PERSONALITY

Susan Marks, 25 years old, is diagnosed with borderline personality disorder. She has been
attending college sporadically, but has only 15 completed credits and no real career goal. She is
angry because her parents have told her she must get a job to support herself. Last week, she
met a man in the park and fell in love with him on the first date. She has been calling him
repeatedly, but he will not return her calls. Declaring that her parents have deserted her and her
boyfriend doesn't love her anymore, she slashes her forearms with a sharp knife. She then calls
911, stating, "I'm about to die! Please help me!" She is taken by ambulance to the emergency
room and is admitted to the inpatient psychiatry unit.

1. Identify two priority nursing diagnoses that would be appropriate for Susan on her admission
to the unit.

 Risk for self-mutation

 Ineffective coping

2. Write an expected outcome for each of the identifies Nursing Diagnosis

 Risk for self-mutation – the client will be safe and free of significant injury, identify precipitating factors or
awareness of arousal state that occurs prior to incident and express increased self-concept or self esteem
 Ineffective coping – the client will demonstrate increased control of impulsive behavior and meet
psychological needs as evidenced by appropriate expression of feelings, identification of option, and use of
resources.

3. List down three Nursing interventions for each of the identified Nursing Diagnosis

 Risk for self-mutation

o Discuss presence and intensity of self-harm urges with client
o Negotiate a no self-harm contract with the client
o Help the client to identify triggers for self-harm behavior

 Ineffective coping
o Evaluate ability to understand events, provide realistic appraisal of situation
o Discuss ways the client can use distraction when gratification must be delayed
o Encourage client to try new coping behaviors and gradually master situation