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LIPPINCOTT's MANUAL of Psychiatric Nursing Care Plans LIPPINCOTT’S MANUAL OF Psychiatric Nursing Care Plans Judith M. Schultz, MS, RN Senior Account Manager Healthways, Inc. San Francisco, California Sheila L. Videbeck, PhD, RN Professor, Nursing Des Moines Area Community College Ankeny, Iowa NINTH EDITION Vice President, Publishing: Julie K. Stegman Supervising Product Manager: Betsy Gentzler Editorial Assistant: Jacalyn Clay Design Coordinator: Joan Wendt Art Coordinator: Brett MacNaughton Manufacturing Coordinator: Karin Duf!eld Prepress Vendor: S4Carlisle Publishing Services 9th edition Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins. Copyright © 2005, 2002 Lippincott Williams & Wilkins. Copyright © 1998 Lippincott-Raven Publishers. Copyright © 1994 by Judith M. Schultz and Sheila Dark Vide- beck. Copyright © 1990, 1986, 1982 by Judith M. Schultz and Sheila L. Dark. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their of!cial duties as U.S. government employees are not covered by the above- mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at [email protected], or via our website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China. Library of Congress Cataloging-in-Publication Data Schultz, Judith M. Lippincott’s manual of psychiatric nursing care plans / Judith M. Schultz, Sheila L. Videbeck.—9th ed. p. ; cm. Manual of psychiatric nursing care plans Includes bibliographical references and index. ISBN 978-1-60913-694-9 (alk. paper) I. Videbeck, Sheila L. II. Title. III. Title: Manual of psychiatric nursing care plans. [DNLM: 1. Mental Disorders—nursing—Handbooks. 2. Patient Care Planning—Handbooks. 3. Psychiatric Nursing— methods—Handbooks. WY 49] 616.89'0231—dc23 2011051681 Care has been taken to con!rm the accuracy of the information presented and to describe generally accepted practices. How- ever, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant "ow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in his or her clinical practice. LWW.com REVIEWERS Dolores Bradley, MSN, BSN, Elaine Kusick, MSN, BSN, RN RN, CNE Instructor, Nursing Nursing Faculty, Associate Professor Butler County Community College Farmingdale State College Butler, Pennsylvania State University of New York Farmingdale, New York Ann Michalski Associate Professor Kay Foland, PhD, RN, CNP, Bakers!eld College CNS-BC, PMHNP-BC Bakers!eld, California Professor College of Nursing Alita Sellers, PhD, RN, CNE South Dakota State University Professor, Coordinator RN to BSN Program Rapid City, South Dakota West Virginia University, Parkersburg Parkersburg, West Virginia Jennifer Graber, EdD(c), APRN, BC, CS Karen Gahan Tarnow, PhD, RN Nursing Instructor Clinical Associate Professor Stanton Campus University of Kansas School of Nursing Delaware Technical Community College Kansas City, Kansas Newark, Delaware Mary Lou Hamilton, MS, RN Nursing Faculty in Psychiatric Mental Health Nursing Delaware Technical Community College Newark, Delaware iii PREFACE The ninth edition of Lippincott’s Manual of Psychiatric Nursing Care Plans continues to be an outstanding resource for nursing students and practicing psychiatric–mental health nurses. The Manual is a learning tool and a reference presenting information, concepts, and principles in a simple and clear format that can be used in a variety of settings. The Manual complements theory-based general psychiatric nursing textbooks and provides a solid clinical orientation for students learning to use the nursing process in the clinical psychiatric setting. Its straight- forward presentation and effective use of the nursing process provide students with easily used tools to enhance understanding and support practice. Too often, students feel ill-prepared for their clinical psychiatric experience, and their anxiety interferes with both their learning and appreciation