Nursing Diagnosis / Scientific Explanation Expected Outcomes/ Nursing Interventions Rationale of the Evaluation

Problems in Nursing Objectives Interventions

Disturbed Thought Bipolar disorder or manic- The patient will be able 1. Determine the 1. Establishing a The patient was able to
Process r/t Mood depressive disorder (also to: client’s previous level baseline data allows for • Exhibit judgment,
Alteration secondary referred to a bipolarism or • Exhibit judgment, of cognitive evaluation of client’s insights, and coping
to DD/Bipolar/BPD manic depression) is a insights, and coping functioning (from progress. skills.
evidenced by psychiatric diagnosis that skills. client, family, past • Express logical, goal-
verbalization of describes a category of mood • Express logical, goal- medical records). oriented thoughts with
distractibility and disorders defined by the oriented thoughts with 2. Orient client and call 2. These steps help absence of delusion.
lack of presence of one or more absence of delusion. client by name, reinforce reality and • Demonstrate
concentration. episodes of abnormally • Demonstrate introduce self; provide cues that orientation to person,
elevated mood clinically orientation to person, frequently mention maintain orientation. place and time.
referred to as mania or, if place and time. time, date, and place. • Have appropriateness
milder, hypomania. • Have appropriateness 3. Use simple, concrete 3. Slowed thinking and of interactions and
Individuals who experience of interactions and words. difficulty concentrating willingness to
manic episodes also willingness to impair comprehension. participate in the
commonly experience participate in the 4. Allow the client to 4. Slowed thinking therapeutic community.
depressive episodes or therapeutic community. have time to think and necessitates time to • Solve problems and
symptoms, or mixed episodes • Solve problems and frame responses. formulate a response. makes decisions
in which features of both makes decisions 5. Provide validation 5. Validation seeks to appropriate for age and
mania and depression are appropriate for age and of thoughts and help the caregiver, status.
present at the same time. status. feelings of client. encouraging empathy.
 These episodes are usually 6. Do not attempt to 6. Acceptance promotes Goal partially met as
separated by periods of argue or change the trust. she is sometime not
“normal” mood, but in some client’s belief. 7. Negative ruminations interacted with her
individuals, depression and 7. Help the client add to feelings of family. However, she
mania may rapidly alternate identify negative hopelessness and are has improved in
known as rapid cycling. thinking/thoughts. part of a depressed general and was able
Teach the client to person’s faulty thought to demonstrate
reframe and/or refute processes. orientation to person,
negative thoughts. 8. May block time, and place. She
8. Administer anti- postsynaptic dopamine also was able to
psychotic drug: Xalipro receptors in the brain. express goal-oriented
9. Administer mood 9. Normalizes the thoughts with absence
stabilizing drug: reuptake of certain of delusion.
Lithium (low dose). neurotransmitters and The plan is to
10. Check mouth reduces the release continue the
if hoarding medicines. of norepinephrine. treatment and
11. Continue to 10. To verify that client attending therapy
support, attending is swallowing the tablets sessions (CBT and
therapy sessions (DBT 11. To improve DBT) until the patient
and CBT) and monitor wellbeing (mental and is achieved with best
psychosocial treatment physical) and prevent outcome.
plans. anxiety from escalating
to unmanageable level.

Updated by V.G Fall 2017 Page 16