Nursing care plan depression
Introduction
Define: Depression is the most common mental health problem in the United States. Depression is a word used to describe feelings of sadness and grief. For someone to be clinically depressed these symptoms should be present for at least two weeks.
Role of Nurses: As Nurses we should be aware of the signs of depression and act on them.
This is because depression can be difficult to diagnose as patients will often complain of physical symptoms which have manifested from depression. Determining which disorder is primary and which is secondary is key. Thus, the nursing care plan for depression examines the symptoms and types of depression, the causes and onset of depression, the goals as a nurse developing the nursing care plan nursing, the nursing care plan for depression, treatment, and the sources to include.
The purpose of this nursing care plan depression guide is to provide a care plan for a patient suffering from depression and guide nursing students on how to develop a nurse care plan.
What should be included in a nursing care plan depression
The structure of a nursing care plan should be as follows;
- Assessment (Supporting data) (Actual- 3 parts; Risk For – 2 parts: Readiness for – 2 parts; include secondary to as appropriate.)
- Nursing Diagnosis (NANDA diagnostic statement) Explain your rationale for choosing this nursing diagnosis. Include connections/relationships between the parts of the n. dx. EX: how the R/T caused the problem.
- Goals & Expected Outcomes (Realistic, timed, measurable) short & long term) With Expected Outcome Criteria Start with “Patient will
- Nursing Interventions (Strategies or actions for care)
- Rationale for interventions Evaluation (Client’s response to nursing actions & progress toward achieving goals & outcomes)
- Evaluation of the expected outcomes
The plan for care for patients with depression should be as follows
Plan of Care
Guidelines for Nursing patients with Depression
- Help the person to identify and develop a range of contacts for support and socialization.
- Monitor recovery, compliance with medication, and general physical health. Provide education on possible side effects to any medication and work with the person to address any possible issues.
- Provide family members and carers with information about the illness, as well as reassure and validate their experiences with the person. Encourage them to look after themselves as well, and seek support if required.
- Be aware of your own feelings when nursing a person with depression. Arrange for a debriefing for yourself if you require support or assistance – such as a clinical supervisor or employee assistance service counselor.
Examples 1 Nursing Care Plan Depression
| Nursing Diagnosis(Actual- 3 parts; Risk For – 2 parts: Readiness for – 2 parts; include secondary to as appropriate.) | ***Clinical Reasoning ***Explain your rationale for choosing this nursing diagnosis. Include connections/relationships between the parts of the n. dx. EX: how the R/T caused the problem. | Client Expected Outcomes(short & long term)
With Expected Outcome Criteria Start with “Patient will” |
Nursing Interventions
(Be clear: What/When or How often/start with “Nursing will”)
|
Rationale(with sources) | Evaluation ofExpected Outcomes
(include date/time) |
||
| SELF- ESTEEM DISTURBANCE
Possible Etiologies: (Related to) Failure in school achievements Dysfunctional family system (absentee father) |
Defining characteristics:(Evidenced by)
Subjective Data: “I am such a failure. My parents never loved me…” verbatim of client. Objective Data: *Lack of eye contact *Guarding behavior (closed posture) *Rejects negative feedback when praised for good grooming *Stooped gait, slightly unkempt hair and nails *Some agitations observed because of frequent wringing of hands |
Short Term:After 2 weeks of nursing interaction, client will be able to view self positively Through realization of strengths and limits as a person
Long Term: At the end of nursing interaction, the client will be able to demonstrate behaviors that show optimism to self, the world and living his life through acceptance of limits, interacting with other people and the ability to express self and solve concerns properly. |
1. Introduce self and intention during the first phase of interaction2. Interact with the client in a slow pace, using a low firm tone.
3. Do not hurry client into an interaction, instead maintain a therapeutic and reassuring atmosphere that you are available if he is already ready to talk or share his thoughts with you. 4. Assess the factors contributing to low self-esteem like previous educational failures, family relationships and interaction, availability of support system, and the ability to express own self 5. . Assess and observe how client views himself and how he copes with his previous and present problems. 6. Conceptualize goals for recovery together with the client and involve client in simple decision making. 7. Involve client in activities that meets his abilities and praise him honestly for achievements done. 8. Interact with the client using broad statements and note for statements that indicate negative thinking or cognitive distortions like overgeneralization, all- or nothing thinking, jumping to conclusions, etc. 9. Encourage client care about self through grooming and eating properly. 10. Let him express self through non stimulating activities like dancing, drawing, or assuming role playing. 11. Encourage reestablishment of relationships with significant ones and emphasize that proper control of anger and guilt could assist him interact appropriately. |
1. This will help client build his trust with the nurse; ensuring that it is a professional type of interaction and that will ensure the confidentiality of interaction.2. This will promote a positive and trusting environment with the client considering that depressed clients sometimes communicate with some gaps or may be unresponsive for some reasons.
