Nursing Care Plans For Delusional Disorder, delusional disorder diagnosis can be made when a person exhibits nonbizarre

delusions of at least 1 month duration that cannot be attributed to other psychiatric disorders. Nonbizarre delusions must be about phenomena that, although not real, are within the realm of being possible. In general, the patients delusions are well systematized and have been logically developed. The persons behavioral and emotional responses to the delusions appear to be appropriate. Usually the persons functioning and personality are well preserved and show minimal deterioration if at all. Nursing Assessment Nursing Care Plans for Delusional Disorder Nursing Diagnosis for Delusional Disorder Nursing Care Plans Delusional Disorder with nursing diagnosis; Disturbed Thought Processes, Social Isolation, Activity Intolerance, Ineffective Coping, Risk for Self-directed or Other-directed Violence. NURSING DIAGNOSE Disturbed Thought Processes related to perceptual and cognitive distortions, as demonstrated by suspiciousness, defensive behavior, and disruptions in thought NURSING OUTCOME Patient showed the Differentiation Between Delusions and Reality INTERVENTION
y

EVALUATION Exhibits improved reality orientation, concentration, and attention span as demonstrated through speech and behavior

y y

Provide patient with honest and consistent feedback in a nonthreatening manner. Avoid challenging the content of patients behaviors. Focus interactions on patients behaviors. Administer drugs as prescribed while monitoring and documenting patients response to the drug regimen. Use simple and clear language when speaking with patient. Explain all procedures, tests, and activities to patient before starting them, and provide written or video material for learning purposes. Encourage patient to talk about feelings in the context of a trusting, supportive relationship. Allow patient time to reveal delusions to you without engaging in a power struggle over the content or the reality of the delusions.

Social Isolation Patient showed related to an inability the Promoting to trust Socialization

Communicates with family and staff in a clear manner without evidence of loose, dissociated thinking

Use a supportive, empathic approach to focus on patients feelings about troubling events or conflicts. Provide opportunities for socialization and encourage participation in group activities. Be aware of patients personal space and use touch judiciously. Help patient to identify behaviors that alienate significant others and family members. Assess patients response to Independently prescribed antipsychotic maintains drug. personal hygiene Collaborate with patient and without fatigue occupational and physical therapy specialists to assess patients ability to perform ADLs. Collaborate with patient to establish a daily, achievable routine within physical limitations. Teach strategies to manage adverse effects of antipsychotic drug that affect patients functional status, including: o Change positions slowly o Gradually increase physical activities o Limit overdoing it in hot, sunny weather o Use sun precautions o Use caution in activities if extrapyramidal symptoms develop. Encourage patient to express Attends group feelings. activities Focus on patients feelings and behavior. Provide honest perceptions

Activity Intolerance Patient showed related to adverse the Improving reactions to Activity psychopharmacologic Tolerance drugs

Ineffective Coping related to misinterpretation of environment and impaired

Patient showed the Improving Coping with Thoughts and Feelings

y y y

communication ability
y

of reality and feedback about symptoms and behaviors. Encourage patient to explore adaptive behaviors that increase abilities and success in socializing and accomplishing ADLs. Decrease environmental stimuli. Monitor patient for Remains free behaviors that indicate from harm or increased anxiety and violent acts agitation. Collaborate with patient to identify anxious behaviors as well as the causes. Tell patient that you will help with maintaining behavioral control. Establish consistent limits on patients behaviors and clearly communicate these limits to patient, family members, and health care providers. Secure all potential weapons and articles from patients room and the unit environment that could be used to inflict an injury. To prepare for possible continued escalation, form a psychiatric emergency assist team and designate a leader to facilitate an effective and safe aggression-management process. Determine the need for external control, including seclusion or restraints. Communicate the decision to patient and put plan into action. Frequently monitor patient within the guidelines of facilitys policy on restrictive devices and assess the patients level of agitation.

Risk for Self-directed Safety appears or Other-directed Violence related to delusional thinking and hallucinatory experiences

When patients level of agitation begins to decrease and self-control is regained, establish a behavioral agreement that identifies specific behaviors that indicate self-control against a reescalation of agitation.

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