Nursing Diagnosis and Nursing Intervention

Nursing Care Plan for Acute Psychotic


Definition of Acute Psychotic

Psychotic is mental disorder characterized by the inability of the individual to assess what actually happened, for example, there are hallucinations, delusions or chaotic behavior / weird.


Clinical Manifestations

The behavior exhibited by the patient are:
  1. Hearing voices no source.
  2. Belief or fear that weird / absurd.
  3. Confusion or disorientation.
  4. Changes in behavior ; be strange or scary as aloof, heightened scrutiny, threatening themselves, other people or the environment, to talk and laugh and get angry or hit for no reason.

Brief psychotic disorder symptoms always include at least one major psychotic symptoms, usually with sudden onset, but not always incorporate the overall pattern of symptoms found in schizophrenia. Some clinicians have observed that affective symptoms, confusion and concentration problems may be more often found in a brief psychotic disorder rather than a chronic psychotic disorder. Symptoms characteristic for brief psychotic disorder is an emotional change, clothing or bizarre behavior, yelling screaming or silent, and impaired memory for recent events occurred. Some of these symptoms are found in disorders that direct and clear diagnosis of delirium requires a complete organic inspection, although the result may be negative.

Mental status examination is usually present with severe psychotic agitation that may be associated with bizarre behavior, uncooperative, aggressive physical or verbal, irregular speak, shout or silence, labile mood or depression, suicide, kill thoughts or behavior, anxiety, hallucinations, delusions, disorientation, impaired attention, impaired concentration, memory impairment, and poor insight.

As in acute psychiatric patients, a history which is necessary to make the diagnosis may not be obtained only from the patient. Despite the presence of psychotic symptoms may be obvious, information on prodromal symptoms, previous episodes of a mood disorder, and a history of ingestion of a recently psychotomimetic substances may not be obtained from clinical interviews alone. In addition, clinical may not be able to obtain accurate information about the presence or absence of precipitating stressor.

The most obvious example is the originator of stresos major life events that can cause significant emotional anger in each person. The event is the death of a close family member and a heavy vehicle accidents. Some argue that the severity of clinical events should be considered in relation to the patient's life. Although this view has a reason, but it may expand the definition to include precipitating stressor events that are not associated with psychotic episodes. Other clinicians argue that stressors may be a sequence of events that cause stress are, rather than single events that give rise to stress the obvious. But the sum of the degree of stress caused by the sequence of events requires a degree of clinical judgment almost impossible.


Diagnosis

For a definite diagnosis of symptoms of acute psychotic disorders are as follows :
  1. Hallucinations (false sensory perceptions or imagined : for instance, no one heard a sound source or see something that no object).
  2. Delusions (strongly held idea that a real one and can not be accepted by social groups of patients, such as patients believe that they are poisoned by a neighbor, receiving messages from the television, or was observed / supervised by someone else).
  3. Agitation or bizarre behavior.
  4. Talks strange or chaotic (disorganization).
  5. Unstable emotional state and extreme (irritable).

Nursing Care Plan for Acute Psychotic

Maintaining patient safety and care of individuals, things to do :
  1. Family or friends should accompany the patient.
  2. Basic needs of patients are met (eg, eating, drinking, elimination, and hygiene).
  3. Be careful that the patient does not get injured.

Counseling patients and families :
  1. Help families identify aspects of the law relating to psychiatric treatment include: patient rights, obligations and responsibilities of the family in the treatment of patients.
  2. Assist patients and families to reduce the stress and contact with the stressor.
  3. Motivation of patients to perform activities of daily living after symptoms improve.
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