9 Major Depression Nursing Care Plans

Risk For Self-Directed Violence

Nursing Diagnosis

• Risk for self-directed violence

Risk factors

The following are the common risk factors:

• Anhedonia, helplessness, hopelessness
• Loneliness
• Social isolation
• Severe personality disorder/ depression/ psychosis, substance abuse

Possibly evidenced by

• Not applicable. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occured and nursing interventions are directed at prevention.

• Previous attempts of violence.
• Suicidal plan (clear, specific, lethal method and available means).
• Suicidal behavior (attempts, ideation, plan and available means).
• When depression begins to lift, clients may have energy to carry out suicidal plan.

Desired Outcomes

Below are the common expected outcomes for this major depression nursing care plan:

• Patient will seek help when experiencing self-destructive impulses.
• Patient will have a behavioral manifestation of absent depression.
• Patient will have satisfaction with social circumstances and achievements of life goals.
• Patient will identify at least two-three people he/she can seek out for support and emotional guidance when he/she is feeling self-destructive before discharge.
• Patient will not inflict any harm to self or others.
• Patient will identify support and support groups with he/she is in contact within one month.
• Patient will state that he/she wants to live.
• Patient will start working on constructive plans for the future.
• Patient will demonstrate compliance with any medication or treatment plan within the next two weeks.
• Patient will demonstrate alternative ways of dealing with negative feelings and emotional stress.

Nursing Assessment and Rationales

Here are the nursing assessment for this major depression nursing care plan.

1. Identify the level of suicide precautions needed. If there is a high risk, does a hospitalization requires? Or if there is a low risk, will the client be safe to go home with supervision from a family member or a friend? For example, does client:

• Admit previous suicide attempts.
• Abuse any substances.
• Have no peers/friends.
• Have any suicide plan.

A client with a high risk will require constant supervision and a safe environment.

2. Check for the availability of the required supply of medications needed.
Normally, a suicidal client’s medical supply should be limited to 3-5 days.

Nursing Interventions and Rationales

The following are the nursing interventions for this major depression nursing care plan.

1. Encourage clients to express feelings (anger, sadness, guilt) and come up with alternative ways to handle feelings of anger and frustration.
Clients can learn alternative ways of dealing with overwhelming emotions and gain a sense of control over his/her life.

2. Contact the family, arrange for crisis counseling. Activate links to self-help groups.
Clients need a network of resources to help diminish personal feelings of helplessness, worthlessness, and isolation.

3. If, hospitalized, follow unit protocols.
There are different measures for the suicidal client in either the hospital, clinic, and community.

4. Implement a written no-suicide contract.
Reinforces action the client can take when feeling suicidal.