3. Sometimes clients who are depressed may have some emotional outbursts, crying spells or hesitancy in sharing their thoughts. Be wary of these nonverbal cues and provide some comforting gestures or allow client cry as it would lessen his exaggerated emotions 4. These will help in knowing which aspects you should reinforce with during the plan of care. It may also help client understand of his limits as person. 5. Knowing these will help you pinpoint with the client if how he cope with his problems effectively or not; these will guide him to avoid negative coping measures 6. This will help client know his strengths as a person and would help him resume his autonomy and integrity. 7. This will not only promote client’s positive concept of self but would also enhance his ability to resume functioning like his daily self- care. 8. These negative thinking statements are often utilized by depressed individuals and correcting this will help client cope appropriately 9. Maintaining a positive image of self helps a person feel good about self. 10. This will promote client’s ability to express self appropriately. 11. This will enhance client’s ability to socialize and view that life is still worth living |
After 2 weeks of nursing interaction, the client can verbalize positive concept of self, know his strengths and limits as a person. At the end of nursing interaction, the client is participative in daily activities, shows eagerness to socialize with other people, copes well with problems through omission of negative thinking, acceptance of honest appraisal, and express emotions productively. | ||
Nursing Care Plan Depression Examples 2
The following Nursing Care plan examples cover the following nursing diagnosis
- High risk for self-harm related to depressed mood, feelings of worthlessness, anger turned inward to self.
- Dysfunctional grieving related to real or perceived loss, bereavement over loads.
- Low self-esteem related to learned helplessness, feelings of abandonment by significant others.
- Powerlessness relate to dysfunctional grieving process, life style of helplessness.
- Spiritual distress related to dysfunctional grieving over loss of valued object.
- Alteration in sleeping pattern related to suicidal thoughts
- Alteration in nutrition less than body requirement related to loss of appetite.
| ASSESSMENT | NURSINGDIAGNOSIS | GOAL | PLANNING | RATIONALE | INTERVENTIONS | EVALUATION |
| SUBJECTIVE DATAClient , told that he doesn’t want to live, because his life is useless and worthless.
OBJECTIVE DATA Client looks very sad and depressive mood. |
Risk for suicide relaxed to depressed mood, feelings of worthlessness, anger turned in ward on the self. | Reduce the risk of self harm or injury. | —Ask Client directly “have you though about harming your self in any way? If so what do you plan to do? Do you have the means to carry out this plan?
—Create a safe environment for the Client. —Formulate a short term verbal or written contract that the Client will not harm self. —Maintain a close observation of Client. |
—The risk of suicide is greatly increased if the Client has developed a plan and particularly it means exist for the Client to execute the plan.—Client safely is a nursing priority.
— A degree of the responsibility for his or her safety is given to client. —Observation helps to find out any suicidal behavior. |
—Client told that he doesn’t want to live, because her life is useless and worthless.
—Created a safe environment for the Client. —A degree of the responsibility for his or her safety is given to client. —Maintained a close observation of Client. |
Client will not harm herself. |
| SUBJECTIVE DATAPatient says that he is separated from his parents because of illness and feels depressed. He says that his | Low self esteem related learned helplessness, feeling of abandonment by significant others. | Improve the Client’s self esteem. | —Encourage the client to become involved with staff and other clients in the therapy through interactions and completion of responsibilities.—Give the Client positive feed back for completion of responsibilities. | —Involvement in interaction helps to build self-esteem.—Positive feedback helps to identify meaning in behavior. | —Encourage the client to become involved with staff and other clients—Give the Client positive feed back for completion of responsibilities.
—Teach assertiveness and communication |
| relatives make fun of him and feels shame to stay in the hospital. He says that he needs others help.
Objective data. Client is not doing activities in a normal pattern. |
—Encourage Client to recognize areas to change and provide assistances towards these efforts.—Teach assertiveness and communication technique.
—Promote attendances in therapy groups that offer Client simple methods of accomplishment. |
—it will helps for effective interaction.
—it is a form of reinforcement for the client. |
technique.—Promote attendances in therapy groups that offer Client simple methods of accomplishment.
—Assessed stages of fixation in grief process. (2nd stage) |
Client will be able to attempts new activities without fear of failure. | |||
| Subjective data Client says “ god is cheating me”
Subjective data: The Client told, that she is not interested in eating food. |
Dysfunctional grieving related to real or perceived loss, overloads. |
Improve the Client’s functional abilities and should behave normality. | —Assess stages of fixation in grief process.
—Develop trust, show empathy concern and unconditional positive regard. —Help Client with honest review of relationship with lost object. —Teach normal behavior associated with grieving. |
—Accurate baseline data is required in order to plan accurate care.—-Developing trust provide the basic for therapeutic relationships.
