The document describes the nursing process used in developing a psychiatric nursing care plan. It discusses the five phases of the nursing process: assessment, nursing diagnosis, goal setting, implementation, and evaluation. It then provides examples of specific nursing problems, diagnoses, goals, interventions, and evaluations for patients experiencing disturbed thought processes and disturbed sensory perception. The care plan aims to provide a safe environment and help patients meet their needs while guiding them towards appropriate behavior.

1. NURSING CARE PLAN
PSYCHIATRIC NURSING CARE PLAN
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2. INTRODUCTION
• Nursing care is the corner stone for all patients’
transition within an illness-health continuum,
regardless of the condition one is suffering from,
starting from surgical to medical to psychiatric
conditions
• If there be recovery, Nursing care marks the hallmark
for all professionals, because it meets all patient’s
needs.
• Before looking at the nursing care plan for
individuals with psychiatric disorders, let us first
have an overview of the nursing process.
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3. The nursing process
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4. Nursing Process
• Nursing Process is a systematic, rational
method of planning & providing care
• This care requires critical thinking skills to
identify & treat actual or potential health
problems & to promote wellness
• It provides a framework for nurses to be
responsible & accountable.
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5. • The nursing process is a cyclical & ongoing
process
• Can end at any stage if the problem is solved
• The nursing process exists for every problem
that the individual/family/community has
• The nursing process not only focuses on ways to
meet physical needs, but also meeting social &
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6. The nursing process is:
a) Cyclic and dynamic
b) Goal directed
c) Client centered
d) Interpersonal and collaborative
e) Universally applicable
f) Systematic
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7. • The entire process is recorded or
documented
• This is done to inform all members of the
health care team.
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8. Phases OF THE NURSINGPROCESS
•Nursing practice was first described as a four
stage nursing process by Ida Jean Orlando in
1958 (Ref).
•The diagnosis phase was added later.
•The five phases are described below:
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9. Phase 1
NURSINGAssessment
• A Nurse uses a systematic, dynamic way to collect &
analyze data about a client
• This is the first step in delivering nursing care
Assessment includes collection of physiological,
psychological, socio-cultural, spiritual, economic, and
life-style data
• E.g. a nurse’s assessment of a hospitalized patient in
pain includes the physical causes & manifestations of
pain, patient’s response :
• e.g. inability to get out of bed, refusal to eat, withdrawal
from family members, anger directed at hospital staff,
fear, or request for more pain mediation.
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10. Phase 2
nursing Diagnosis
•The nursing diagnosis is the nurse’s clinical
judgement about the client’s response to actual
or potential health conditions or needs.
•The diagnosis should not only on physical
presentation of an illness but other related
problems brought up by the physical condition.
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11. Diagnosis Cont.
•E.g., a patient who is in pain may have other
problems such as anxiety, poor nutrition, &
conflict within the family,
•or may have potential complications, e.g.
respiratory infection due to immobility
•The diagnosis is the basis for the nurse’s care
plan.
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12. Phase 3
Goal Setting
• Based on assessment & diagnosis, the nurse sets
measurable & achievable short- and long-range goals in
agreement with client and family
• A common methods for formulating goals (expected
outcomes) is to use evidence-based Nursing Outcomes
Classification
• This allows for use of standardized language which
improves consistence
• Examples of goals include; to maintain adequate
nutrition, to resolve conflict, to relieve dyspnoea, to
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13. PHASE 4
Implementation
• This involves carrying out specific,
individualized nursing interventions
• Throughout the implementation, the nurse
must evaluate the effectiveness of the chosen
interventions.
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14. ImplementationCont.
Examples of nursing interventions:
• Assisting with activities of daily living e.g. eating
grooming
• Physical care techniques e.g. turning and positioning
patients, performing invasive procedures such as
inserting urinary catheter
• Lifesaving measures e.g. administering emergency
drugs
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15. ImplementationCont.
•Nursing care is implemented according to the
care plan
•This allows for continuity of care for the patient
during hospitalization & in preparation for
discharge
•Care is documented in the patient’s record.
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16. PHASE 5
Evaluation
• Evaluation involves determining the extent to which
the chosen interventions have been successful in
alleviating the patient’s problems
• Evaluation should not only occur after the
implementation of the plan but should continue
throughout the process
• If progress towards the goal is slow or if regression
has occurred the nurse must change the plan of care
accordingly
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17. Evaluation
•New problems may be identified at this stage,
thus the process will start all over again
•Both the patient’s status & effectiveness of the
nursing care must be continuously evaluated, &
the care plan modified as needed.
