NANDA Nursing Diagnosis: Adjustment Disorder Definition: Adjustment Disorder is a psychiatric diagnosis given to individuals who experience significant emotional or behavioral symptoms in response to an identifiable stressor or multiple stressors.
These symptoms go beyond what would be expected for the given situation and cause impairment in functioning. The diagnosis is made when the symptoms develop within three months of the onset of the stressor(s) and last no longer than six months after the stressor(s) have ceased.
Defining Characteristics
- Difficulty coping with stressors
- Emotional distress (e.g., sadness, anxiety, irritability)
- Changes in behavior (e.g., social withdrawal, aggression)
- Impaired occupational or academic performance
- Sleep disturbances (e.g., insomnia, hypersomnia)
- Physical complaints (e.g., headaches, stomachaches)
Subjective
The patient may report feeling overwhelmed, unable to cope, or experiencing intense emotional distress. They may express worry, sadness, anger, or fear. The individual might also describe changes in sleep patterns, appetite, or difficulty concentrating.
Objective
Objective findings may include observable changes in behavior, such as social withdrawal, increased irritability, or aggressive outbursts. Physical symptoms like headaches, gastrointestinal distress, or changes in sleep patterns may also be observed.
Related Factors
- Life changes or events (e.g., divorce, job loss, relocation)
- Chronic or acute illness
- Traumatic experiences (e.g., accidents, natural disasters, violence)
- Major financial difficulties
- Relationship problems or loss
- Occupational or academic stressors
- Lack of social support
Risk Population
Adjustment Disorder can occur in individuals of all ages and backgrounds. However, those who lack strong coping skills, have a history of mental health disorders, or have experienced significant stressors are at a higher risk.
Associated Problems
- Depression and anxiety disorders
- Substance use disorders
- Suicidal ideation or self-harm
- Impaired occupational or academic performance
- Relationship difficulties
- Physical health problems (e.g., headaches, gastrointestinal issues)
Suggestions for Use
Adjustment Disorder nursing diagnosis can be used when a patient presents with significant emotional or behavioral symptoms following an identifiable stressor(s). It helps identify the impact of stress on the patient’s well-being and guides nursing interventions and care planning.
Suggested Alternative NANDA Diagnoses
- Anxiety related to situational stressors
- Risk for Self-Harm related to impaired coping mechanisms
- Ineffective Coping related to stress and inadequate support
Usage Tips
- Assess the patient’s perception of stressors and their emotional response.
- Identify the patient’s available support system and coping strategies.
- Collaborate with the interprofessional team to provide holistic care, including therapy or counseling referrals.
- Educate the patient about stress management techniques and coping skills.
- Monitor the patient’s response to stressors and evaluate the effectiveness of interventions.
NOC Outcomes
- Coping
- Emotional Regulation
- Interpersonal Relationships
- Sleep Quality
- Social Support
NOC Results: The patient demonstrates improved coping skills, better emotional regulation, improved interpersonal relationships, satisfactory sleep quality, and increased social support.
NIC Interventions
Nursing Interventions for Adjustment Disorder
- Therapeutic Communication: Establishing a therapeutic nurse-patient relationship to explore and address the patient’s emotions and concerns.
- Stress Management: Assisting the patient in identifying stressors, developing coping strategies, and promoting relaxation techniques.
- Supportive Counseling: Providing emotional support, validation, and guidance to help the patient navigate the stressor(s) and associated emotions.
- Referral to Therapy Services: Collaborating with mental health professionals to facilitate individual or group therapy sessions to address the patient’s adjustment difficulties and provide specialized interventions.
- Education on Coping Strategies: Educating the patient on healthy coping mechanisms, stress reduction techniques, and problem-solving skills to enhance their ability to adapt to stressors.
- Collaboration with Support Systems: Engaging the patient’s support system, such as family, friends, or community resources, to provide additional emotional support and assistance during the adjustment process.
- Medication Management: Collaborating with the healthcare provider to assess the need for pharmacological interventions to manage severe symptoms or co-existing mental health conditions.
