PROBLEM: Body Image Disturbance NURSING DIAGNOSIS: Body image disturbance related to obvious skin rash, patches in the

mouth, lesions in oral cavity, palm of hands secondary to syphilis TAXONOMY: Self perception self concept pattern CAUSE ANALYSIS: Since organism multiply locally and disseminate systemic through bloodstream and lymphatics results with diffusion of plasmacytic infiltrate and endothelial proliferation cause to body image disturbance. (Medical Surgical Nursing 6th ed. by Black, Pathologic Basic of disease 5th ed. by Robbins CUES OBJECTIVES STO: After 2-3 days in giving nursing intervention, the patient will be able to verbalize acceptance of self in situation, relief of anxiety and adaptation to altered body image and will be able to verbalize understanding of body changes. INTERVENTION INDEPENDENT: >Acknowledge and accept expression of feelings of frustration, grief, hostility. Note withdrawn behavior and use of denial. RATIONALE >Acceptance of this feeling as a normal response to what has occurred facilitates resolution. It is not helpful of possible to push patient ready to deal with situation. Denial maybe prolonged and be an adaptive mechanism because patient is not ready to cope with personal problems. > Enhance trust and rapport between patient and nurse. > Promotes positive attitude and provides opportunity to set goals and plan for future based on reality. > Words of encouragement can support development of positive coping behaviors. >maintain open lines of communication and provides on ongoing support for patient and family. > Promotes ventilation of feelings and allow for more helpful responses to patient. > Prepares patient for reactions of others and anticipates ways to deal with them. > To begin to incorporate changes in body image. EXPECTED OUTCOME STO: After 2-3 days of giving nursing interventions the patient was able verbalized acceptance of self in situation relief anxiety and adaptation to altered body image and was able verbalized understanding of body changes.

OBJECTIVES >skin rash >lesions either in oral cavity, soles of the feet >patches in the mouth >actual change of the skin

>Be realistic and positive during treatments in health teaching and setting goals within limitations. > Provide hope within parameters of individual situation, do not give false reassurance. LTO: > Give positive reinforcement of After 10 days of giving progress and encourage endeavors nursing intervention, the toward attainment of rehabilitation patient will be able to goals. recognize and incorporate > Encourage family interaction with body image change into each other and with rehabilitation self concept in accurate team. manner without negating >Provide support group for So. Give self esteem, and will be information about how so can be able to acknowledge self as helpful to patient. an individual who has > Role play social situation of concern responsibility to self. to patient. >Encourage patient to look at/ touch affected body part.

LTO: After 10 days the patient was able to recognized and incorporated body image into selfconcept in accurate manner without negating self-esteem and was able to acknowledge self as an individual who has responsibility for self.

References: NCP 6th edition by: Doenges Nurses Pocket Guide 7th edition by: Doenges