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18. the NURSING CARE PLAN
• A nursing care plan outlines the nursing care to be
provided to an individual/family/community
• It is a set of actions the nurse will implement to
resolve/prevent actual nursing diagnoses or potential
health problems accordingly
• The creation of the plan is an intermediate stage of
the nursing process
• It guides in the ongoing provision of nursing care &
assists in the evaluation of that care.
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19. Characteristics of nursingcare Plan
• Its focus is holistic, and is based on the clinical judgment of the
nurse, using assessment data.
• It is based upon identifiable nursing diagnoses (actual, potential or
health promotion)
• It focuses on client-specific nursing outcomes that are realistic for
the care recipient
• It includes nursing interventions which are focused on the etiologic
or risk factors of the identified nursing diagnoses
• It is a product of a deliberate systematic process
• It relates to the future.
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20. Elements of the Nursing Care Plan
The nursing care plan consists of the following:
• The patient’s actual or potential problem
requiring the nurses’ action
• A nursing diagnosis with an explanation of the
mechanism leading to that particular problem as
well as defining characteristics:
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21. Defining characteristics of Nursing Diagnosis
Actual or potential problem of the patient
Cause of that particular problem which is
mainly attributed to the pathophysiology of a
condition
Evidence of the problem
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22. ElementsCont.
However, with the potential problem, only the first
two characteristics above are indicated.
• The goal outlining the intention of nursing
interventions that will relieve/prevent the actual or
potential problem.
• The nursing intervention outlining the actions that the
nurse will undertake; including specific reasons for
undertaking that particular action
• Evaluation indicating whether the goal has been
attained or not with evidence suggesting such.
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23. Format of Nursing CarePlan
Nursing
Problem
Nursing
Diagnosis
Goal
Nursing
Interventions
Evaluation
State the nursing
problem identified
in this box.
Avoid using medical
terms like
insomnia, fever etc
The format follows
as;
Problem identified
+
cause (related to)
+
evidence (sign that
a problem exists)
This is in line
with what you
want to achieve.
Adding time
frame is
important
because that
determines
whether you
have set long
term or short
term goals
Stipulate what you will
do in details to solve
the problem you have
identified.
The rationale must be
added (the reason you
are doing what)
Look back and see
if your goal set was
achieved by the
implementations
put in place to
achieve it
It must be in the
past with the
evidence that
shows the problem
has been solved
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24. PSYCHIATRIC NURSING CARE
PLAN
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25. • To provide a safe environment,
• to improve the self-esteem,
• to meet the physiologic needs and
• guide patients toward socially appropriate
behavior.
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26. Disturbed
thought
processes
Disturbed thought
processes related
to Biochemical
alterations
evidenced by
decreased ability
to grasp ideas
Client will be
able to
recognize and
verbalize
when thinking
is non–reality-
based.
within 1 week
of
hospitalization
• Convey your acceptance of client’s need for the
false belief, while letting him or her know that
you do not share the delusion.
• Do not argue or deny the belief to avoid
jeopardizing the development of a trusting
relationship.
• Use reasonable doubt as a therapeutic technique:
e.g. “I understand that you believe this is true,
but I personally find it hard to accept.
• Reinforce reality by talking about real events and
real people. Use real situations and events to
divert patient from long, tedious, repetitive
verbalizations of false ideas.
• Give positive reinforcement to enhances self-
esteem as client begins to differentiate between
reality-based and non–reality-based thinking.
The patient’s
thought processes
improved
evidenced by the
patient’s ability to
reflect an accurate
interpretation of
the environment.
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27. Disturbed
sensory
perception
Disturbed sensory
perception related to
Sleep deprivation
evidenced by
Hallucinations.
Client will be
able to define
and test reality,
eliminating the
occurrence of
sensory
misperceptions.
within the first
72 hours of
hospitalization
• Observe client for signs of hallucinations such as
laughing or talking to self and intervene early.
• Avoid touching the client before warning him or her
that you are about to do so as client may perceive
touch as threatening and respond in an aggressive
manner
• Portray an attitude of acceptance to encourage the
client to share the content of the hallucination with
you in order to prevent possible injury to the client or
others from command hallucinations.
