Self Care Deficit Nursing Diagnosis and Nursing Care Plan

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Self Care Deficit Nursing Care Plans Diagnosis and Interventions

Self Care Deficit NCLEX Review and Nursing Care Plans

Self Care Deficit is a NANDA nursing diagnosis that defines a client’s inability to perform self-care on his/her own.

Self-care involves activities of daily living (ADLs) that involve the promotion and maintenance of personal well-being. These self-care tasks include feeding, bathing, toileting, grooming, and dressing.

A client may experience a deficit in the ability to self-care after experiencing an accident or trauma such as fracture, a debilitating mental disorder such as major depression or schizophrenia, a progressive disease such as rheumatoid arthritis, dementia, or Alzheimer’s disease, or while on the recovery phase after surgery.

Self Care Deficit Theory

The nursing theorist Dorothea Orem developed the Self-Care Deficit Theory, a grand nursing theory that states that patients should be allowed to perform self-care to their best ability.

It involves performing and achieving the self-care requisites of a patient, which are divided into 3 categories:

1. Universal Self-Care Requisites

  • Air
  • Water
  • Food
  • Elimination
  • Balance between Activity and rest
  • Balance between Social interaction and Solitude
  • Promotion of Normalcy and Human Functioning
  • Prevention of Hazards

2. Developmental Self-Care Requisites

  • Maintenance of developmental environment
  • Prevention and management of conditions that threaten normal development

3. Health Deviation Self-Care Requisites

  • Seeking appropriate medical assistance
  • Adherence to medical regimen
  • Awareness of potential problems
  • Promotion/ modification of self-image
  • Lifestyle adjustment to meet current health status and medical regimen
Orem identified five methods of helping a patient with self-care deficit:
  1. Acting for and doing for the client
  2. Guiding the client
  3. Supporting the patient and his/her carers
  4. Promoting personal development in relation to meet future demands
  5. Educating the patient and his/her carers

Self Care Deficit Nursing Diagnosis

Self Care Deficit Nursing Care Plan 1

Fracture

Nursing Diagnosis: Self-Care Deficit related to musculoskeletal impairment and physical limitations due to immobilizer secondary to arm fracture as evidenced by inability to bathe, get dressed, and perform toileting activities as normal

Desired Outcome: The patient will be able to demonstrate optimal performance of ADLs or activities of daily living.

Nursing Interventions for Self Care DeficitRationale
Assess the patient’s limitations to self-care by asking open-ended questions.To explore the patient’s self-care limitations and needs while allowing him/her to express his/her personal thoughts and feelings related to ADLs.
Offer appropriate pain medication as prescribed at least 30 minutes before the patient performs self-care activities.Pain might discourage the patient to mobilize and carry out self-care activities.
Educate the patient’s carer or significant other on providing appropriate assistance to the patient while he/she performs self-care tasks.To provide learning to the carer or significant other and to ensure that the patient has a good amount of support while doing ADLs at home. Skilled home services might be needed if there is no available significant other to care for the patient.
Refer the patient to occupational therapist.Occupational therapists are skilled professionals in helping clients achieve optimal performance in their daily activities like bathing, dressing, and personal hygiene tasks.
Coordinate with the physical therapy team on how to create and initiate an exercise program for the patient.A customized exercise plan can help the patient in terms of increasing his/her endurance and strength which he/she will need when doing self-care activities.
Encourage the patient to use assistive devices and grooming aids as needed.To promote autonomy when performing self-care activities.

Self Care Deficit Nursing Care Plan 2

Depression

Nursing Diagnosis: Self-Care Deficit related to perceptual or cognitive impairment with anergia and severe anxiety secondary to major depression, as evidenced by unwashed hair, foul body odor, weight loss, constipation, persistent hypersomnia or insomnia, and inability to bathe, get dressed, and perform toileting activities as normal

Desired Outcome: The patient will be able to demonstrate optimal performance of ADLs or activities of daily living as well as gradual return to normal BMI with the assistance of family, nurse, or carer.

