928 NURSING CARE PLAN The Child or Adolescent Hospitalized ...

NURSING CARE PLAN
NIC Priority Intervention: Hope
Instillation: Facilitation of the
development of a positive outlook.
■ Encourage open expression of
feelings. Explore hopeless, sad, or
lonely feelings. Point out the
connection between feelings and
behavior. Assess the child or
adolescent to identify the
precipitating event when feelings of
sadness arose.
■ Encourage the child or adolescent
to take part in self-care and unit
activities. Use routines to establish
feelings of control.
■ Medicate as ordered and document
results.
NIC Priority Intervention: Coping
Enhancement: Assisting a patient to
adapt to perceived stressors, changes,
or threats which interfere with
meeting life demands and roles.
■ Teach positive, effective coping
strategies such as guided imagery
and relaxation. Assist the child or
adolescent to focus on strengths
rather than weaknesses.
■ Assist the child or adolescent to
identify friends, family members,
and others who are positive and
supportive.
The Child or Adolescent Hospitalized
with Depression
GOAL INTERVENTION RATIONALE EXPECTED OUTCOME
1. Hopelessness related to long-term stress
The child or adolescent will discuss
feelings of hopelessness.
■ Expressing feelings may help to
relieve sadness, loneliness, despair,
and hopelessness. An accepting
and nonjudgmental attitude must
be maintained regarding any
feelings expressed by the child.
■ An active role in self-care and
treatment helps the child or
adolescent to feel more in control.
■ Antidepressants modify mood to a
more hopeful outlook.
2. Ineffective Individual Coping related to inadequate social support or disturbance in pattern of appraisal of threat.
The child or adolescent will use
effective coping skills.
■ Therapeutic techniques can help
the child or adolescent to replace
negative thoughts and images with
more positive and effective beliefs
and images. These interventions
foster resilience.
■ Helps the child or adolescent to
become aware that people can be
caring and supportive (thus
validating self-esteem).
NOC Suggested: Outcome: Hope:
Presence of internal state of optimism
that is personally satisfying and life
supporting.
By discharge, the child or adolescent
expresses an interest in the future.
NOC Suggested Outcome: Coping:
Actions to manage stressors that tax
an individual’s resources.
The child or adolescent verbalizes and
demonstrates ability to cope
appropriately for his or her age.

NURSING CARE PLAN
NIC Intervention: Socialization
Enhancement: Facilitation of ability
to interact with others.
■ Assist the child or adolescent to
identify topics and activities of
interest.
■ Encourage interaction with peers
and staff.
■ Facilitate visits from family and
friends.
■ Provide guidance to family
regarding interaction that
promotes self-esteem.
NIC Intervention: Nutrition
Management: Assistance with or
provision of a balanced dietary intake
of foods and fluids.
■ Offer nutritious finger foods,
sandwiches, and high-calorie liquid
supplements frequently throughout
the day.
■ Offer easy-to-carry drinks that are
high in vitamins, minerals, and
calories.
■ Encourage daily vigorous physical
activity of at least 30 minutes.
The Child or Adolescent Hospitalized
with Depression (continued)
GOAL INTERVENTION RATIONALE EXPECTED OUTCOME
3. Impaired Social Interaction related to self concept disturbance
The child or adolescent will participate
in and initiate activities and
conversation.
■ The more the child or adolescent
focuses on areas of interest, the less
he or she will focus on internal
anxiety and depression.
■ Each positive interaction reinforces
feelings of success. Each success
reinforces the desire for future
social interaction.
■ Reinforces positive and rewarding
relationships.
■ The family’s existing interaction
style is often negative.
4. Altered Nutrition: Less Than Body Requirements related to loss of appetite secondary to depression
The child or adolescent’s daily intake
will be adequate to maintain optimal
nutritional status.
■ Convenient easy-to-eat foods
encourage the child or adolescent
to eat and maintain nutritional
status.
■ These are a convenient method for
meeting hydration and electrolyte
needs.
■ Physical activity stimulates appetite.
NOC Outcome: Social Interaction
Skills: An individual’s use of effective
interaction behaviors.
By discharge, the child or adolescent
initiates conversation and activities
with staff and peers.
NOC Outcome: Nutritional Status:
Amount of food and fluid taken into
the body over a 24-hour period.
The child or adolescent’s daily intake
will be adequate to maintain optimal
nutritional status by discharge.