• Avoid reinforcing the hallucination by using words
such as “the voices” instead of “they” when referring
to the hallucination because Words like “they” validate
that the voices are real.
• Try to distract the client away from the misperception
by Involvement in interpersonal activities and
explanation of the actual situation, this will bring the
client back to reality.
Patient’s sensory
perception normalized,
evidenced by the
patient’s ability to
differentiate between
reality and unrealistic
events or situations.
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28. Disturbed
sleeping
pattern
Insomnia related to
excessive
hyperactivity
evidenced by pacing
in the hall way during
sleeping hours.
Patient will be
able to
acquire 6 to 8
hours of
uninterrupted
sleep within 1
week of
hospitalization
• Provide a quiet environment, with a low level of
stimulation to promote sleep
• Monitor the patient’s sleeping patterns.
• Provide structured schedule of activities that
includes established times for naps or rest.
• Assess client’s activity level and intervene as
patient may collapse from high levels of exhaustion.
• Before bedtime, provide nursing measures that
promote sleep, such as back rub; warm bath; warm,
non-stimulating drinks; soft music; and relaxation
exercises.
• Prohibit intake of caffeinated drinks, such as tea,
coffee, and colas to avoid stimulating the CNS
which may interfere with the client’s achievement
of rest and sleep.
• Administer sedatives as ordered, to assist client
achieve sleep until normal sleep pattern is restored
The patient’s sleep pattern
improved evidence by the
patient’s ability to fall
asleep within 30 minutes of
retiring and sleeping
for 6 to 8 hours per night
without medication.
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29. Impaired
social
interaction.
Impaired social
interaction related
to disturbed
thought processes
evidenced by
Discomfort in
social situations.
Client will
demonstrate
use of
appropriate
interaction
skills within 1
week
• Set limits on manipulative behaviours and explain
to client what you expect and what the
consequences are if the limits are violated.
• Avoid arguing, bargaining, or reasoning with the
client, instead follow through with consequences
if limits are violated as consistency is essential for
success of this intervention.
• Provide positive reinforcement for non-
manipulative behaviours.
• Help client recognize consequences of own
behaviours and refrain from attributing them to
others.
• Help client identify positive aspects about self,
recognize accomplishments, and feel good about
them to stop patient from manipulating others for
self-gratification.
Patients’
interaction with
others improved
evidenced by
patient relating
well with others
without
manipulating them
for self-
gratification.
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30. Risk of
injury to
self and
others
Risk for injury to
self and others
related to
extreme
hyperactivity.
Evidenced by
increased
agitation and
lack of control
over purposeless
and potentially
injurious
movements
Client will
experience
no physical
injury
• Remove all injurious objects from the
patient’s room to prevent injuries.
• Put the patient in seclusion room when
she/he is violent to prevent injury to others.
• Administer tranquilizers such as haloperidol
or chlorpromazine to quickly relief agitation.
• Reduce environmental stimuli, ensure soft
lighting, low noise and simple room décor to
prevent unnecessary stimulation of the
patient
• limit group activities and observe patient’s
behaviour frequently
• Stay with the client and offer support and
provide a feeling of security.
Patient’s safety
maintained,
evidenced by
patient
exhibiting no
physical injury
obtained while
experiencing
hyperactive
behaviour
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31. Imbalance
d
nutrition
less than
body
requireme
nts
Imbalanced
nutrition less
than body
requirement
related to
patient’s
inability to
sit long
enough to
eat meals
evidenced by
loss of
weight.
Client will
consume
sufficient
finger foods
and in
between-meal
snacks to meet
recommended
daily
allowances of
nutrients 24
hours of
hospitalisation
• Provide the client with high nutritious finger meals
and drinks that can be consumed while on the run
• Ensure availability of snacks on the unit all the
time
• Maintain accurate record of intake and output.
• Weigh the patient daily to asses nutritional status.
• Determine the patient’s favourite foods and
ensure they are provided
• Administer vitamins and mineral supplements
prescribed by the physician
• As agitation reduce sit with the patient and
encourage the patient to eat.
• Educate the client on the importance of adequate
nutrition.
Patient
nutritional
status improved
evidenced by
patient gaining
and maintaining
weight during
hospitalization
and patient’s
ability to
verbalize the
importance of
good nutrition.