—Only when the Client is able to see both positive and negative aspects related to the lost objects. —To develop the positive attitude. |
—Developed trust, showed empathy concern and unconditional positive regard.
—Helped the client with honest review of relationship with lost object. |
Client will be able to verbalize normal behavior associate d with grieving and begin progressi on resolutio n. | |
| Subjective data Client , told that he doesn’t want to live, because her life is useless and worthless.
Objective data Client looks very sad and depressive mood. |
Powerlessness related to dysfunctional grieving process life style of helplessness. |
Improve the Client’s problem solving abilities. |
—Allow Client in participate in goal setting and decision making regarding own care. —Ensure the goals are realistic and the Client is able to identify areas of life situation that are realistically under control —- Encourage Client to verbalize feelings about areas that are not within her ability to control. —Be accepting and non- judgmental when Client express anger and bitterness toward god, stay with Client. |
—Providing Client with choices will increase the feelings of control. — Realistic goals will avoid setting Client up for further failure. — It may help Client to accept what cannot be changed. — To promote trust in relationship. |
—Taught the normal behavior associated with grieving. —Allowed the client in participate in goal setting and decision making regarding own care. —Ensured the goals are realistic |
Client will be able to solve problems to take control of life situations. |
|
Subjective data Client , told that he doesn’t want to live, because his life is useless and worthless. |
Spiritual distress related to dysfunctional grieving over loss of valued object. |
Reduce client’s spiritual distress. |
—Encourage the client to ventilate feelings related to meaning of own existence in the face of current. —Ensure the client that he or she is not alone when feeling inadequate in the search of life’s |
—Catharsis can provide relief and put life back into realistic perspective. —increases spiritual well being. |
—Encouraged the |
Client will express achievem ent of support and |
| Objective data Client looks very sad and depressive mood. | answer.
—Provide food in a small quantity and at a time but frequently. |
client to ventilate feelings related to meaning of own existence in the face of current.—Ensured the client that he or she is not alone when feeling inadequate in the search of life’s answer. | personal satisfacti on from spiritual practices. | |||
| Subjective data: Client says “I am feeling not well. I have fatigue and not able to do any thing”.Objective data:
Look weak Poor food intake Dry mouth and tongue. |
Alteration in nutrition less than body requirement related to loss of appetite. | Maintain the Client’s nutritional and fluid status. | –Ask choice of food and serve in an attractive manner.—Serve food when every one is eating.
—Be with the patient when he is eating food. —Talk about his success and good behavior while the patient is eating. —Pursue the patient to eat full meal. |
increase digestion and palatability.
—serving in attractive manner improve attitude. —to ensure whether client is taken food. —improve self esteem. |
—Provided food in a small quantity and at a time but frequently.—Served food when every one is eating.
—Be with the patient when he was eating food. —Told about his success and good behavior while the |
The quantity of food intake improved |
Sample Questions
In this assignment it will define and discuss a nursing intervention for a client with a long enduring mental health illness. A systematic approach will be used the nursing process and the role of the mental health nurse will be clearly identified in providing care for the client. The nursing process consists of four stages, the assessment, planning, implementing and evaluation. This problem solving approach will be adopted to structure, organise, and present the nursing intervention. A fully detailed client’s profile will be given. The “mental health assessment and plan” process will also be addressed. The client will be involved in the whole process as far as possible in order to empower him / her, a plan that is person centred and interventions that are evidence based will be displayed in the assignment. In this profile a pseudonym (James) will be used in accordance with the Nursing and Midwifery Council, (NMC, 2002) to maintain confidentiality. The need of the Multi – Displinary Team (MDT) for collaboration will be discussed in order to safe guard the patient to share skills and knowledge and to improve the quality of care.
Sample Solutions
Templates
| Patient’s Initials: | Age: Gender: | C.S. Mott Community CollegeNursing Care Plan Form | Student Name: | ||||||
| Date(s) Cared For (Month & Day only):_ | Instructor’s Name:
Course Number:_ Care Plan #:__ |
||||||||
| Nursing Diagnosis(Actual- 3 parts; Risk For – 2 parts: Readiness for – 2 parts; include secondary to as appropriate.) | ***Clinical Reasoning ***Explain your rationale for choosing this nursing diagnosis. Include connections/relationships between the parts of the n. dx. EX: how the R/T caused the problem. | Client Expected Outcomes(short & long term)
With Expected Outcome Criteria Start with “Patient will” |
Nursing Interventions
(Be clear: What/When or How often/start with “Nursing will”)
|
Rationale(with sources) | Evaluation ofExpected Outcomes
(include date/time) |
||||
Write From Scratch