Question

Develop a plan of care for a family including at least two (2) priority nursing diagnoses for each of the following needs: psychological, sociocultural, spiritual, and physiological needs. The family has a history of domestic violence, child sexual abuse, depression, ptsd,

Answer 1

Plan of care for a Family with Domestic violence, child sexual abuse and PTSD:

Domestic violence

A violence committed in a Domestic setting , such as in marriage, or cohabitation.  

Child abuse

Maltreatment of a child, physically, sexually or emotionally.

PTSD : Post Traumatic stress disorder

Assessment:

* Assess the parents understanding about the child's growth and development

* Assess parents for the achievement of developmental task of self

* Assess the coping skills of individuals and family members

* Assess the signs of physical abuse

1. Nursing Diagnosis

Impaired parenting related to unmet emotional and social maturation needs of parental figures as evidenced by lack of parental attachment behaviors

Expected outcome:

Parent will demonstrate appropriate parental behaviours

Nursing Interventions:

* Encourage the parents to express their feelings, goals , personal needs

* Praise the parents for their participation in child care

* inform them that the Child Protection Services have been contacted and they may come for assessing the child's safety and wellness.

* Teach the parents about the growth and development of the child and the importance of emotional support for the child in his/ her growth.

*Instruct the parents to provide a safe environment for the child and to spend quality time with him or her.

* Include parents in setting the goals and plan of child care.

2. Nursing Diagnosis

Ineffective individual coping related to being a victim of domestic violence as evidenced by the verbalization.

Expected outcome: Patient will identify that the violence exists and will understand removing herself from the situation is a process that usually occurs overtime.

Nursing Interventions:

* Assist the patient to develop a safety plan as there is chance for the recurrence of the incident.

* Identity the high- risk dependent relationships of the patient and help her to identify the actions to prevent further violence.

* Do Referrals for social services and Counselling.

* Provide helpline numbers of Agencies that works against Domestic violence.  

* Refer the patient to a therapist to open up what leads to the violence.  

3. Nursing Diagnosis

Anxiety related to previous traumatic experience as evidenced by the experience of the flash backs and recurrent anxiety attacks.

Expected outcome: Patient will use appropriate coping strategies and will identify the anxious feelings

Interventions:

* Assess anxiety level of the patient and the contributing factors

* Encourage the patient for ventilating her feelings.

* Offer counselling services or refer for it

*Assist the patient to identify the Anxious feelings and contributing factors

* Assess the non threatening factors that causes anxiety.

* Train the patient to apply relaxation techniques like deep breathing, yoga etc .