9 Major Depression Nursing Care Plans

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Included in this nursing care plan guide are nine (9) nursing diagnosis for major depression. Get to know the nursing assessment, interventions, goals, and related factors to the different nursing diagnosis for major depression.

What is Major Depression? 

Major depression (or major depressive disorder) 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.

You can learn more about major depression in our study guide here.

Nursing Care Plans for Major Depression

Nursing care plan goals for patients with major depression includes determining a degree of impairment, assessing the client’s coping abilities, assisting the client to deal with the current situation, providing for meeting psychological needs, and promote health and wellness.

Here are nine (9) nursing care plans (NCP) and nursing diagnosis for major depression:

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  1. Risk For Self-Directed Violence
  2. Impaired Social Interaction
  3. Spiritual Distress
  4. Chronic Low Self-Esteem
  5. Disturbed Thought Processes
  6. Self-Care Deficit
  7. Grieving
  8. Hopelessness
  9. Deficient Knowledge
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Self-Care Deficit

Nursing Diagnosis

May be related to

  • Anergia (Decreased or lack of motivation).
  • Perceptual or cognitive impairment.
  • Severe anxiety.
  • Severe preoccupation.

Possibly evidenced by

  • Awakening earlier or later than desired.
  • Body odor/hair unwashed and unkempt.
  • Constipation related to lack of exercise, roughage in diet, and poor fluid intake.
  • Consuming insufficient food or nutrients to meet minimum daily requirements.
  • Decreased ability to function secondary to sleep deprivation.
  • Inability to organize simple steps in hygiene and grooming.
  • Persistent insomnia or hypersomnia.
  • Weight loss.

Desired Outcomes

  • Patient will groom and dress appropriately with help from a nursing staff and/ or family.
  • Patient will regain more normal elimination pattern with aid of foods high in roughage, increased fluid intake, and exercise daily (also with the aid of medications).
  • Patient will sleep between 4 to 6 hours with aid of nursing measures and/or medications.
  • Patient will gain 1 pound a week with encouragement from family, significant others, and/or staff if significant weight loss is noted.
  • Patient will demonstrate progress in the maintenance of adequate hygiene and be appropriately groomed and dressed (shave/makeup, clothes clean and neat).
  • Patient will experience normal elimination with the aid of diet, fluids, and exercise within 3 weeks.
  • Patient will sleep between 6 to 8 hours per night within one month.
  • Patient will gradually return to weight consistent for height and age or baseline before illness.
Nursing InterventionsRationale
Bathing and/or Hygiene Self-Care Deficit:
  • Encourage the use of soap, washcloth, toothbrush, shaving equipment, make-up etc.
Being clean and well groomed can temporarily increase self-esteem.
  • Give step-by-step reminders such as “Brush the teeth “Clean the outer surfaces of your upper teeth, then your lower teeth. . .”
Slowed thinking and difficulty concentrating make organizing simple tasks difficult.
Constipation
Most of the depressed clients are constipated. If this problem is not addressed, it can lead to fecal impaction.
  • Encourage the intake of nonalcoholic and noncaffeinated fluids, 6 to 8 glasses a day.
Fluids can help prevent constipation.
  • Offer fiber-rich foods and periods of exercise.
Roughage and exercise stimulate peristalsis and help evacuation of fecal material.
  • Evaluate the need for laxatives and enemas.
 These prevent the occurrence of fecal impaction.
Disturbed Sleep Pattern
  • Provide rest periods after activities.
Fatigue can intensify feelings of depression.
  • Encourage relaxation measures in the evening (e.g., drinking warm milk, back rub, or tepid bath).
These measures induce sleep and relaxation.
  • Encourage the client to get up and dress and to stay out of bed during the day.
Minimize sleep during the day increases the likelihood of sleep at night.
  • Reduce environmental and physical stimulants in the evening; Provide decaffeinated coffee, soft music, soft lights and quiet activities.
Decreasing caffeine and epinephrine levels increases the possibility of sleep.
Imbalanced Nutrition
  • Weight the client weekly and observe the eating patterns of the client.
Give the information needed for revising the intervention.
  • Encourage eating with others.
Increases socialization, decrease focus on the food.
  • Serve foods or drinks the client likes.
Clients are more likely to eat foods they like.
  • Encourage small, high-calorie, and high-protein snacks and fluids frequently throughout the day and evening if weight loss is noted.
Minimize weight loss, constipation, and dehydration.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans for mental health and psychiatric nursing:

References and Sources

References and recommended sources for this care plan guide for major depressive disorder:

  • Boyd, M. A. (Ed.). (2008). Psychiatric nursing: Contemporary practice. lippincott Williams & wilkins.
  • Keltner, N. L. (2013). Psychiatric nursing. Elsevier Health Sciences.
  • Videbeck, S. L. (2010). Psychiatric-mental health nursing. Lippincott Williams & Wilkins.
  • Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
  • Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]
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Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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