Nurse's Pocket Guide

• Evaluate possibility of client being the victim of or using
destructive behaviors against self or others. (Refer to NDs risk
for other-/self-directed Violence.) Problems with communication
lead to frustration and anger, leaving the individual with
few coping skills, and may result in destructive behaviors.
• Interview family, SO(s), friends, spiritual leaders, coworkers,
as appropriate, to obtain observations of client’s behavioral
changes and effect on others.
• Note effects of changes on socioeconomic level, ethnic/religious
practices.
NURSING PRIORITY NO. 3.To assist client/SO(s) to recognize/
make positive changes in impaired social and interpersonal
interactions:
• Establish therapeutic relationship using positive regard for
the client, active-listening, and providing safe environment
for self-disclosure.
• Have client list behaviors that cause discomfort. Once recognized,
client can choose to change as he or she learns to listen
and communicate in socially acceptable ways.
• Have family/SO(s) list client’s behaviors that are causing discomfort
for them. Family needs to understand that the
client is unable to use social skills that have not been
learned.
• Review/list negative behaviors observed previously by caregivers,
coworkers, and so forth.
• Compare lists and validate reality of perceptions. Help client
prioritize those behaviors needing change.
• Explore with client and role play means of making agreed
upon changes in social interactions/behaviors.
• Role play random social situations in therapeutically controlled
environment with “safe” therapy group. Have group
note behaviors, both positive and negative, and discuss these
and any changes needed.
• Role play changes and discuss impact. Include family/SO(s),
as indicated. Enhances comfort with new behaviors.
• Provide positive reinforcement for improvement in social
behaviors and interactions. Encourages continuation of
desired behaviors/efforts for change.
• Participate in multidisciplinary client-centered conferences to
evaluate progress. Involve everyone associated with client’s
care, family members, SO(s), and therapy group.
• Work with client to alleviate underlying negative self-concepts
because they often impede positive social interactions.
Attempts at trying to connect with another can
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 637
impaired SOCIAL INTERACTION