Tuesday, October 13, 2009

Nursing care plans for patient’s with Delusional disorders

. Tuesday, October 13, 2009

Psychiatric nursing care plans for Delusional disorders. Delusional disorders are characterized by false beliefs with a plausible basis in reality. Formerly referred to as paranoid disorders, delusional disorders are known to involve erotomanic, grandiose, jealous, or somatic themes as well as persecutory delusions. Some patients experience several types of delusions; other patients experience unspecified delusions that have no dominant theme. Delusional disorders typically chronic, these disorders often interfere with social and marital relationships but seldom impair intellectual or occupational functioning significantly. (DSM-IV-TR)

Delusional disorder is characterized by the presence of one or more no bizarre delusions that last for at least 1 month. Hallucinatory activity is not prominent. Apart from the delusions, behavior and functioning are not impaired. The following types are based on the predominant delusional theme (AMA, 2000):
  • Persecutory
  • Jealous
  • Erotomanic
  • Somatic
  • Grandiose

Causes for Delusional disorders
Hereditary predisposition. Some researchers suggest that delusional disorders are the product of specific early childhood experiences with an authoritarian family structure. sensitive personality is particularly vulnerable to developing a delusional disorder. At least one study has linked the development of delusional disorders to inferiority feelings in the family. Certain medical conditions exaggerate the risks of delusional disorders: head injury, chronic alcoholism, deafness, and aging.

Complications for Delusional disorders
Patient’s irrational beliefs may pose a threat to him or others. Greater patient's rage, the greater the risk of violent behavior or suicide.

Treatment for Delusional disorders
  • Combination of drug therapy and psychotherapy.
  • Drug with antipsychotic agents is similar other psychiatric drugs, such as antidepressants and anxiolytics.

Nursing diagnoses Nursing care plans for Delusional disorders
  • Risk for other-directed violence
  • Risk for self-directed violence
  • Social isolation
  • Anxiety
  • Disabled family coping
  • Disturbed personal identity
  • Disturbed sensory perception (visual, auditory)
  • Disturbed thought processes
  • Fear
  • Imbalanced nutrition: Less than body requirements
  • Impaired home maintenance
  • Impaired social interaction
  • Ineffective coping
  • Powerlessness
  • Risk for injury

Nursing Key outcomes nursing care plans for patient’s with Delusional disorders
  • The patient will consider alternative interpretations of a situation without becoming hostile or anxious. Anxiety is maintained at a level at which client feels no need for aggression.
  • Client demonstrates trust of others in his or her environment.
  • Client maintains reality orientation.
  • Client causes no harm to self or others.
  • Client demonstrates willingness and desire to socialize with others, voluntarily attends group activities.
  • Client approaches others in appropriate manner for one-to-one interaction.
  • The patient and his family will participate in care and prescribed therapies.
  • The patient will identify internal and external factors that trigger delusional episodes.
  • The patient will maintain functioning to the fullest extent possible within the limitations of his visual or auditory impairment.
  • The patient will express all fears and concerns.
  • Client is able to recognize that hallucinations occur at times of extreme anxiety.
  • Client is able to recognize signs of increasing anxiety and employ techniques to interrupt the response.
  • The patient will demonstrate effective social interaction skills in both one-on-one and group settings.
  • The patient will demonstrate adaptive coping behaviors.
  • The patient will identify and perform activities that decrease delusions.
  • The patient will remain free from injury.
  • The patient will maintain family and peer relationships.
Nursing interventions nursing care plans for patient’s with Delusional disorders


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