Intermittent explosive disorder care plan example

Patient’s identifier:  medical history patient’s medical diagnosis: intermittent explosive disorder.

Nursing diagnosis: risk for Violence: self-directed of other directed as evidence by the patient previous fight with a boy, the patient had also threaten to kill himself.

Assessment dataGoals and outcomeNursing interventionRationaleOutcome evaluation and replanning
Objective data: The patient is a fifteen year old boy with two younger siblings and a single mother.The patient was diagnosed with a bipolar disorder 2 years ago.The patient has also been diagnosed with post-traumatic stress disorder and intermittent explosive disorder.The patient has been admitted in the hospital for four times in two years and four additional admissions to the children crisis center.The patient has recently beaten up a boy after school for making fun of his weight and is currently suspended from school.The patient has since withdraw from all the social activities and tends to stay in his room and play video games. Subjective data : The patient is five fit tall and weighs 170 pounds.The patient has gained 40 pounds in six months since he was prescribed Olanzapine.The weight gain has been accompanied with increased depression and suicidal thoughts.The patient was hospitalized two days ago after locking himself in his room with a knife and threatening to kill himself.To ensure that the patient is able to control his feelings. To ensure that the patient   openly discusses his fears and what causes those fears.To ensure the patient is able to effectively use coping behaviors and resume normal activities.To ensure that the patient will be able to refrain from physically harming others with aids such as seclusions.To ensure that the patient respond well to external controls such as medications, nursing interventions and seclusion.To ensure the patient is informed on the condition and is informed on when to seek medical assistance. To ensure that the patient is safe and free from injury to self and to those around him. To ensure that the patient seek help when he starts to experience aggressive impulse.Assess and observe the patient frequently for any signs of agitation and fear.                                     Use  a  firm  and  calm approach while       chatting with the  patient                       Redirect the  patient   violent  behaviors  with physical  outlets  such as  the  use  of  a  punching bag .     Provide the patient with a quiet and calm environment; away from environmental stimuli.       Including in the charts what   help to calm the patient agitation and what escalated it; when medications were given and their effect.                       Encourage  and  teach  the  patient on healthy coping techniques                                         Coaching the  patient and  family  interaction       Frequent checkup help I early detection and introduction of interventions; this in turn will prevent the patient from harming others and self. It also decreases the patients need for seclusion.This nursing practitioner should  set limit of the  unacceptable  behavior ; this  provide  a  structure  and   control  of  a patient  in case  he  is  out of  control.This helps the patient by reducing muscle tension and as well as   relieving any pent up hostility.   a calm environment helps  decrease the  patient  anxiety  and  as  well prevent escalation of  manic symptoms .   the   nursing staff   should  recognize  all the  potential signals  escalating  the  maniac symptoms   and  develop a  guideline  on what may work best for the  patient.    Nurses should encourage the patients to implement positive coping strategies such as relaxation techniques, listening to music and self-talk.    The  nursing practitioner should  provide s and  teach the  parents    age related activities  and  expectations for  patients   such as  household responsibilities, reasonable  curfews and  acceptable behaviors .The patient was informed s about the condition and he fully participated in his treatment.The   able demonstrated   effective use of   problem solving and coping skills.The  client was  able  to use  age  appropriate  and  acceptable  behavior’s   while  interacting with others.The patient was able to verbalize positive statement to self and   was able the best coping mechanism. The  patients  parent  were educated  on the   condition and  how to handle  the  client .The patient was taught on various methods of weight management to help reduce his weight.

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