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4 Personality Disorders Nursing Care Plans

By

Paul Martin, BSN, R.N.

Updated on December 7, 2018

0
Personality is defined as the differences in the characteristic patterns of behaving, feeling
and thinking of an individual.

A personality disorder is a type of mental illness in which a person’s personality traits

have become rigid, inflexible, maladaptive and can hinder the person’s perception and
association to situations and people. This can cause significant problems and restriction in
the family, social activities, school, employment and other functional roles.

Nursing Care Plans

The nursing care plan varies according to the kind of personality disorder, its severity, and
life situation. A collaborative intervention is needed to make sure all of the clients social,
medical and psychiatric needs are met.

The goals of the nurse for clients with personality disorders focus on establishing trust,
providing safety and comfort, teaching basic living skills and promoting a responsible
behavior.

Here are four (4) nursing care plans (NCP) for personality disorders:

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1. Risk For Self-Mutilation

2. Chronic Low Self-Esteem
3. Impaired Social Interaction
4. Ineffective Coping

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1. Risk For Self-Mutilation

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Risk For Self-Mutilation: At risk for deliberate self-injurious behavior causing tissue
damage with the intent of causing nonfatal injury to attain.

Risk factors

 Desperate need for attention.

 Emotionally disturbed or battered children.
 Feelings of depression, rejection, self-hatred, separation anxiety, guilt, and
depersonalization.
 History of self-injury.
 History of physical, emotional, or sexual abuse.
 High-risk populations (BPD, psychotic states).
 Impulsive behavior.
 Inability to verbally express feelings.
 Ineffective coping skills.
 Mentally retarded and autistic children.

Possibly evidenced by

 Fresh superficial slashes on wrists or other parts of the body.

 Intense rage focused inward.
 Signs of old scars on wrists and other parts of the body (cigarette burns,
superficial knife/razor marks).
 Statements as to self-mutilation behaviors.

Desired Outcomes

 Patient will be free of self-inflicted injury.

 Patient will participate in impulse control training.
 Patient will participate in coping skills training.
 Patient will seek help when experiencing self-destructive impulses.
 Patient will discuss alternative ways a client can meet demands of current
situation.
  Patient will express feelings related to stressand tension instead of acting-out
behaviors.
 Patient will sign a “no-harm” contract that identifies steps he or she will take when
urges return.
 Patient will respond to external limits.
 Patient will participate in the therapeutic regimen.
 Patient will demonstrate a decrease in frequency and intensity of self-inflicted
injury.
 Patient will demonstrate two new coping skills that work for the client for when
tension mounts and impulse returns.

Nursing Interventions Rationale

Assess client’s history of self-

mutilation:

Identifying patterns and

1. Types of mutilating circumstances
behaviors. surrounding self-injury
can help the nurse plan
2. Frequency of interventions and
behaviors. teaching strategies
suitable to the client.
3. Stressors preceding
behavior.

Feelings are a guideline

Identify feelings experienced
for future intervention
before and around the act of
(e.g., rage at feeling left
self-mutilation.
out or abandoned).

Self-mutilation might
also be:
Explore with the client what
these feelings might mean. 1. A way to gain
control over
others.

Secure a written or verbal no-
harm contract with the client.
Identify specific steps (e.g.,
persons to call upon when
prompted to self-mutilate).
Set and maintain limits on
acceptable behavior and make
clear client’s responsibilities. If
the client is hospitalized at the
time, be clear regarding the unit
rules.
Be consistent in maintaining and
enforcing the limits, using a
nonpunitive approach.
Use a matter-of-fact approach
when self-mutilation occurs.
Avoid criticizing or giving
sympathy.
After the treatment of the
wound, discuss what happened
right before, and the thoughts
and feelings that the client had
immediately before self-
mutilating.
2. A way to feel
alive
through pain.
3. An
expression of
self-hate or
guilt.
Client is encouraged to
take responsibility for
healthier behavior.
Talking to others and
learning alternative
coping skills can reduce
frequency and severity
until such behavior
ceases.
Clear and nonpunitive
limit setting is essential
for decreasing negative
behaviors.
Consistency can establish
a sense of security.
A neutral approach
prevents blaming, which
increases anxiety, giving
special attention that
encourages acting out.
identify dynamics for
both client and clinician.
Allows the identification
of less harmful responses
to help relieve intense
tensions.
 Work out a plan identifying
alternatives to self-mutilating
behaviors.

1. Anticipate certain
situations that might
lead to
increased stress(e.g.,
tension or rage).
2. Identify actions that Plan is periodically
reviewed and evaluated.
might modify the Offers a chance to deal
intensity of such with feelings and
struggles that arise.
situations.
3. Identify two or three
people whom the
client can contact to
discuss and examine
intense feelings
(rage,self hate)
when ther arise.

BackNext

See Also

You may also like the following posts and care plans:

 Nursing Care Plan: The Ultimate Guide and Database – the ultimate database
of nursing care plans for different diseases and conditions! Get the complete list!
 Nursing Diagnosis: The Complete Guide and List – archive of different nursing
diagnoses with their definition, related factors, goals and nursing interventions
with rationale.
 Mental Health and Psychiatric Care Plans

Care plans about mental health and psychiatric nursing:

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 Anxiety and Panic Disorders | 7 Care Plans

 Bipolar Disorders | 6 Care Plans
 Major Depression | 6 Care Plans
 Personality Disorders | 4 Care Plans
 Schizophrenia | 6 Care Plans
 Sexual Assault | 1 Care Plan
 Substance Dependence and Abuse | 8 Care Plans
 Suicide Behaviors | 3 Care Plans

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 TAGS

 Chronic Low Self-Esteem

 depression

 Impaired Social Interaction

 ineffective coping

 personality

 Personality Disorders

 Risk For Self-Mutilation

 Paul Martin, BSN, R.N.

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as
a medical-surgical nurse for five years, he handled different kinds of patients and learned how to
provide individualized care to them. Now, his experiences working in the hospital is carried over to
his writings to help aspiring students achieve their goals. He is currently working as a nursing
instructor and have a particular interest in nursing management, emergency care, critical care,
infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical
knowledge and skills to students and nurses helping them become the best version of themselves
and ultimately make an impact in uplifting the nursing profession.

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