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RISK FOR OTHER - DIRECTED VIOLENCE Nursing Care Plan

        We will share to you a sample of nursing care plan(NCP) of violence, risk for other-directed. This violence is a behavior in which an individual demonstrates that he or she can be physically or even emotionally and/or sexually harmful to others. It is a state in which the client is at risk be assaultive towards others or in the environment. In making a nursing care plan for violence,  the nursing focus is to decrease the violent episodes and protecting both the client and others. Always remember that do not use this diagnosis to address other problems such as anxiety and poor self-esteem, but instead should make and refer to ANXIETY Nursing Care Plan and Effective Coping. Don't be confused between this diagnosis and domestic violence, use Disabled Family Coping instead.

ASSESSMENT:
Subjective:
"I will kill everyone!", as verbalized by the patient.

Objective:
- Clenching of fist
- Facial flaring
- Shouting
- Flaring eyes
- Grunting of teeth

Diagnosis:
        Risk for other-directed violence related to aggressive acts and manic excitement as manifested by shouting and clenching of fist.

Planning:
After 2 hours of nursing intervention, the client will refrain from threatening, loud language towards others and identifies calming strategies.

INTERVENTIONS:
- Promote trust to the client first by acknowledging the client's feelings. Tell the client: "You are having a rough time." Just be genuine and empathetic and tell the client that you will help and do not do anything destructive.

- Set limits when the client is poses a risk to others. Do not touch the client, avoid feelings of physical entrapment but do not do this intervention alone, presence of three to four staffs is necessary in order for the client not to lose control. Offer choices, sometimes it is necessary to give necessary demands to avoid a power struggle. Also encourage client to express anger by saying or verbally instead of acting out.

- Do not take the verbal abuse personally. Be calm at all times, if you become upset, leave the situation to others. After the nursing intervention, discuss your feelings about the situation to other staffs.

- Remove the client from the environment if it contributes to the aggressive behavior using the least amount of control needed, like asking others to leave or taking the client to the quiet room. Repeatedly tell the client what will going to happen before external control begins.

- Explore what precipitates the client's out of control. Assist the client to recall the physical  symptoms associated with anger. Teach the use of deep breaths and relaxation breathing.

- Encourage increased recreational activities.

Evaluation:

After 2 hours of nursing intervention, the client refrained from threatening, loud language towards others and identified calming strategies.

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