Nurse's Pocket Guide

• Identify blocks to social contacts (e.g., physical immobility,
sensory deficits, housebound, incontinence). Client may be
unable to go out, embarrassed to be with others, and reluctant
to solve these problems.
• Ascertain implications of cultural values/religious beliefs for
the client because these impact choice of behaviors and may
even script interactions with others.
• Assess factors in client’s life that may contribute to sense of
helplessness (e.g., loss of spouse/parent). Client may withdraw
and fail to seek out friends who may have been in his
or her life previously.
• Ascertain client’s perception regarding sense of isolation. Differentiate
isolation from solitude and loneliness which may
be acceptable or by choice.
• Assess client’s feelings about self, sense of ability to control situation,
sense of hope.
• Note use/effectiveness of coping skills.
• Identify support systems available to the client, including
presence of/relationship with extended family.
• Determine drug use (legal/illicit). Possibility of a relationship
between unhealthy behaviors and social isolation or
the influence others have on the individual.
• Identify behavior response of isolation (e.g., excessive sleeping/daydreaming,
substance use), which also may potentiate
isolation.
• Review history and elicit information about traumatic events
that may have occurred. (Refer to ND Post-Trauma Syndrome.)
NURSING PRIORITY NO. 2.To alleviate conditions contributing to
client’s sense of isolation:
• Establish therapeutic nurse-client relationship. Promotes
trust, allowing client to feel free to discuss sensitive matters.
• Spend time visiting with client, and identify other resources
available (e.g., volunteer, social worker, chaplain).
• Develop plan of action with client: Look at available
resources, support risk-taking behaviors, financial planning,
appropriate medical care/self-care, and so forth.
• Introduce client to those with similar/shared interests and
other supportive people. Provides role models, encourages
problem solving, and possibly making friends that will
relieve client’s sense of isolation.
• Provide positive reinforcement when client makes move(s)
toward others. Encourages continuation of efforts.
• Provide for placement in sheltered community when necessary.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 641
SOCIAL ISOLATION