Nursing Care Plan for Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder is characterized by recurrrent obsession (intruitive images,impulses and though) and compulsion (repetitive behaviour in response to an obsession.

The obsession and compulsion can cause intense stress and impairement of functioning. Fear of losing control, fear of losing the self esteem, overly conscientious, perfectionistic, have trouble to being spontaneously and filled with self-doubt are common experiences by client. Frequently the client will use defence mechanisms of denial, reaction formation, isolation and undoing.

Contributing factors client with obsessive compulsive are

likely because childhood trauma, multiple stressors, lack of role model to teach coping skills and brain lesions. Common obsessions are self doubt, germs and illness with common compulsions like checking, washing, avoiding and counting.

Assesment finding for obsessive-compulsive disorder;

• Social impairment
• Obsessive thought (repetitive worries, repeating and counting images or words)
• Compulsive behaviour (repetitive activity, like touching, counting, doing or undoing)

Treatment for obsessive compulsive disorder;

• Behavioral therapy and individual therapy
• Monoamino oxidase inhibitor (nardil, parnate)
• Benzodiazepine (ativan, klonopin)
• Trycyclic antidepresant (norpramin, tofranil)
• Selective serotonin reuptake inhibitor (paxil)

Nursing diagnoses for obsessive compulsive disorder;

• Anxiety
• Chronic low self-esteem
• Ineffective individual coping

Planning and goal for obsessive compulsive disorder, the client will;

• Learn coping strategis to decrease obsessive thinking and compulsions
• Verbalize sign and symptoms of increasing anxiety
• Develop and maintain an enhanced self esteem and increased sense of the competency

Implementation for obsessive compulsive disorder;

• Encourage to express the feeling, in order to decrease the level of stress
• Help the client to assess how the compulsive behavior affect his functioning
• Help the client to engage in anticipatory planning, to feel in control of potentially anxiety-producing situations
• Help the client to identify expectation of self an others
• Instruct the client to keep a daily journal of thought, feeling and actions to identify immediately the onset of his obsessive compulsive
• Work with client to develop appropiate coping skills
• Encourage the client to identify situations that produce anxiety and precipitate obsessive compulsive behavior

Evaluation for obsessive compulsive disorder, the client will;

• Identifies situations and activities that may precipitate obsessive compulsive
• Able to verbalize thoughts openly and has realistic expectation self and others
• Demonstrate a decreased reliance on negative coping mechanism such ritual, and will demonstrate the new coping strategies

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