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Top priority Nursing diagnosis for patients with depression

Risk for suicide/ Risk for self-directed violence

Other important nursing diagnosis for depression

Ineffective coping, hopelessness, social isolation, imbalanced nutrition

Additional nursing diagnosis for depression

ineffective role performance
bathing/hygiene self-care deficit
chronic low self-esteem
sleep deprivation
ineffective sexuality patterns
spiritual distress

Nursing interventions for depression

Safty!!! - watch for signs of suicide
Milieu therapy
Therapeutic communication
electroconvulsive therapy
transcranial magnetic stimulation (TMS)

Milieu therapy for patients with depression

-maintenance of self care
-positive group activities
-pharmacologic therapy
-possibly electroconvulsive therapy

communication with patients with depression

-make time to be with the patient even if he doesn't speak
-make observations rather than asking direct questions - "i noticed you attended the unit group meeting today"
-give directions in simple, concrete sentences - client may have difficulty focusing
-give sufficient time to respond - response may be greatly slowed

Counseling for patients with depression

-Problem solving
-increase coping abilities
-change neg thought processes to positive
-assertiveness training
-use of available community services

Top nursing diagnosis for patients with anxiety

-ineffective coping

Other nursing diagnosis for patients with anxiety

-post traumatic stress syndrome
-ineffective role performance
-bathing/hygiene or toileting self-care deficit
-chronic or situational low self-esteem
-disturbed sleep pattern

top Interventions for patients with anxiety

-Remain with the patient during the worst of the anxiety to provide comfort (and safety)

Other interventions for patients with anxiety

- sit and talk with patient using therapeutic communication skills to help them express feelings
- Teach about medications
- When anxiety has passed help patient evaluate the coping mechanisms that work and don't work
-instill hope (but not false reassurance)
-Enhance self-esteem

Health teaching for patients with anxiety

postpone until after acute anxiety subsides

Nursing diagnosis for patients with bipolar disorder

-ineffective coping
-interrupted family process
-risk for injury
-self-care deficit
-disturbed sleep pattern
-disturbed thought process
-Risk for other or self-directed harm

Therapeutic milieu for patients with bipolar disorder

-provide safe environment
-be aware of noises, other patients, etc that can lead to escalation of patient's behavior
-observe closely for escalating behavior
-provide outlets for physical activity - NOT high concentration or for long periods of time
-maintenance of self-care needs

Maintenance of self care needs for patient with bipolar disorder

-monitor sleep, fluid intake and nutrition
-Provide portable nutritious food
-supervise choice of clothing
give step-by-step reminders for hygiene and dress

Communication with patients with bipolar disorder

-use calm matter-of-fact, specific approach
-give concise explanations
- provide consistency among staff
- avoid power struggles
- direct energy to constructive channels such as unit chores
- hear and act on legitimate complaints
- reinforce non-manipulative behavior

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