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32. Self-
care
deficit
Self-care
deficit related
to cognitive
impairment
evidenced by
patient
looking
untidy.
Patient will
maintain
good
personal
hygiene
throughou
t
hospitaliza
tion
• Encourage the patient to bath and
supervise the patient during
bathing.
• Encourage the patient to wash
his/her clothes when dirty.
• Encourage the patient to brush teeth
every after each meal
• Encourage and supervise the patient
in maintaining her/his hair.
The patient’s
hygiene status
improved
evidenced by
the patient
looking, smart
all the time .
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33. Other interventions
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34. Nursing Problems
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35. Schizophrenia
• Disturbed thought processes.
• Disturbed sensory perception.
• Social withdrawal.
• Risk of violence/aggression.
• Self care deficit.
• Inadequate nutrition.
• Inadequate sleep.
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36. Depression
• Disturbed thought processes.
• Disturbed sensory perception.
• Risk for suicide.
• Social withdrawal.
• Self care deficit.
• Inadequate nutrition.
• Inadequate sleep.
• Low self esteem.
• Powerlessness.
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37. ManicEpisode
• Disturbed thought processes.
• Disturbed sensory perception.
• Inadequate nutrition.
• Inadequate sleep.
• Risk of injury/Hyperactivity.
• Risk of violence.
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38. Disturbed ThoughtProcesses
• Convey acceptance of client’s need for the
false belief, but indicate that you do not
share the belief. Client must understand that
you do not view the idea as real.
• Do not argue or deny the belief. Use
reasonable doubt therapeutically. This will
help in development of a trusting
relationship
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39. • Reinforce and focus on reality. Discourage
long ruminations about the irrational
thinking. Talk about real events and real
people.
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40. For a highlysuspiciouspt:
• Use same staff as much as possible, be honest
and keep all promises to promotes trust.
• Avoid physical contact, avoid laughing,
whispering, or talking quietly where client can
see but cannot hear what is being said,
• Provide canned food with can opener or serve
food family style (where possible).
• Avoid competitive activities.
• Use friendly approach.
• This prevents the pt from feeling threatened.
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41. Disturbed Sensory Perception
• Observe client for signs of hallucinations. Early
intervention may prevent aggressive response to
command hallucinations.
• Avoid touching the pt without warning. Pt may
perceive touch as threatening and may respond
in an aggressive manner.
• An attitude of acceptance will encourage the pt
to share the content of the hallucination with
you. This is important to prevent possible injury
to the client or others from command
hallucinations.
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42. • Do not reinforce the hallucination. Let client
know that you do not share the perception.
Pt must accept the perception as unreal
before hallucinations can be eliminated.
• Involvement in interpersonal activities and
explanation of the actual situation will help
bring the pt back to reality.
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43. Social Withdrawal
• Convey an accepting attitude, show
unconditional positive regard and make
brief, frequent contacts to increases feelings
of self-worth and facilitate trust.
• Be with pt during group activities that he or she
finds frightening or difficult to provide emotional
security for the client.
• Give recognition and positive reinforcement for
voluntary interactions with others to enhances
self-esteem and encourage repetition of the
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44. Riskfor Violence
• Maintain low level of stimuli in pt’s
environment.
• Observe pt’s behaviour frequently. Do this
while carrying out routine activities to avoid
creating suspiciousness on the part of the pt.
• Close observation is necessary so that
intervention can occur if required to ensure
safety.
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45. • Remove all dangerous objects from pt’s
environment to prevent pt, in an agitated,
confused state, from harming self or others.
• Redirect violent behaviour with physical
outlets to relieve pent-up tension.
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46. • Staff should maintain a calm attitude toward
pt.
• Have sufficient staff available to indicate a
show of strength to pt if it becomes
necessary. This shows the pt evidence of
control over the situation and provides some
physical security for staff.
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47. • Provide assistance with controlling anger
• Acknowledge angry feelings and anger inducing
experiences.
• Help patient identify triggers.
• Discuss feelings of anger.
• Role play ways to deal with anger.
• Physical activity as an outlet for feelings.
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48. • Provide environmental management
• Identify staff to be with patient during times of
increased confusion, activity, or noise.
• Observe for signs of increasing tension between
persons or in groups.
• Use verbal interventions to prevent violence.
• Show respect to the patient.
• Directly communicate with the patient who has
lost control.
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49. • Administer tranquilizing medications as
ordered by physician.