of psychiatric nursing. The Man- ual can help to diminish this anxiety by its demonstration of the use of the nursing process in psychiatric nursing and its suggestions for speci!c interventions addressing particular behaviors, together with rationale, giving the student a sound basis on which to build clinical skills. The continued, widespread, international use of this Manual supports our belief in the enduring need for a practical guide to nursing care planning for clients with emotional or psychiatric problems. However, the care plans in this Manual do not replace the nurse’s skills in assessment, formulation of speci!c nursing diagnoses, expected outcomes, nursing inter- ventions, and evaluation of nursing care. Because each client is an individual, he or she needs a plan of nursing care speci!cally tailored to his or her own needs, problems, and circum- stances. The plans in the Manual cover a range of problems and a variety of approaches that may be employed in providing nursing care. This information is meant to be adapted and used appropriately in planning nursing care for each client. TEXT ORGANIZATION The Manual is organized into three parts. Part One, Using the Manual, provides support for nursing students, instructors, and clini- cal nursing staff in developing psychiatric nursing skills; provides guidelines for developing interaction skills through the use of case studies, role play, and videotaped interaction; and provides strategies for developing written nursing care plans. Part Two, Key Considerations in Mental Health Nursing, covers concepts that are con- sidered important underpinnings of psychiatric nursing practice. These include the therapeutic milieu, sexuality, spirituality, culture, complementary and alternative medicine, aging, lone- liness, homelessness, stress, crisis intervention, community violence, community grief and disaster response, the nursing process, evidence-based practice, best practices, the interdis- ciplinary treatment team, nurse–client interactions, and the roles of the psychiatric nurse and of the client. Part Three, Care Plans, includes 52 care plans organized into 13 sections. The section titles are General Care Plans; Community-Based Care; Disorders Diagnosed in Childhood or Adolescence; Delirium, Dementia, and Head Injury; Substance-Related Disorders; Schizo- phrenia and Psychotic Disorders/Symptoms; Mood Disorders and Related Behaviors; Anxi- ety Disorders; Somatoform and Dissociative Disorders; Eating Disorders; Sleep Disorders and Adjustment Disorders; Personality Disorders; and Behavioral and Problem-Based Care Plans. iv Preface v NURSING PROCESS FRAMEWORK The Manual continues to use the nursing process as a framework for care, and each care plan is organized by nursing diagnoses. The care plans provide an outcomes-focused approach, and therapeutic goals content is included in the basic concepts section and the introductory paragraphs of the care plans. NEW TO THIS EDITION r /FXJOGPSNBUJPOPO$PNQMFNFOUBSZBOE"MUFSOBUJWF.FEJDJOFJOGPSNBUJPOBOE Using the Internet r "MMDBSFQMBOTSFWJTFEBOEVQEBUFE r &YQBOEFEPVUDPNFTTUBUFNFOUTXJUITQFDJàDUJNJOHFYBNQMFT r 6QEBUFE3FDPNNFOEFE3FBEJOHTJOFBDITFDUJPO r 6QEBUFE3FTPVSDFTGPS"EEJUJPOBM*OGPSNBUJPOGPSFBDITFDUJPOBEEJUJPOBMJOGPSNBUJPO is also available on thePoint r 6QEBUFESFGFSFODFTUISPVHIPVUUIFManual r 3BUJPOBMFGPSDPSSFDUSFTQPOTFTPGUIFTFDUJPOSFWJFXRVFTUJPOT r 6QEBUFE/"/%"*OUFSOBUJPOBMmOVSTJOHEJBHOPTFTJODMVEFE* r /FXBQQFOEJYPO&MFDUSPDPOWVMTJWF5IFSBQZ r &YQBOEFE VQEBUFE BOESFGPSNBUUFE1TZDIPQIBSNBDPMPHZ"QQFOEJY r /FXBQQFOEJYPO4JEF&GGFDUTPG.FEJDBUJPOTBOE3FMBUFE/VSTJOH*OUFSWFOUJPOT r /FXBQQFOEJYPO4DIJ[PJE )JTUSJPOJD /BSDJTTJTUJD "WPJEBOU BOE0CTFTTJWF$PNQVMTJWF Personality Disorders USING THE MANUAL The Manual is an ideal text and reference for mental health and general clinical settings, including community and home
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