Psychiatric Mental Health Nursing by Videbeck

16 PERSONALITYDISORDERS 385

NURSING CARE PLAN ANTISOCIAL PERSONALITY DISORDER

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

• Low frustration tolerance


• Impulsive behavior


• Inability to delay gratification


• Poor judgment


• Conflict with authority


• Difficulty following rules and obeying
  laws


• Lack of feelings of remorse


• Socially unacceptable behavior


• Dishonesty


• Ineffective interpersonal relationships


• Manipulative behavior


• Failure to learn or change behavior
  based on past experience or punishment


• Failure to accept or handle
  responsibility

EXPECTEDOUTCOMES

Immediate

The client will

• Not harm self or others


• Identify behaviors leading to
  hospitalization


• Function within limits of therapeutic
  milieu
  Stabilization
  The client will


• Demonstrate nondestructive ways to
  deal with stress and frustration


• Identify ways to meet own needs
  that do not infringe on the rights of
  others
  Community
  The client will


• Achieve or maintain satisfactory
  work performance


• Meet own needs without exploiting
  or infringing on the rights of others

IMPLEMENTATION

Nursing Interventions *denotes collaborative interventions Rationale

These clients frequently deny responsibility for

consequences to their own actions.

Honest identification of the consequences for the

client’s behavior is necessary for future behavior

change.

Encourage the client to identify the actions that
precipitated hospitalization (e.g., debts, marital
problems, law violation).

Give positive feedback for honesty. The client
may try to act as though he or she is “sick” or
“helpless” or use other techniques to avoid
responsibility.

continued on page 386