PSYCH Help!!!!!!!!

[Nursetob2005]

Hi all! I have a question...For Mental Health Clinicals....we had an assignment to wath a movie from a list that was given to us. I chose "Awakenings". For those who have seen it....I have to do a nursing care plan....I was trying to find a NANDA diagnosis for Cognitive Disorder, because of the post-encephalatic catatonic state that Leonard was in. I am basically having to use stuff r/t dementia. I thought it would be good to have stuff on how to continuously talk to the pt. and interact with him even though he is non-verbal and does not respond. Anyone have any other ideas?

Thanks!!!!!!!!

Jami

[MistyLou]

what about something like disturbed thought processes r/t neurological impairment, disruption of cerebral arterial blood flow, chemical imbalance or mental disorder???

I'm pretty new to this nursing dx stuff and am in my first quarter of clinicals, so I could be wrong. I just looked up cognitive deficit and chronic confusion in my Nsg Dx Handbook.

[Tony35NYC]

"...post-encephalitic catatonic state..."

This is an interesting one. I haven't seen the movie but I'm thinking that it will be tough to construct communications outcomes in a psych care plan for a pt who's in a perpetual state of catatonia. In other words, I'd love to help but I don't understand what the objectives (goals) of such a care plan would be since you wouldn't be getting any type of feedback from the pt that would indicate whether the nursing actions are successful or not. And if there's no way to interpret or measure the outcome, how would you rationalize the interventions?

What is the degree of catatonia (negativism, catalepsy, stupor)? You say the pt is non-verbal and does not respond, does he respond to ANY type of stimulus at all? I'm thinking you could go with Altered Thought Process r/t neurologic diseases impacting the brain. Apart from the usual physical neuro nursing assessments you could ad lib your own interventions like: Speak to pt in brief clear sentences; Read various magazine/newspaper articles to the pt; talk to the pt about recent news items; encourage family to visit regularly and talk to pt about recent family developments and interesting experiences; talk to the pt about his care; explain medications and procedures... you could use facilitates the client's contact with reality as the rationale for all of these.

Is this the type of stuff you had in mind?