Ncp Mam Dela Cruz

Assessment CUES Subjective:

“parang hindi nawawala ang rashes ko sa mukha at braso. Ano kaya pwede kong gawin? ” as verbalized by the client.

Objective: -Behaviors of acknowledgeme ntof ones body -actual change in structure -change in social involvement -Trauma to nonfunctional parts

NURSING DIAGNOSIS

RATIONALE

Problem: Disturbed body image

Socialization, as a process, is characterized by the internal struggle between the biological components and the social cultural environment of the individual. Disturbance about the physical appearance can cause decrease self esteem and affects your socialization.

Etiology: Related to perception of what other says. Signs and symptoms: -Behaviors of acknowledgement of ones body -actual change in structure -change in social involvement -Trauma to nonfunctional parts

(Freud’s theory of personality development) Reference: general psychology by Francisco Zulueta and Maricel Paraiso, pages 310

PLANNING

NURSING INTERVENTIONS

Long term: After 4 hours of nursing intervention the patient will be able To recognize and incorporate body image change into self concept in accurate manner without negating self esteem

INDEPENDENT

Short term: After 30 minutes of nursing intervention the patient will be able to verbalized understanding of body image.

RATIONALE

1. determine whether condition is permanent or no expectation for resolution

There is always something that can be done to enhance acceptance and it is important to hold but the possibility of living a good life.

2. Evaluate level of client knowledge of and anxiety related situation.

Emotional changes may indicate acceptance or non acceptance to the situation.

3.note use of addictive substance or alcohol

May reflect dysfunctional coping

4.allow patient to use denial without participating

Provide opportunities for listening to concerns and questions. Provide individual time to adapt to situation.

EVALUATION

Long term: After 4 hours of nursing intervention the patient has recognize and incorporate body image change into self concept in accurate manner without negating self esteem -goal fully met Short term: After 30 minutes of nursing intervention the patient has verbalized understanding of body image. -fully met

PRIORITIZED PROBLEMS: 1.

Disturbed body image related to perception of one’s image.

2.

Knowledge deficient related to cognitive limitation

3.

Nausea related to gastric irritation and unpleasant taste

4.

Fatigue related to psychosocial problem(boring lifestyle, stress, anxiety, depression)

5.

Sexual dysfunction related to altered body function.