بعد طلب يانيرس محمد

[(روح المحبه)]

اولاً مشكور على الاجابه وبالعكس انت ماتأخرت

ويعطيك الله العافيه

ولي طلب بعد ابي N C P

حق الـــ Depression

[nurse_mohammad]

حياك الله

NCP:
Nursing Assessment
1. Assess posture and affect for:
A) Poor or slumped posture.
B) Appearance of being older than stated age.
C) Facial expression of sadness, dejection.
D) Episodes of weeping.
E) Anhedonia — inability to experience pleasure.
2. Assess thought processes:
A) Identify the presence of suicidal thoughts.
B) Poor judgment, indecisiveness.
C) Impaired problem solving, poor concentration.
D) Negative thoughts.
3. Explore feelings for:
A) Anger and irritability.
B) Anxiety, guilt.
C) Worthlessness.
D) Helplessness, hopelessness.
4. Assess physical behavior for:
A) Psychomotor agitation or retardation.
B) Vegetative signs of depression.
- Change in eating patterns
- Change in sleeping patterns
- Change in elimination patterns
- Change in level of interest in sex
- Change in personal hygiene
5. Assess for evidence of masked depression‌:
A) Hypochondriasis.
B) Psychosomatic disorders.
C) Compulsive gambling.
D) Compulsive overwork.
E) Accident proneness.
F) Eating disorders.
G) Addictive illnesses.
6. Assess for risk of suicide

Nursing Diagnoses:
1. Hopelessness related to depressive thoughts
2. Risk for Injury related to hopelessness and impaired problem solving
3. Bathing or Hygiene Self-Care Deficit related to lack of motivation and poor concentration
4. Disturbed Sleep Pattern related to insomnia

Nursing Interventions
Strengthening Coping and Sense of Hope
1. Initiate interaction with patient at a regularly scheduled time.
2. Be clear and honest about your own feelings related to patient's behavior.
3. Encourage verbal expression of feelings.
4. Validate feelings that are appropriate to the situation.
5. Explore with patient what is producing and maintaining the feeling of depression.
6. Encourage patient to identify events that cause unpleasant emotional responses.
7. Assess significant losses patient has experienced.
8. Identify cultural and social factors that may contribute to how patient copes with loss and feelings.
9. Assess patient's support network

Maintaining Safety
1. Assess current suicide risk.
2. Implement appropriate level of observation based on a focused suicide assessment (eg, constant observation or 15-minute checks).
3. Explain observation precautions to patient.
4. Remove harmful objects from patient's possession, and assess environmental safety of patient's room and unit.
5. Encourage patient to negotiate a “no-self-harm and no-suicideâ€‌ agreement with the staff.
6. Monitor need to revise level of observation.
7. Provide additional structure by keeping patient involved in therapeutic and psychorehabilitative activities.

Encouraging Participation in ADLs
1. Collaborate with occupational and physical therapists to determine patient's functional capacity to accomplish ADLs.
2. If patient cannot accomplish ADLs independently, provide hygiene activities in collaboration with patient.
3.Acknowledge and reinforce patient's efforts to maintain appearance; do not rush patient when self-care is slow.
4. Reinforce what patient can do rather than what patient cannot do without assistance.
5. Remain with patient during mealtime to determine the level of need for assistance or cueing in the ability to eat.

Facilitating Sleep
1. Determine patient's past and current sleep patterns and sleep hygiene.
2.Ask what strategies patient has already used to improve sleep, and elicit which ones have been successful.
3. Consider decreasing the amount of daytime sleep by encouraging participation in an activity.
4. Discuss alternative methods for facilitating sleep:
A) Avoid caffeine and nicotine.
B) Avoid emotionally charged or upsetting discussions before bedtime.
C) Avoid exercise 30 minutes to 1 hour before bed.
D) Increase physical activity within functional limits.
E) Use relaxation techniques.
F) Try a warm bath or warm milk.
5. Administer prescribed drugs that cause sleepiness at bedtime; avoid giving drugs that cause insomnia at night.

Community and Home Care Considerations
1. Mood disorders tend to be chronic, with acute episodes that may require inpatient treatment. The patient in the home or community setting will require ongoing monitoring regarding the use of drugs as well as support and education in terms of the disorder.
2. Community health care providers, including nurses, must be aware of the need for primary and secondary prevention programs directed at education as well as early case finding and prompt treatment.

Patient Education and Health Maintenance
1. Instruct patient and family members about symptoms of depression.
2. Instruct patient and family members about purpose of antidepressant drugs, effects, adverse effects and their management, and how to recognize early signs and symptoms of relapse.
3. Instruct patient and family members about the effect of a depressive disorder on the family system.
4. Provide patient and family members with written material on coping with depression.
5. Provide patient and family members with information about appropriate community-based programs and support groups. Contact the National Foundation for Depressive Illness, http://www.depression.org.

Evaluation: Expected Outcomes
1. Reports improvement in mood and increased interest in daily living
2. Remains free from self-harm
3. Accomplishes ADLs in an independent manner
4. Obtains a minimum of 5 hours of uninterrupted sleep