- Psychoeducation: Providing information about Adjustment Disorder, its symptoms, course, and expected outcomes, to enhance the patient’s understanding and reduce distress related to their diagnosis.
- Self-Care Promotion: Assisting the patient in developing self-care routines, including exercise, relaxation techniques, and healthy lifestyle choices, to improve overall well-being and stress management.
Adjustment Disorder Nursing Questions
Question 1: Which statement best describes Adjustment Disorder?
A. It is a chronic mental illness that requires long-term treatment.
B. It occurs when an individual is unable to adapt to a significant stressor(s) within three months.
C. It is characterized by a loss of contact with reality and hallucinations.
D. It is an inherited condition that affects individuals from birth.
Answer: B Rationale: Adjustment Disorder refers to significant emotional or behavioral symptoms that occur in response to identifiable stressors. The symptoms exceed what would be expected and cause impairment in functioning. The diagnosis is made when symptoms develop within three months of the stressor(s) and last no longer than six months after the stressor(s) have ceased.
Question 2: Which of the following is a defining characteristic of Adjustment Disorder?
A. Delusions and hallucinations
B. Chronic sleep disturbances
C. Impaired occupational or academic performance
D. Persistent sadness for over a year
Answer: C Rationale: Impaired occupational or academic performance is a defining characteristic of Adjustment Disorder. It refers to a decline in an individual’s ability to perform their work or academic responsibilities as a result of the emotional or behavioral symptoms associated with the disorder.
Question 3: What is a common related factor for Adjustment Disorder?
A. Genetic predisposition
B. Social support
C. Regular exercise
D. Chronic physical illness
Answer: D Rationale: Chronic physical illness is a common related factor for Adjustment Disorder. The presence of ongoing physical health problems can contribute to the development of emotional and behavioral symptoms when combined with the stress of the illness itself.
Question 4: What is a suggested alternative nursing diagnosis for Adjustment Disorder?
A. Risk for Infection
B. Ineffective Coping
C. Acute Pain
D. Impaired Tissue Integrity
Answer: B Rationale: Ineffective Coping is a suggested alternative nursing diagnosis for Adjustment Disorder. It reflects the patient’s difficulty in utilizing adaptive coping mechanisms to effectively manage and navigate the stressors they are experiencing.
Question 5: Which nursing intervention is appropriate for a patient with Adjustment Disorder?
A. Administering antipsychotic medication
B. Encouraging social isolation to avoid stressors
C. Facilitating referral for therapy services
D. Providing excessive reassurance and validation
Answer: C Rationale: Facilitating referral for therapy services is an appropriate nursing intervention for a patient with Adjustment Disorder. Collaboration with mental health professionals and providing access to specialized therapy can help address the underlying issues and develop effective coping strategies for the patient.
Please note that the answers and rationales provided are based on general knowledge and understanding of Adjustment Disorder. It is always important to refer to current evidence-based practice and consult with healthcare professionals for specific patient
Nursing References
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier.
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
Best Nursing Books and Resources
These are the nursing books and resources that we recommend.
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The Nursing Diagnosis Handbook E-Book: An Evidence-Based Guide to Planning Care
This is an excellent reference for nurses and nursing students. While it is a great resource for writing nursing care plans and nursing diagnoses, it also helps guide the nurse to match the nursing diagnosis to the patient assessment and diagnosis.
This handbook has been updated with NANDA-I approved Nursing Diagnoses that incorporates NOC and NIC taxonomies and evidenced based nursing interventions and much more.
NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
All introductory chapters in this updated version of a ground-breaking text have been completely rewritten to give nurses the knowledge they require to appreciate assessment, its relationship to diagnosis and clinical reasoning, and the goal and use of taxonomic organization at the bedside.
Nursing Care Plans: Nursing Diagnosis and Intervention
It contains more than 200 care plans that adhere to the newest evidence-based recommendations.
Additionally, it distinguishes between nursing and collaborative approaches and highlights QSEN competencies.
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