Nursing Care Plan for Delusional Disorder
Nursing care plan for delusional disorder is an important tool in the process of treating affected individuals. Patients suffering the disorder are characterized by following wrong beliefs. This kind of disordes was primarly referred to as paranoid condition. However, later it was changed with the term "delusion". For various patients, the condition is experienced in differently. While some of the patients tend to experience different types of specific delusion (for example, jealousy, grandiose or somatic themes, etc.), some of them do not express one single clearly identified theme.
Commonly, the signs of disorder start expressingafter 40. However, there are cases when younger people experienced delusions. Fortunately, the condition affects less than 1% of total population and is typicall both for men and women. Without doubt, the condition has to be dealt with, as it strongly affects not only social behaviors and marticla relationships of peope but also may negatively influence intellectual functuions of individuals.
In order to create an effective nursing care plan for delusional disorder, different issues have to be taken into account. One of them is cause of the disease.
One of the causes of this disorder development is heredity. However, not all reasons of condition development are so obvious. For example, such isses as feelings of inferiority in the family, weak personality and low self-esteem, as well as negative childhood experience may also become causes of illness.
In addition, while developing delusional disorder care plan, it is important to rewiev medical history of a patient, as such medical conditions as trauma of head, aging, deafness or alcoholism can also become a reason of delusional disorder development. In addition, stress can also serve a reason for disease occurrence.
Nursing Care Plan for Depressiona and Other Delusional Disorders
In fact, it is difficult to notice the symptoms of delusion disorder patients. Generally, behavior of the individuals has to be observed. Such observation will help to understand whether the patient has problem with communication in society, family, any martial relationship problems, as well as symptoms of depression. Considering that the patients suffering from the current disorder are expected to have some problems in life, the signs of the disease should be looked for among divorced, vidowed, lonely or even hostile individuals.
People suffering from the disorder can also be detected by observing different non-verbal signs. They can include listrust or excessive apprehension and vigilance. Defensive behavior, especially as a reaction to imaginative insults, as well as such signs as folding arms in a form of defending him/herself or sitting at the edge of the sit are also indicate on developing of a disorder.
Nursing Care Plan for Delusional Disorder
Psychiatric examination is important for revealing such diagnostic criteria:
- Non-bizzare delusions. These delusions have to be present for at least 1 month and foresee reflection of situations from life, sich as being followed, fear that someone intends to poison or ifect a patient, non-grounded assumptions that the lover tries to deceive a patient, etc.;
- Hallucinations (both visual and auditory);
- The patient does not suffer any intellectual problems except for delusions;
- If a person experiences a mix of maniac or depressive syndrome and delusions, the duration of mood syndrome has a slight relation to the general duration of delusional syndrome;
- An individuals has never suffered or showed any signs of schizophrenia and it is impossible to prove that orhanic factor was the main cause of disturbance development;
- Numerous tests (such as psychological, urine/blood test, etc.) show no signs that delusion conditions are developed due to organic reasons. In addition, it is recommended to run a endocrine function test to exclude anemia, medness and/or hyperadrenalism.
Regardless of the severity of condition, it is curable. Treatment of delusional disorder includes a combination of a physio and drug therapy. The aim of the treatment is to get rid of disturbances and improve the behavior of the patient by correcting the system of worng beliefs of the patient. In case of aging and isolated individuals, supportive systems can also be used.
Basically, treatment of delusive disorder is similar to that of schizophrenia. It is recommended to use antipsychotics, which serve as blockers of dopamine receptors. As a result of their intake, such symptomps as hallucinations, anxiety, agitation and delusions will be suppressed. In order to control other symptomps related to the current disease, antidepressants are often used.
The mostly used antypsychotics include the following: haloperidol, trifluoperazine, fluphenazine and thiothixene. In case of a severe case where usual antypsychotics do not help, it is recommended to use clozapine. It has a different chemical structure and much stronger effect. Moreover, it helps in controlling different psychotic syndroms without negative consequences.
Nevertheless, clozapice may have a number of adverse effects on human body. Some of them include dizziness, sedation, seizures, tachycardia, etc. In addition, it can lead to agranulocytosis, which may even lead to death. As a result, it is extremely important to monitor individuals taking this drug and take immediate actions if the health of a patient worsens.
Delusional Disorder Prognosis and Diagnoses
- Low ability of coping;
- Poor nutrition;
- Low ability to interation in society;
- Poor process of thinking;
- Poor self-identity;
- Possibility of violent behavior development towards others;
- Possibility of violent behavior development towards oneself;
- High possibility of self-injuring;
- Isolation from the surrounding world;
Expected Outcomes of Treatment
- Development of ability to interpret situation from different angles instead of expressing hostility;
- The patient does not resist taking part in therapies. Family members participate in treatment process, as well;
- The person will be able to differentiate factors that may lead to delusional disorder;
- The patient will be able to express his/her fears;
- The patient will develop proper dietary behaviors;
- Proper orientations of a patient in time, place and situation;
- Considering all possible limitations caused by episodes of visual or auditory hallucinations, the patient will be able to live fully functional life;
- The patient will stop harm and injure him/herself and others;
- The patient will develop an ability to communicate with other members of the society freely;
- The patient will develop ability co communicate properly and effectively with family members;
- The patient will fully adhere to the schedule of medication intake;
- The patient will learn to recongnize the symptoms of the disease and report about them to the supervisor;
- Development of proper and effective coping behaviors;
- Development of effective skills necessary for interaction in the society.
- It is recommended to be direct while interacting with a patient. It is forbidden to express aggression or hostility;
- At the early stages of treatment it is important to avoid arguments about what patient finds real;
- Showing respect to patient's privacy;
- It is important to monitor how the patient takes medicine and food, especially if he/she is afraid to be poisoned;
- It is important to reduce isolation and try to improve communication with the patient after some time of adaptation.
- Educate patients on correct medicine intake, especially in regard to clozapine;
- Educate patients on the importance of following the care plan;
- Educate patients on providing feedbacks in relation to treatment and its adverse affects;
- Involve and educate family members on how to deal with people suffering the delusion disorders.