IMPAIRED ADJUSTMENTS Nursing Care Plan

Most people really hard to accept changes that suddenly appear in their life, because they are tend to stay in comfort than to take the risk to move forward. We are fear and so afraid to accept adjustments and sometimes people need a lot of times like weeks or months to accept and to adjust about these changes. That is why nurses are challenged to take good care of these people who have impaired adjustments. It is really challenging on how a person will trust you and trust your interventions especially if these people are not looking for a change or to modify their life. That is why the nurse must explain to the patient that these changes will result a more favorable outcome and will not create more problems. This is a nursing care plan sample about impaired adjustment of Mr. Dutrio, 78 years old, former City Mayor on provincial area. The patient is diagnosed with type-2 diabetes and the doctors imply to make adjustments in his nutritional diet, leading to reduce his intake of foods with high- carbohydrates and stopping him to drink alcohol. The patient is rejecting those changes and denies of having type-2 diabetes. If the patient does not make adjustments, this could lead to complications like blindness and amputation.

Assessment:

SUBJECTIVE:
The patient verbally denies his health status

OBJECTIVE:
The patient rejects medical treatment, leading to a failure to take actions that would prevent further health problems. There patient refuses to communicate with the nurse and rejects nursing intervention. The patient still eats food and drink beverages that could lead to life-threatening condition. The patient acts energetic to hide his health condition.

Diagnosis:

Impaired adjustments related to failure to take actions that would prevent further health problems.

PLANNING

After 2 hours of nursing intervention, the patient will demonstrate increasing interest and participation in self-care, the patient will also develop ability to assume responsibility for personal needs when possible. The patient will also initiate lifestyle changes that will permit adaptation to current life situations. In addition, the patient will identify stress situations leading to impaired adjustment and specific actions for dealing with them and identify and use appropriate support systems.

INTERVENTIONS

- Check the level of Mr. Dutrio’s impaired function. Assess if it is life-threatening and do the patient, Mr. Dutrio need an immediate care.

 

- A physical and psychosocial assessment must be done to the patient to know the extent of the limitations in the condition of Mr. Dutrio. Consider to the patient the limitations of a person having type-2 diabetes. Since the patient’s situation is really hard for him to accept you must adapt to the situation by listening to the patient's perception of inability. Note any helpful resources of Mr. Dutrio's past and present significant support systems such as his family, relatives, church, co-workers, groups, and organizations.

- You must identify what kind of adjustments express by Mr. Dutrio in his situation. Is the patient signifying impaired adjustments by expressing emotions such as overwhelming anxiety? Fear? Anger? Active or passive denial? 

- There are a lot of contributing factors related to impaired adjustments. Note all the possible contributing factors in Mr. Dutrio's case by listening to his perception of the factors leading to the present impairment, noting onset, duration, presence or absence of physical complaints and his social withdrawal. Compare his previous life situations and role changes with patient to determine coping skills used. Indentify Mr. Dutrio’s lack of inability to use available resources. You must also check available documentation and resources to determine his actual life experiences, resources like his past medical records, interview statements by his parents, relatives, friends and co-workers because in this situations of a great stress, physical or emotional, the patient may not accurately tell the occurrences leading to present situation.

- Establish a regular team conference with the patient and ancillary services that focuses on causes of Mr. Dutrio’s impaired adjustments to deal with the impairment and make a solid plan for managing the situation. Tell the patient that he is doing a great job and acknowledge every time he is doing his efforts to adjust because it can lessen his feelings of blame, guilt, and defensive response. Share some information with the patient's peers when illness or injury affects body image because peers can support for that kind of situation.

- Mr. Dutrio must understand the disease process, causative factors, and prognosis. Always remember to let the patient ask questions because this will greatly improve his understanding about your nursing care. Provide an open environment-encouraging communication so that he can express his true feelings concerning his impaired function that can be dealt with reality. Use therapeutic communication skills such as active-listening, acknowledgment, silence, and I-statements.

EVALUATION

After 2 hours of nursing intervention, the patient demonstrated increasing interest and participation in self-care, the patient also developed ability to assume responsibility for personal needs when possible. The patient also initiated lifestyle changes that will permit adaptation to current life situations. In addition, the patients identified the stress situations leading to impaired adjustment and specific actions for dealing with them and identify and use appropriate support systems.

If you need a video representation of this sample nursing care plan about impaired adjustments, you can play the video above this article.