• If client is not calmed by “talking down” or by
medication, use of mechanical restraints may
be necessary.
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50. Self-care Deficit
• Provide assistance with self-care needs as
required. Some clients who are severely
withdrawn may require total care.
• Encourage client to perform independently as
many activities as possible. Provide positive
reinforcement for independent
accomplishments. Independent
accomplishment and positive reinforcement
enhance self-esteem and promote repetition of
desirable behaviours.
• Use concrete communication to show client
what is expected.
•
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51. • If toileting needs are not being met,
establish a structured schedule for the client.
A structured schedule will help the client
establish a pattern so that he or she can
develop an independent habit of toileting
independently.
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52. Risk For Suicide
• Increased if the client has developed a plan and
particularly if means exist for the client to
execute the plan.
• A degree of the responsibility for safety is given
to the client. Increased feelings of self-worth
may be experienced when client feels accepted
unconditionally regardless of thoughts or
behaviour.
• Close observation is necessary to ensure that
client does not harm self in any way. Being alert
for suicidal and escape attempts facilitates being
able to prevent or interrupt harmful behaviour.
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53. • Ensure pt takes medication to prevents
saving up to overdose.
• Prevent staff surveillance from becoming
predictable. Make rounds at frequent,
irregular intervals (especially at night, toward
early morning, at change of shift, or other
predictably busy times for staff).
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54. • Encourage verbalisation in a nonthreatening
environment, to help pt resolve feelings of
suicide.
• Ask pt directly: “Have you thought about
harming yourself 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 pt.
Supervise closely during meals and
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55. • Formulate a short-term verbal or written
contract that the client will not harm self.
Secure a promise that the pt will seek out
staff when feeling suicidal.
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56. • Place in room close to nurse’s station, do not
assign to private room.
• Accompany to off-ward activities if
attendance is indicated. May need to
accompany to bathroom.
• Encourage pt to express honest feelings,
including anger. Provide hostility release if
needed.
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57. Low Self-esteem
• Be accepting of pt and spend time with pt
• Focus on strengths and accomplishments
and minimize failures. Interventions that
focus on the positive contribute toward
feelings of self-worth.
• Pt will be able to verbalize positive aspects
about self.
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58. InadequateNutrition
• Involve pt is less consuming activities
• Give energy foods.
• Sit with pt during meals and encourage
him/her to eat.
• Be positive in offering food.
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59. • Provide opportunity for pt to discuss reasons
for not eating.
• Keep intake and output chart.
• Weigh client weekly.
• For pt in manic episode, provide food that
can be eaten ‘on the run’.
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60. InadequateSleep
• Encourage pt to discuss concerns that may
be preventing sleep.
• Plan nursing activities to include adequate
periods of uninterrupted sleep.
• Create quiet environment.
• Plan activities that require client to stay out
of bed during the day.
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61. • Ask pt to describe in specific terms the
quality of sleep during the previous night.
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62. Powerlessness
• Providing pt with choices to increase feelings of control
and independence that will promote feelings of self-
worth.
• Realistic goals will avoid setting pt up for further failures.
• Effective communication and assertiveness techniques
enhance self-esteem.
• Verbalization of unresolved issues may help pt accept
what cannot be changed.
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63. • Allow pt to participate in goal setting and
decision-making regarding own care.
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64. Riskof Injury
• Reduce environmental stimuli by assigning a
private room with simple decoration and
keep lighting and noise level low. Client is
extremely distractible and responses to even
the slightest stimuli are exaggerated.
• Remove hazardous objects and substances
as patient’s rationality is impaired, and client
may harm self accidentally.
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65. • Stay with the client who is hyperactive and
agitated. Nurse’s presence may offer support
and provide feeling of security.
• Provide physical activities to help relieve
pent-up tension.
• Give prescribed antipsychotics to provide
rapid relief from symptoms of hyperactivity
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66. ImpairedSocialInteractions
• Recognize that manipulative behaviours help
to reduce feelings of insecurity by increasing
feelings of power and control.
• Understanding the motivation behind the
behaviour to facilitate acceptance of the pt.
• Set limits on manipulative behaviours.
Explain what is expected and the
consequences if limits are violated.
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67. • Terms of the limitations must be agreed on by all staff who will be working with pt for consistency.
• Ignore attempts by client to argue, bargain, or charm his or her way out of the limit setting to decrease the
behaviours.
