Major depression is classified under mood disorders which are characterized by disturbances in the regulation of mood, behavior, and affect that go beyond the normal fluctuations that most people experience.
Nursing Care Plans
The nurse’s plan of care for patients with major depression should be to determine degree of impairment, assess coping abilities, assist client to deal with current situation, provide for meeting psychological needs, and promote health and wellness.
- Risk For Self-Directed Violence
- Impaired Social Interaction
- Spiritual Distress
- Chronic Low Self-Esteem
- Disturbed Thought Processes
- Self-Care Deficit
Risk For Self-Directed Violence
Risk for self-directed violence: At risk for behaviors in which an individual demonstrates that he/she can be physically, emotionally, and/or sexually harmful to self.
- Anhedonia, helplessness, hopelessness
- Social isolation
- Severe personality disorder/ depression/ psychosis, substance abuse
Possibly evidenced by
- 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.
- 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.
|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:||A client with a high-risk will require a constant supervision and a safe environment.|
|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.|
|Check for the availability of required supply of medications needed.||Normally, a suicidal client’s medical supply should be limited to 3-5 days.|
|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.|
|If, hospitalized, follow unit protocols.||There are different measures for the suicidal client in either the hospital, clinic, and community.|
|Implement a written no-suicide contract.||Reinforces action the client can take when feeling suicidal.|
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Mental Health and Psychiatric Care Plans
Care plans about mental health and psychiatric nursing:
- Anxiety and Panic Disorders | 7 Care Plans
- Bipolar Disorders | 6 Care Plans
- Major Depression | 6 Care Plans
- Personality Disorders | 4 Care Plans
- Schizophrenia | 6 Care Plans
- Sexual Assault | 1 Care Plan
- Substance Dependence and Abuse | 8 Care Plans
- Suicide Behaviors | 3 Care Plans
Recommended books and resources:
- Nursing Care Plans: Diagnoses, Interventions, and Outcomes
- Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
- Nursing Diagnoses 2015-17: Definitions and Classification
- Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR)
- Manual of Psychiatric Nursing Care Planning
- Maternal Newborn Nursing Care Plans
- Delmar's Maternal-Infant Nursing Care Plans, 2nd Edition
- Maternal Newborn Nursing Care Plans