Psychotic Disorders no. 4029

Psychotic Disorders no. 4029

QUESTION: A client who has been hospitalized with disorganized type schizophrenia for 8 years can't complete activities of daily living (ADLs) without staff direction and assistance. The nurse formulates a nursing diagnosis of <i>Dressing or grooming self-care deficit related to inability to function without assistance.</i> What is an appropriate goal for this client?

✘O a.) "Client will be able to complete ADLs independently within 1 month."
✘O b.) "Client will be able to complete ADLs with only verbal encouragement within 1 month."
✓O c.) "Client will be able to complete ADLs with assistance in organizing grooming items and clothing within 1 month."
✘O d.) "Client will be able to complete ADLs with complete assistance within 1 month."

RATIONALE

RATIONALE: The client's disorganized personality and history of hospitalization have affected the ability to perform self-care activities. Interventions should be directed at helping the client complete ADLs with the assistance of staff members, who can provide needed structure by helping the client select grooming items and clothing. This goal promotes realistic independence. As the client improves and achieves the established goal, the nurse can set new goals that focus on the client completing ADLs with only verbal encouragement and, ultimately, completing them independently. The client's condition doesn't indicate a need for complete assistance, which would only foster dependence.
NURSING PROCESS STEP: Evaluation
CLIENT NEEDS CATEGORY: Psychosocial integrity
CLIENT NEEDS SUBCATEGORY: None
COGNITIVE LEVEL: Knowledge