Nursing Care Plan

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Medical Diagnoses: Chronic low self-esteem r/t impaired cognitive self-appraisal

Nursing DX/Clinical Problem

Client Goals/Desired Outcomes/Objectives

Nursing Interventions/Actions/Orders

I

Evaluation

Goals

Interventions

Chronic low self-esteem r/t impaired cognitive self-appraisal AEB negative feedback about self through client’s statement of, “I don’t have any good qualities” and client seeking validation.

       

Long Term

Client will verbally give an accurate and nonjudgmental account of three positive qualities as well as identify two areas that he wishes to improve by [Month] 8, [Year] at 1400.

Short Term

Client will identify one or two strengths by [Month] 14, [Year] at 1400.

       

       

       

Long Term

1: Work with client on areas that he or she would like to improve using problem-solving skills. Evaluate need for more teaching in this area.

Rationale: Feelings of low self-esteem can interfere with usual problem-solving abilities (Varcarolis, pg 171).

2: Work with client to identify cognitive distortions that encourage negative self-appraisal.

Rationale: Cognitive

       

       

       

distortions reinforce negative, inaccurate perception of the world (Varcarolis, pg. 170).

Developing both self-acceptance and self-esteem have been identified as ways to enhance cognitive interventions (Macinnes, pg 483).

Short term:

1: Assess existing strengths and coping abilities, and provide opportunities for their expression and recognition.

Rationale: Supporting a client’s beliefs and self-rejection and helping them cope can affect self-esteem (Ackley & Ladwig, pg. 716).

2: Reinforce the personal strengths and positive perceptions that the client identifies.

Rationale: Clients with low self-esteem need to have their existence and value confirmed (Ackley & Ladwig, pg. 717).

       

       

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Long Term

Evaluation set for [Month] 8, [Year] at 1400. Client has made some progress toward goal; on [Month] 14, [Year] he was able to identify 2 strengths and did not reject positive self feedback.

Short Term

Goal met. As of [Month] 14, [Year] at 1400 client was able to identify two strengths: being a good listener and having good communication skills.

       

Long Term

Client states that he doesn’t know of areas that he could improve on. He thinks that he has reached his maximum potential. Nursing student worked with client to identify that he focuses on negative qualities while discounting his positive attributes. Client states that he would like to work on being able to accept positive feedback.

Short Term

Assessment of client’s

       

       

       

strengths shows that he is very intelligent and can hold a good conversation. The nursing student worked with the client to identify his strength in communication.

       

       

       

       

Assessment

Subjective Data:

Client’s statements of: “I don’t have any good qualities”, “Do you think I’m unique?”, “Am I different from most people that are like me?”

Objective Data

Lack of eye contact

Rejects positive feedback about self

Excessively seeks reassurance

       



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