimin
    Thankyou. That is a lot clearer
  10. by   Daytonite
    You are welcome. Good luck with your care plan.
  11. by   carrothead73
    Hi!

    I have an assignment on psychosocial responses to illnesses and as a part of it I have to formulate a nursing diagnosis based on the following case study.

    A 22 year girl with a hx of idiopathic epilepsy first diagnosed at age 12. She was prescribed dilantin and weaned off it at age 19. She has been seizure free until now when she has been admitted to ED with a tonic clonic seizure. She had one seizure at home in front of her fiance and another in the ED. She is due to be married in 2 weeks and has been stressed leading up to the wedding. She and her fiance want to start a family soon so she has stopped the pill. The key point... she has not told her partner of her hx of epilepsy!

    I keep coming back to the diagnosis of Ineffective coping but it's not sitting quite right with me. Coping, to me, seems to be a here and now issue and I think that after three years she probably doesn't see it as an issue any more. My feeling is something along the lines of she hasn't had a seizure in years so what's the point in raising an issue that need not be addressed. I think it is more of a denial thing - an effort to retain the idea of normalcy but how does that fit into a nursing diagnosis?

    I hope that makes sense.

    Thanks in advance fior your help.
  12. by   Daytonite
    ineffective coping is what i would diagnose. what you must understand about diagnoses is that the nursing diagnosis itself is a label. it is a shorthand expression of the true problem which is fully described in the definition. the definition of ineffective coping can be found in any publication that contains the nanda taxonomy. the definition of ineffective coping is inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources (page 254, nanda international nursing diagnoses: definitions and classifications 2009-2011). that a bride-to-be has not disclosed her history of epilepsy demonstrates a failed operation of problem solving skills. the entire upcoming wedding is a stressor, but no other symptoms of stress are given in the scenario. the time element, if anything, is insignificant as far as i can see except that it added to her stress and may have had something to do with bringing on her seizure.

    i would diagnose ineffective coping r/t impaired problem solving skills aeb failure to disclose medical history of epilepsy to fianc prior to the wedding.

    what makes psychosocial diagnoses a little more difficult to word is that the nanda taxonomy only offers guidelines and we have to supply the actual wording. for the physiological diagnoses the related factors and defining characteristics are pathophysiology, signs and symptoms we readily recognize. it's different and much more vague with these psychosocial diagnoses because they are based upon behaviors the patient exhibits and they are dependent on the patient assessment.
  13. by   Smurfie
    Lol, I think you might be in my class at uni Actually, given your username I think I have an idea who you might be too (Did I see you in Woolies last week?!) I just googled for epilepsy nursing diagnosis ideas and found this!! I too have been struggling and am considering a diagnosis of Ineffective Coping. Not only has the nursing diagnosis guru Daytonite suggested it, but it's also the only one listed in our Brown & Edwards for psychosocially related epilepsy nursing diagnoses (page 1640 if you're interested), and it's really the only one I can find. Sucks that we'll all probably use the same one, but if it's the right one, who cares huh? I did consider using the Anxiety one, related to threat to role function (she won't be able to drive etc) but there's no evidence for her being anxious and I can't find a 'Risk for Anxiety' one. Good luck finishing it!!
  14. by   Smurfie
    Also...

    Can we use future assumptions for Ineffective Coping in our AEB bit by the way? ie. she's proven her coping mechanisms are inadequate by not disclosing her medical disorder to her fiance, but we can also assume (not necessarily a wise move, I understand) that her coping techniques will also be stretched in weeks/months to come given the changes in her life that come with a re-diagnosis (which is what it essentially is for her) of epilepsy?

close