• Give positive reinforcement for non manipulative behaviours to enhance self esteem and promotes repetition of
desirable behaviours.
•
• 5. Discuss consequences of client’s behavior and
• how attempts are made to attribute them to
• others. Client must accept responsibility for own
• behavior before adaptive change can
• occur.
• 6. Help client identify positive aspects about self,
• recognize accomplishments, and feel good about
• them.As self-esteem is increased, client will
• feel less need to manipulate others for
• own gratification.
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68. Other interventions
• Schedule activities for the day.
• Provide information to the family as
appropriate.
• Provide time to talk with family to discuss
views about the situation.
• Encourage relatives to assist the client with
taking medication and keeping review dates.
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69. General nursing care
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70. Conditionsof interest
For the following condition
• Mania
• Schizophrenia
• Anxiety disorders
• Somatoform disorder
• Delirium
• Dementia
• Aggression
• Suicidal attempt
• Mental crisis
• Mental illness
• HIV related psychosis
• depression
And these other conditions
• Amnesia
• Sleeping disorders
• Personality disorders
• Substance abuse
• Eating disorders
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71. 1. generalaims
• to promote quick recovery
• to promote patient
comfort
• to prevent suicide ideation
• to prevent injury to self or
others
• to prevent further
complication
• to promote good nutrition
status
• to promote nurse- patient
relationship
• To provide a safe
environment,
• to improve the self-esteem,
• to meet the physiologic needs
• To guide patients toward
socially appropriate behavior.
• To prevent violence
• To prevent dehydration
• To prevent orient the patient
• To maintain communication
process
• To improve cognitive
performance
• To improve reality testing
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72. 2. Creatinga Safeenvironment
• I will Nurse my patient in an environment which
does not have any sharp instruments and
hazardous instruments which may harm self or
others
• I will seclude the patient from all other patients
to prevent injuries to others
• I will Nurse my patient in a non slippery floor to
prevent falls
• I will Nurse my patient in a clean environment to
prevent nosocomial infection
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73. •I will nurse my patient in a noise-free
environment to prevent triggering aggression
and to promote rest
•I will nurse my patient in an environment which
has no naked wires to prevent electrical shocks
and electrocution
•I will remove all shoelaces, belts long-sleeved
shirts to prevent suicide ideation or attempt
•I will nurse my patient in a well-ventilated
environment to promote good air circulation
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74. •I will nurse my patient in a well-lit environment
for easy observation
•I will nurse my patient in a dim lit environment to
prevent visual hallucinations
•I will nurse my patient in a lockable seclusion
when the patient shows in aggressive traits and
psychotic behaviours to prevent injuries to others
•I will make sure that I put all drugs in a lockable
drug locker to prevent drug abuse or overdose
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75. 3. Nursepatient relationship
•I will explain my roles as a nurse and that I wish
them to recover to promote cooperation
•I will be non-judgemental to my patient to
promote nurse patient relationship
•I will actively listen to my patients complaints and
advice appropriately to promote nurse patient
relationship
•I will avoid whispering in front of my patient to
prevent suspicions or paranoid
•I will spend some time with the patient to
promote a therapeutic relationship
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76. •I will minimise eye contact to my patient to
prevent triggering aggression
•I will give praises on good behaviour that patient
portrays to promote continuity. (positive
reinforcement)
•I will be greeting my patient always when I report
for work to promote nurse patient relationship
•I will be speaking in a non provocating manner
to prevent triggering aggression
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77. 4. Observations
• I will observe for the vital signs such as temperature
to rule out hypothermia and hyperthermia ,blood
pressure and pulse to rule out cardio pulmonary
failure and respirations to rule out dyspnea
• I will observed for the mental state of my patient
using a mental state examination strategy to rate the
patients well-being
• I will observe for the visual hallucinations to monitor
the progress of the patient to medication
• I will observe for the side effects of the patients drug
to monitor the patients progress and I will intervene
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78. • I will observe for the aggressive behaviours and I
will intervene appropriate to promote patient
recovery
• I will observe for the feeding pattern status of
the patients to monitor the patients condition
and promote good nutrition
• I will observe for the social withdraws of the
patients to prevent suicidal ideation
• I will observe for the sleeping pattern of the
patients to monitor the patients progress to
medication and rest
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79. 5. Psychologicalcare
• I will explain the condition in simple terms to both the
patient and the relatives to promote cooperation
• I will always first get consent before touching the
patient as this can be perceived as a feeling of attack
• I will explain all the procedures to be done to
promote cooperation
• I will explain the side effects of the drug the ptient is
on to both the patient and the relatives to promote
cooperation
• I will explain the rules of the ward to the patient most
especially related to fighting and any undesirable
behaviours either be rewarded or punished
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80. 6. Maintenance of goodsleeping pattern
• I would advise my patient to exercise during
daytime so to allow enough sleep at night
• I will advise my patient to avoid taking any
caffeinated drinks at bedtime to promote rest
• I will do bed making to prevent irritation during
sleep
• I will minimise any noise from the environment to
promote rest
• I will make sure that the light is dim to promote
rest
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81. •I will administer prescribed hypnotics eg
termazepam or corazepam to induce and
maintain sleep.