Nursing Interventions for Self Care DeficitRationale
Assess the patient’s limitations to self-care by asking open-ended questions.To explore the patient’s self-care limitations and needs while allowing him/her to express his/her personal thoughts and feelings related to ADLs.
 Assist the patient to use toiletries and hygiene aids such as soap, shampoo, wash cloth, toothbrush, and shaver. Encourage the patient to perform self-care and offer help as needed.To promote the patient’s autonomy and increase his/her self-esteem.
Provide gentle instructions to the patient using a step-by-step method. For example: When bathing: “damp your face first using a washcloth, lather soap on hands and gently apply on the face.”Insomnia or hypersomnia as well as having major depression in general can decrease the level of concentration and cognition for the patient, so breaking down tasks into simple steps can help organize thoughts and actions.  
Encourage the patient to increase oral fluid intake to reach 8 to 10 glasses a day, and to increase high calorie and fiber-rich foods. Monitor the patient’s intake and output and bowel movements daily. Perform weekly weight checks.Many patients with clinical major depression suffer from constipation and weight loss. Increased fluid intake and fibre-rich foods can help resolve constipation.
Ensure that the patient takes medications on time and as prescribed.To ensure adherence to medical regimen.
Educate the patient’s carer or significant other on providing appropriate assistance to the patient while he/she performs self-care tasks.To provide learning to the carer or significant other and to ensure that the patient has a good amount of support while doing ADLs at home. Skilled home services might be needed if there is no available significant other to care for the patient.
Encourage the patient to perform activities like crafts and games during the day and discourage sleeping during the day.Sleeping during the day can make the patient less sleepy at night, which can cause insomnia. Encouraging socialization can help the patient cope with depression.

Self Care Deficit Nursing Care Plan 3

Alzheimer’s Disease

Nursing Diagnosis: Self-Care Deficit (Toileting) related to cognitive impairment with secondary to Alzheimer’s disease, as evidenced by foul body odor, constipation, and inability to perform toileting activities as normal

Nursing Interventions for Self Care DeficitRationale
Assess the patient’s limitations to self-care by asking open-ended questions. Observe the patient’s cognitive and functional ability to perform self-care activities, especially toileting.  To explore the patient’s self-care limitations and needs while allowing him/her to express his/her personal thoughts and feelings related to ADLs.
Allow sufficient time for the patient to perform his/her toileting routine without interrupting or rushing but offering help whenever it is needed.To promote the patent’s autonomy and independence while ensuring patient’s safety and support by the nurse or carer’s presence. Avoiding to rush the patient when doing self-care routines or rituals can help prevent mental stress to the Alzheimer’s disease patient.
Educate the patient’s carer or significant other on providing appropriate assistance to the patient while he/she performs self-care tasks.To provide learning to the carer or significant other and to ensure that the patient has a good amount of support while doing ADLs at home. Skilled home services might be needed if there is no available significant other to care for the patient.
Create a urinary and bowel routine care program with the patient’s carer if he/she is not able to complete toileting on his/her own. This may include toilet training by taking the patient to the bathroom every 2 to 3 hours.To help identify problems in urinary and bowel care and resolve these issues through careful planning and monitoring.
Note any sudden changes in urinary or bowel status.Incontinence, diarrhea, and/or constipation are common in patients with AD.
Administer laxatives or stool softeners as needed.To relieve constipation.
Ensure that the patient takes medications on time and as prescribed.To ensure adherence to medical regimen.
Encourage the patient to use assistive devices and grooming aids as needed.To promote autonomy when performing self-care activities.

Self Care Deficit Nursing Care Plan 4

Rheumatoid Arthritis

Nursing Diagnosis: Self-Care Deficit related to musculoskeletal impairment and physical limitations secondary to rheumatoid arthritis as evidenced by inability to bathe, get dressed, and perform toileting activities as normal, pain triggered by movement, and decreased level of strength and endurance

Desired Outcome: The patient will be able to demonstrate optimal performance of ADLs or activities of daily living.

Nursing Interventions for Self Care DeficitRationale
Observe the patient’s cognitive and functional ability to perform self-care activities, especially toileting. Use functioning assessment (from 0 to 4) scale.  To determine the functional capability of the patient.
Assess the patient’s limitation and barriers to self-care by asking open-ended questions.To explore the patient’s self-care limitations and needs while allowing him/her to express his/her personal thoughts and feelings related to ADLs.
Offer appropriate pain medication as prescribed at least 30 minutes before the patient performs self-care activities.Pain might discourage the patient to mobilize and carry out self-care activities.
Ensure that the patient takes medications on time and as prescribed.To ensure adherence to medical regimen.
Allow the patient to have sufficient time to complete activities of daily living. Advise the patient to be patient with one’s self when performing self-care.To build patient’s confidence and allow him/her to have a greater sense of self-worth.
Refer the patient to occupational therapist.Occupational therapists are skilled professionals in helping clients achieve optimal performance in their daily activities like bathing, dressing, and personal hygiene tasks.
Encourage the patient to use assistive devices and grooming aids as needed.To promote autonomy when performing self-care activities.

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.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines and policies and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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