Contents:

1) Nursing needs
¤Therapeutic need
¤Physiosocial need
¤Physical need
¤Recreational need
¤Spiritual need
2) Discharge Plan
 ¤Compliance to treatment
Goals:
 To help the patient to recover.
 To enable the patient to learn the importance of treatment,decrease his
symptoms & recover from disease.
Planning:
 Plan the drug therapy with doctor and relatives.
 If physical therapy, ECT is to be given, it should be discussed with
relatives and patients.
Implementation:
 Give the drugs prescribed by the doctor.
 Keep 5 R in mind.
 Observe for side effects.
 Record any change in the patient after medicine.
 Record and report early and late side effects of antipsychotic drugs.
 Explain ECT therapy to the relative.
 Allow him to speak about his illness.
Evaluation:
 Patient participates in his treatment.
 Asks how many more injections(ECT) are required.
To decrease disturbed thoughts.
Goals:
To help the patient communicate his problem
effectively.
To help the patient to develop effective
communication ability and develop skill in
integrating his thoughts and speaking.
Planning:
Plan to establish positive relationship, help the
patient develop trust in the nurse and provide a
planned opportunity for interaction.
Implementation:
Teach the patient when the patient is feeling sad.
Talk to the patient about his problem.
Don't criticise the patient.
Interact with the patient as planned.
Make conversation simple and encourage patient
to talk.
Evaluation:
Develops trust in the nurse and others in
communicating
 To reduse illusions:
Goals:
 To help the patient to accept
reality.
Planning:
 Plan to identify the relationship of
reality and delution.
 Ignore the delusions expressed by
the patient.
Implementation:
 Listen to the patient's delusion and
find out its relationship with his
behaviour.
 Assure and provide the safe
environment.
Evaluation:
 Decrease need to use delusions.
 To decrease hallucinations.
Goals:
 To help the patient to concentrate on his tasks and care.
 To enable the patient to lead a productive life, reduce his
anxiety and develop relationship with others.
Planning:
 Plan to talk to patient to find out the reason for anxiety.
 Develop good relationship with the patient.
 Do not give any importance to the voices or visual
objects.
Implementation:
 Select a separate room for interaction.
 Talk in a trustworthy and comfortable environment so that
his anxiety is reduced.
 Talk about all other things but not the hallucinations.
Evaluation:
 Gains insight into his illness, hallucinations decrease.
 To improve socialization.
Goals:
 To help the patient to have a sense of belongings.
 To help him to improve his self confidence.
 To enable the patient to improve his self concept,
feel comfortable in group and increase social
interaction with others.
Planning:
 Plan sociaization with other patients who are not
overactive, so that self confidence of the patient is
enhanced.
Implementation:
 Speak in clear short sentences.
 Allow the patient to sit with others.
 Allow him to talk to one patient,then two and
gradually in the group.
 In the group, the patient should be given a chance
to talk.
 Tell other patients to come and play with him.
 Allow him to spend more time with others.
Evaluation:
 Enjoys interaction with others.
 Provide protection
Goal:
 To prevent harm to othersand self.
 To enable the patient to protect from injury.
Planning:
 Provide a safe environment.
 Set limits on the patient behaviour.
 Discourage his acts of violence.
Implementation:
 Avoid keeping a glass,knife,blade or any
sharp instrument with the patient.
 Tell the patient he will not alloed to see tha
tv or to meet the person he likes, if he will
be violent.
Evaluation:
 The patient identifies that his behaviour is
unacceptable and makes effort to have more
self control.
 To assist in personal hygiene care
Goal:
 To improve his personal appearance.
 To help him to have sense of well being by being clean.
 To enable the patient to maintain self respect and self identity.
Planning:
 Ensure that the patient takes his bath and attends to personal hygiene,
brushing, shaving, going to toilet, bathing, changing his clothes.
Implementation:
 Be with the patient or tell his relative to be with him, if required.
 Tell the patient to get up from the bed.
 Encourage him to go and brush his teeth.
 Send the patient to bathroom and wait outside or tell the relative to wait
till the patient finishes up bath.
 Tell him to wear his own clean clothes daily.
Evaluation:
 Starts maintaining cleanliness.
 Takes pride in his appearance.
 To improve sleep pattern.
Goals:
 To help him to get up fresh and active.
 To enable the patient to develop a regular sleep
pattern.
Planning:
 Try to provide a calm and comfortable environment.
 The patient should be allowed to have less of sleep
in the day time.
 Plan of activities should be made for the day time.
Implementation:
 Patients should be encouraged to go to sleep
between 9.30 to 10.30.
 Switch off the lights.
 Put on the bedside floor lights.
 If any patient is having disturbing behaviour isolate
him.
Evaluation:
 The patient have longer hours of sleep, feels less
tired.
 Nutritional care:
Goal:
 To increase the patient's energy level.
 To help him develop interest in eating.
 To enable the patient to improve his physical health, accept the
need for an intake of fluids and food and develop interest in
eating.
Planning:
 Diet may be given according to the choice of patient. The
patients are not interested in eating so encourage them to eat.
 Sometimes they are unable to eat, so somebody should help them
to eat.
Implementation:
 Plan an adequate diet and balanced diet with the patient on the
previous day.
 Serve food in a neat and attractive manner.
 Provide a clean environment before serving food.
 Encourage the patient to eat himself.
Evaluation:
 The patient's appetite improves.
Goals:
 To divert the attention of the patient from his
sickness.
 To help him feel that he is recovering.
 To enable the patient to lead towards normal
pattern of life and improve socialization.
Planning:
 Provide the activities of his interest.
 Provide the activities which give him a sense of
achievement.
Implementation:
 Ask the patient his hobbies.
 Tell him to play carrom board with two to four
people.
 Encourage him to play badminton to utilize his
energy.
 If the patient is good in some activity allow
competition and help him to achieve success.
Evaluation:
 Enjoys life routine. Finds meaning in his
activities.
Goals:
 To provide freedom to the patient.
 To enable the patient to feel a sense of
satisfaction and freedom.
Planning:
 Provide a place for the patient to practice
his beliefs.
 Provide opportunities for religious activities.
Implementation:
 Allow the patient to say his prayers daily.
 Provide a separate corner in the ward for
praying.
 Celebrate with the patients holi, diwali and
other religious functions.
 Don't force the patient if he does not want
to participate in other religious activities.
Evaluation:
 The patient feels confident of his life.
Goal:
To help the patient to lead a meaningful
life in the family and community.
To enable the patient to take up family
roles and not to become a burden on
family and society.

Planning:
Activities should be planned according to
the symptoms of the patient from the day
he is admitted.
Help the patient to take up social and
family roles whenever required.

Implementation:
Encourage the patient to meet his
relatives.
Encourage the family members to take his
opinion on important issues of the family.
Send the patient on parole.

Evaluation:
The patient develops a sense of recovery.
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