Nursing Diagnoses in Psychiatric Nursing Care Plans and Psychotropic Medications

Short-term Goals[History of attempting to light burner or oven and leaving gas [Cutting self when using sharp instruments][Exposing self to frigid conditions with insuffiGoals/Objectives[Frequent shuffl[Purposeless, thrashing movements; hyperactivity that is out of [Falls, caused by muscular incoordination or seizures][Bumping into furniture][Smoking and leaving burning cigarettes in various places; lighted cigarette in hand]symptoms:smoking in bed; falling asleep sitting on couch or chair with on in house]touch with the environment] dysfunctional physical condition resulting in the following clothing]Extreme psychomotor agitation observed in the late stages Memory impairmentSeizuresMuscular incoordinationWea k ne s sDisorientation; confusionPoor visionof delirium] ing of feet and stumbling]Delirium, Dementia, and Amnestic Disorders cient protective ●^59

2506_Ch03_054-070.indd 59 2506 Ch 03 054 - 070 .indd Client will not experience physical injury.Long-term Goal 2. Institute appropriate safety measures, such as the following: 1. Client will accept assistance when ambulating or carrying 1. Assess client’s level of disorientation and confusion to deter- 5 2. Client will not experience physical injury.Interventions with 9 level of functioning is necessary to formulate appropriate out other activities.mine specifi a. Place furniture in room in an arrangement that best plan of care. b. Observe client behaviors frequently; assign staff on one-accommodates client’s disabilities.long distances.client when ambulating; use wheelchair for transporting to-one basis if condition warrants; accompany and assist c requirements for safety. Selected RationalesKnowledge of client’s 1 10/1/10 9:33:39 AM 0 / 1 / 10 9 : 33 : 39 AM