Patsy Buchell Mental Health Care Plan A.

Nursing Diagnosis: Risk for violence related to history of aggression as evidence by aggressive acts and poor parental support system. Interventions: 1. Place child in least restrictive environment that continues to allow for necessary level of observation. Recreation/TV room area is recommended for this child as the least restrictive area in the pediatric unit. Staff are to be present for observation at all times. Rationale: Ensures safety and provides integrations and stimulation rather than isolation. 2.Remove potential safety hazards in patients environment. This includes sharp objects or any objects that may be used as a weapon or to injure. Rationale: Ensure the safety of self and others 3. Monitor for signs of agitation at all times during observation. Signs include fidgeting, raising tone of voice, nervousness, dominating eye contact, and restlessness. Rationale: Staff can intervene before the patient escalates.

B. Nursing Diagnosis: Thought process disturbed related to poor coping and mental illness as evidence by inappropriate social behavior. Patient yells when wanting to get point across, and expresses negative emotions with destructive behavior and words. Interventions: 1. Discuss in daily evening group, alternative methods of coping. Include teaching of writing letters or journals to express feelings. Have patient write down one alternative method per day in group.

Rationale: Teach new skills to cope 2.Allow expression of negative emotions during daily art room activities. Patient may draw how they are feeling or write a story on feelings. Rational: Provide a constructive outlet to release negative energy.

C. Nursing Diagnosis: Powerlessness related to lack of control of patient's current situation as evidence by being committed and separated from his mother and home. Patient expresses powerlessness by acting out behavior/untrusting of staff. Interventions: 1. Encourage personal possessions by artwork and projects made in art group. Clothing style, and any belongings brought from home. Acknowledge privileges obtained from good behavior, such as MP3 privilege given to patients. Rationale: Allows for a sense of possession of items specific to him. 2.Explain all procedures and scheduled activities for each day in the morning/daily. Rationale: Allow child to feel he has some control of his day and is informed. 3. Provide child with choices whenever possible within limits of facilitys rules and regulations. Child may choose TV channel from selected choices, activity choices, and meal planning choices. Rationale: Provides sense of control of his own life.