As a nurse, it is essential to understand the nursing diagnosis for personality disorders to provide effective care and support to these patients. In this article, we will discuss the nursing diagnosis for personality disorders in detail, including its definition, types, assessment, interventions, and management strategies.
What are Personality Disorders?
Personality disorders are a group of mental health conditions characterized by persistent and maladaptive patterns of behavior, cognition, and emotions that significantly impair social, occupational, and other areas of functioning. Individuals with personality disorders often experience difficulties in relating to others, regulating their emotions, and coping with stress.
Personality is defined as the differences in the characteristic patterns of behaving, feeling, and thinking of an individual.
A personality disorder is a type of mental illness in which a person’s personality traits have become rigid, inflexible, and maladaptive and can hinder the person’s perception and association with situations and people. This can cause significant problems and restrictions in the family, social activities, school, employment, and other functional roles.
Nursing Care Plans
The nursing care plan varies according to the kind of personality disorder, its severity, and life situation. A collaborative intervention is needed to make sure all of the client’s social, medical, and psychiatric needs are met.
The goals of the nurse for clients with personality disorders focus on establishing trust, providing safety and comfort, teaching basic living skills, and promoting responsible behavior.
Here are four (4) nursing care plans (NCP) and nursing diagnoses for personality disorders:
Risk For Self-Mutilation
Patients with a history of self-injury may continue to engage in self-mutilation as a maladaptive coping mechanism for emotional distress. In cases of abuse, the patient may engage in self-injury as a way to exert control over their own body, while those with mental retardation may engage in self-injury as a result of an inability to communicate emotional distress effectively. Attention-seeking behaviors may also contribute to self-injury as a means of eliciting a response from caregivers or loved ones.
- Risk For Self-Mutilation
- Desperate need for attention
- Emotionally disturbed or battered children
- Feelings of depression, rejection, self-hatred, separation anxiety, guilt, and depersonalization
- History of self-injury
- History of physical, emotional, or sexual abuse
- High-risk populations (BPD, psychotic states)
- Impulsive behavior
- Inability to verbally express feelings
- Ineffective coping skills
- Mentally retarded and autistic children
Possibly evidenced by
- Not applicable for risk diagnosis. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred and nursing interventions are directed at prevention.
- The patient will be free of self-inflicted injury.
- The patient will participate in impulse control training.
- The patient will participate in coping skills training.
- The patient will seek help when experiencing self-destructive impulses.
- The patient will discuss alternative ways a client can meet the demands of the current situation.
- The patient will express feelings related to stress and tension instead of acting-out behaviors.
- The patient will sign a “no-harm” contract that identifies steps he or she will take when urges return.
- The patient will respond to external limits.
- The patient will participate in the therapeutic regimen.
- The patient will demonstrate decreased frequency and intensity of the self-inflicted injury.
- The patient will demonstrate two new coping skills that work for the client when tension mounts and impulse returns.
Nursing Assessment and Rationales
1. Assess the client’s history of self-mutilation which includes: types of mutilating behaviors, frequency behaviors, and stressors preceding behavior.
Identifying patterns and circumstances surrounding self-injury can help the nurse plan interventions and teaching strategies suitable to the client.
2. Identify feelings experienced before and around the act of self-mutilation.
Feelings are a guideline for future intervention (e.g., rage at feeling left out or abandoned).
3. Explore with the client what these feelings might mean.
Self-mutilation might also be a way to gain control over others, a way to feel alive through pain, and an expression of self-hate or guilt.
Nursing Interventions and Rationales
1. Secure a written or verbal no-harm contract with the client. Identify specific steps (e.g., persons to call upon when prompted to self-mutilate).
The client is encouraged to take responsibility for healthier behavior. Talking to others and learning alternative coping skills can reduce frequency and severity until such behavior ceases.
2. Set and maintain limits on acceptable behavior and make clear the client’s responsibilities. If the client is hospitalized at the time, be clear regarding the unit rules.
Clear and nonpunitive limit setting is essential for decreasing negative behaviors.
3. Be consistent in maintaining and enforcing the limits, using a nonpunitive approach.
Consistency can establish a sense of security.
4. Use a matter-of-fact approach when self-mutilation occurs. Avoid criticizing or giving sympathy.
A neutral approach prevents blaming, which increases anxiety, giving special attention that encourages acting out.
5. After the treatment of the wound, discuss what happened right before, and the thoughts and feelings that the client had immediately before self-mutilating.
Identifies dynamics for both client and clinician. Allows the identification of less harmful responses to help relieve intense tensions.
6. Work out a plan identifying alternatives to self-mutilating behaviors.
The plan is periodically reviewed and evaluated. Offers a chance to deal with feelings and struggles that arise.
- 6.1. Anticipate certain situations that might lead to increased stress (e.g., feeling overwhelmed, rejected, tense, or rage).
Anticipation can help the patients be better prepared to manage those situations without resorting to self-mutilation.
- 6.2. Identify actions that might modify the intensity of such situations.
Learning and practicing coping skills like deep breathing, meditation, or mindfulness can help decrease stress and manage difficult emotions.
- 6.3. Identify two or three people the client can contact to discuss and examine intense feelings (rage, self-hate) when they arise.
Discussing intense emotions with others can help the client learn coping strategies for dealing with difficult emotions and avoid self-mutilation.
Recommended nursing diagnosis and nursing care plan books and resources.
Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.
Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance.
NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans for mental health and psychiatric nursing:
- Alcohol Withdrawal | 5 Care Plans
- Anxiety and Panic Disorders | 7 Care Plans
- Bipolar Disorders | 6 Care Plans
- Major Depression | 9 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
3 thoughts on “4 Personality Disorders Nursing Care Plans”
As a healthcare provider with a diagnosis of BPD, these care plans seem well written and well researched. I think there is a lot of stigma around personality disorders. But this was broken down well to manage many chronic symptoms.
Children who has these conditions needs to undergo Child Psychiatry treatment.
Nurses get more information than therapists. You have to be a clinical therapist to know this!
And therapists have knowledge to help people.
What a shame, waste of time this can be when therapists don’t get this information