Psychiatric Mental Health Nursing by Videbeck

11 ABUSE ANDVIOLENCE 229

NURSING CARE PLAN FOR A CLIENT WHO IS BEING ABUSED

Nursing Diagnosis

➤Ineffective Coping

Inability to form a valid appraisal of the stressors, inadequate choices of practiced

responses, and/or inability to use available resources.

ASSESSMENTDATA

• Verbalization of inability to cope


• Inability to problem solve


• Difficulty in interpersonal
  relationships


• Lack of trust


• Self-destructive behavior


• Denial of abuse


• Guilt


• Fear


• Anxious, withdrawn, or depressive
  behavior


• Manipulative behavior


• Social isolation

EXPECTEDOUTCOMES

Immediate

The client will:

• Express feelings of helplessness, fear,
  anger, guilt, anxiety, and so forth


• Demonstrate decreased withdrawn,
  depressive, or anxious behaviors


• Demonstrate a decrease in stress-
  related symptoms
  Stabilization
  The client will:


• Identify support systems outside
  the hospital


• Continue to express feelings directly


• Verbalize plans for continued
  therapy if indicated
  Community
  The client will:


• Cope effectively with stress and
  stressful life events


• Participate in treatment for
  associated problems


• Use community support systems
  effectively

IMPLEMENTATION

Rationale

Clients who are in abusive situations are at

increased risk for aggressive or self-destructive

behavior, including homicide and suicide.

Abusive situations engender a variety of feelings

that the client needs to express, including grief

for the loss of an ideal or healthy relationship,

Nursing Interventions

Remain aware of the client’s potential for self-

destructive or aggressive behavior, and intervene

as necessary.

Spend time with the client, and encourage the

client to express his or her feelings through

talking, writing, crying, and so forth. Be accepting

continued on page 230