•I will do nursing care in blocks to promote enough
time to rest
•I will take all the squeaking trollies to the
maintenance department to have them oiled to
prevent noise
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82. 7. Maintenanceof optimal Nutrition
• I would give small and frequent meals to promote
good nutrition
• I will give my patient meals together with other
patients to promote appetite and prevent suspicions
• If the patient is manic I will give food strategically to
the places that the patient always likes to pass by so
that they grab a meal to promote nutritional status
• I will ask my patient and relatives the patients
favourite foods to promote good nutrition
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83. • I would give prescribed mult vitamins to promote
appetite
• I will serve food to the patient in plastic cups and
plates to prevent injuries and any form of harm.
• I will also involve the nutritionist in the planning of
meals so as to prepare a well-balanced diet
• I will give a well-balanced diet containing
carbohydrates for energy ,vitamins to boost the
immunity, roughage to prevent constipation and
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84. 8. Orientation
•I will Ask my patient if he or she is oriented to
time, place and person.
•I will ask my patient his name, age and sex to
see if the patient is well oriented even to his own
details to rule amnesia
•I will orient my patient to the ablution, the ward
and kitchen to promote cooperation and
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85. 9. Hygiene
•I will dump dust the patients unity to prevent
nosocomial infection
•I will remove and change all the soiled linen to
prevent nosocomial infection
•I will observe and maintain all sterile techniques
in my nursing procedures to prevent
contamination
•I will perform assisted bath to promote good
grooming and good blood circulation
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86. •I will perform assisted and supervised oral care
to prevent Halitosis
•I will perform nail care to my patient to prevent
harbouring microorganism
•I will perform hair care to my patients to prevent
lice or pediculosis
•I will assist my patient how to make their own
bed to promote good grooming and enhance
independence
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87. 10. selfawarenesstraining
• I will examine myself the mood am in that
day if I'm not in good mood I will counsel
myself before coming in contact with my
patient to prevent exhibiting aggressive
behaviours to the patient
• I will train my Patient in self awareness skills
using the Johari window model in simple and
in a language he can understand to promote
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88. 11. Effectivecommunication
• I will speak in a non provocating manner to
prevent aggression
• I will avoid making eye contact on my patients
to prevent exhibiting aggressive behaviours
• I will wear a calm appearance to prevent
aggressive behaviours
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89. 12. REHABILITATION measures
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90. Behaviouralmodification
• I will teach my patient how to make their own beds to
enhance behaviour modification and promote
responsibility
• I'll teach my patient accepted behaviours in the ward
to enhance behavioural modification and
responsibility
• I'll give praises and gifts whenever the patient does
something that is to good to promote continuity of
good behavior
• I will warn my patient that bad behaviours are
punishable and can warrant to be locked into
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91. Socialskills training
• I'll teach my patient how to live with others in the
society eg how to greet and respect elders and other
people around
• I will teach my patient how to maintain relationships
in the society to promote social skills
• I will teach my patient to hold a conversation in
society to my patient to promote social skills
• I will teach my patient how to handle himself when
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92. Assertivetraining
• I'll teach my patient appropriate assertive
skills such as saying no to unreasonable
request without hurting others feeling to
promote assertiveness
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93. Stress management
• I will teach my patient stress management
skills such as playing soccer, watching TV ,
to relieve stress
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94. 13. Dischargepreparation
• As soon as the patient is admitted in my
word I'll tell her or him that he will be
discharged and they will join his or her
family members and friends to rule out
institutionalisation.
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