Labuen, Mark Johne E.

NCM107-F Schizophrenia - Social isolation r/t altered mental status CUES NURSING DIAGNOSIS Social isolation related to altered mental status GOALS OF CARE/OUTCOME CRITERIA After 8 hours of nursing interventions, the client will be able to: Identify causes and actions to correct isolation Verbalized willingness to be involved with others Participate in activities/ programs at level of ability/desire Expresse increased sense of self-worth NURSING INTERVENTIONS Assess factors in clients life that may contribute to sense of helplessness Rationale: Client may withdraw and fail to seek out friends who may have been in his life previously Ascertain clients perception regarding sense of social isolation. Rationale: to assess causative/contrib uting factors Assess clients feeling about self, sense of ability to control situation, sense of hope Ratinale: to IMPLEMENTATION EVALUATION

Subjective Cues: ayaw ko makipagusap sa mga tao dahil iba ako sa kanila at di ko sila kailangan as patient verbalized -patient verbalized that he dont want to talk with other people because he is different and he dont need them Objective Cues: Lack of support system Seeks to be alone Lack of eye contact

Established nurse-patient relationship by telling the patient reality story and allowing him to respond/react about the story. Allow client to verbalize her feelings and concerns. Introduced client to those with similar/shared interests Encouraged participation in any activities ( egg sandwich activity ).

At the end of our shift Patient shows trust to me, he told me stories about her life including sensitive matters. Patient verbalized that he enjoyed joining the activity provided. After 3 hours of talking to the client, he was able to talk to me with an eye contact. Client had a conversation with other

assess causative/contrib uting factors Establish therapeutic nurse-client relationship Rationale: to promote trust, allowing client to feel free to discuss sensitive matters Introduce client to those with similar/shared interests and other supportive people. Rationale: To provide role models, encourages problem solving, and possibly making friends that will relive clients sense of isolation. Promote participation in recreational/ special interest activities in

people around her and was able to find a new friend.

setting that client views as safe Rationale: to alleviate conditions contributing to clients sense of isolation