Sample NCP: Interrupted Family Processes

Assessment	Diagnosis	Scientific Explanation	Planning	Interventions	Rationale	Evaluation
Subjective:      “Nag-away lang naman kami ng misis ko, tapos dito na nila ko dinala.” Objective: ·   Records show that the family members haven’t visited the client since his admission.	Interrupted family processes related to mental disorder of family member as manifested by changes in stress reduction behavior	Genetic vulnerability Prenatal, drugs, alcohol, etc.   Chronic heightened glucocorticoid release   Hippocampal  damage Impaired feedback system Disturbed thought processes Disturbed family processes	Discharge outcome      Upon discharge, the family members will be able to: a.  Demonstrate problem-solving skills for handling tensions and misunderstandings within the family environment b.  Discuss the disease (schizophrenia) knowledgeably c.   Verbalize understanding for strict medical adherence of their ill member. Short Term outcome      After 2 weeks of nursing interventions, the family members will be able to: a.       Attend atleast two family support groups. b.      State what medications can do for their ill member, the side effects and toxic effects of the drugs and the understanding of adherence to the medication at least 2 to 3 days before discharge c.       State and have written information identifying the signs of potential relapse and whom to contact in said situations d.      Include themselves in the discharge planning of their ill member	Independent: ·   Identify the family’s ability to cope (experiences of loss, caregiver burden, needed supports) ·   Provide opportunity for the family to discuss feelings related to ill family member and identify their immediate concerns ·   Assess the family members’ current level of knowledge about the disease and medications used to treat the disease. ·   Provide information on the disease and treatment strategies at family’s level of knowledge ·   Teach at client’s and family’s level of understanding and readiness ·   Inform the client and family in clear, simple terms about psychopharmacologic therapy: dosage, the need to take medication as prescribed, side effects and toxic effects. Written information should be given to the client as well. ·   Provide information on family and client community resources for the client and family after discharge: support groups, organizations, day hospitals, psychoeducational programs etc. ·   Teach family and client the warning symptoms of potential relapse. Collaborative: ·   Collaborate with community resources for the client and family after discharge: support groups, organizations, day hospitals, psychoeducational programs respite centers etc.	Family’s needs must be addressed to stabilize the family unit Nurses can best intervene when there is understanding of the family’s experience and needs Family might have misconceptions and misinformation about schizophrenia and treatment, or no knowledge at all. Meet family members’ needs for information For maximum understanding Understanding of the disease and the treatment of the disease encourages better family support and client adherence. Schizophrenia is an overwhelming disease for both the client and the family. Groups, support groups and psychoeducational centers can help. Rapid recognition of early warning symptoms can help ward off potential relapse when immediate medical attention is sought Early collaboration with facilities may help for the expectation of the participation the client with their services. It may also gain easier access, enhance support and minimize isolation of the client and family members in their community, improving life for all members. Reference: Varcarolis, Elizabeth M., Psychiatric NCP, pp. 245- 249	Discharge outcome Outcome Achieved      Upon discharge, the family members were able to demonstrate problem-solving skills for handling tensions and misunderstandings within the family environment, discuss the disease (schizophrenia) knowledgeably and verbalize complete and understanding for the strict medical adherence of their ill member. Short Term outcome Outcome Achieved After 2 weeks of nursing interventions, the family members were able to attend two family support group sessions. They were also able to state what medications can do for their ill member, the side effects and toxic effects of the drugs and the understanding of adherence to the medication at least 2 to 3 days before discharge, along with the discussion of the signs of potential relapse and whom to contact in said situations. More importantly, they voluntarily included themselves in the discharge planning of their ill member. Recommendation: Terminate the Plan