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DISTURBED BODY IMAGE Nursing Care Plan

Disturbed body image is when a person distress his/her appearance that is actually divergent to which is considered normal. Below is a sample of nursing care plan for disturbed body image patients.

ASSESSMENT
Subjective:
"How could I go to school in this situation, my classmates would probably laugh at me," as verbalized by the patient.

Objectives:
I observed from the patient that he/she had damages in facial structure, his/her face was sad and no eye contact when I was taking to him/her. He/she only used non-verbal response to communication and he/she skipped meals. Vital signs was taken and noted as follows: Body temperature is 36.6 degrees Celcius, blood pressure is 110/80 mmHg, respiratory rate is 16 cycles per minut,  and pulse rate of 72 beats per minute.
DIAGNOSIS
Disturbed body image related to change in facial structure secondary to negative eye contact and using only non-verbal communication. (Non-verbal communication is when a person only uses facial expressions, gestures, and hands to communicate with others).

PLANNING
After 8 hours of nursing intervention, the patient will able to verbalize acceptance to body changes and incorporate body image change into self-concept.

INTERVENTION
Establishment rapport to the patient because this will increase the nurse-patient relationship. Note withdrawn  behavior and use of denial. Discuss pathophysiology present and situation affecting the individual. For example, when alteration of the body image is related to neurological deficit such as cerebrovascular accident, refer to unilateral neglect.

Assess mental and physical influence of illness or conflict on the client's emotional state such as disease of the endocrine system or use of thyroid therapy. Recognize behavior indicative of overconcern with body and its processes. Have client describe self, noting what is positive and what is negative. Be aware of how client believes others see self.  

Discuss meaning of loss or change in client. A small loss may have a bid impact such as the use of a urinary catheter or enema for incontinence. A change in function such as immobility in elderly may be more difficult for some to deal with than a change in appearance. Permanent facial scaring of child may be difficult for parents to accept. Note signs of grieving or indicators of severe or prolonged depression to evaluate need for counseling and medication.

Listen to client's comments and responses to the situation. Different situations are upsetting to different people, depending on individual coping skills and past experiences. Note use of addictive substances or alcohol because it may reflect dysfunctional coping.

Alert staff to monitor own facial expressions and other non-verbal behaviors because they need to convey acceptance and not revulsion when the client's appearance is affected. Encourage family members to treat client normally and not as invalid. Help client to select and use clothing and make up to minimize body changes and enhance appearance. Provide information at client's level of acceptance and in small pieces to allow easier assimilation. Clarify misconception. Reinforce explanations given by other health team members. Offer positive reinforcement for efforts made such as wearing make up, using prosthetic device.

EVALUATION
After 8 hours of nursing intervention, the patient had verbalized acceptance to body changes and intervention body image change into self-concept.

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