Nursing Diagnosis: Ineffective Health Maintenance…
- Lack of knowledge about the disease process
- Deficient knowledge about medications
- Physical impairment
- Mental impairment
- Insufficient/lack of support
- Deteriorating health status
- Lack of financial resources
- Unwillingness to implement necessary changes
- Engagement in risky behavior that worsens health
- Unhealthy lifestyle choices
- Illicit drug use
- Poor diet
- Lack of exercise
Common Signs & Symptoms…(evidenced by)
- Deteriorating health status
- Unawareness of bad health status
- Inability to make sound decisions
- No interest in health improvement
- Ignorance of the need for improvement of lifestyle
Expected Outcome (add a time frame)
- Patient will express willingness to participate in activities improving health status
- Patient will able to identify appropriate resources and use them
- Patient will show increased engagement in health-promoting activities
|Subjective Data: Your patient my state…|
… that he or she is not interested in making lifestyle changes
… he or she does not see the need for change
|Objective Data: Your assessment and other data might show…|
… that there is a history of alcohol use, and drug abuse
… that the patient appears unkempt
… that lab values might be out of the normal range (for example, blood sugar or blood pressure)
… that prescription medications have not been filled regularly
|Assess the patient’s perception of his or her health status|
The patient’s point of view reveals if he or she is open to change. The patient has to recognize that increased health issues are caused by their inability to manage their health.
|Assess the patient’s home environment|
If the patient is hospitalized, this part might be more difficult. The patient’s home environment mostly gives clues about the contributing factors to the patient’s inability to manage their health. If possible, pay a visit to the home and gather information from family and friends to paint a clear picture of the current situation.
|Assess the patient’s family dynamic|
Family and friends can influence behavior and social activities that might contribute to the patient’s lifestyle.
|Discuss the patient’s habits and health maintenance in the past|
This provides information about whether these habits are new due to recent changes or whether the patient has been dealing with them for a long time. Practices that have been a part of the patient’s life for a long time might need a different approach to break these habits.
|Assess the patient’s knowledge about his or her behavior|
To change, the patient has to know about the inadequacy of skills to maintain a healthy lifestyle. The nurse needs to know if the patient wants to change but does not have the means or is unwilling to change.
|Assess for sensory or cognitive deficits|
Sensory or cognitive impairment might be the reason for the patient not being receptive to treatment.
|Note any language barrier|
The patient has to be able to understand the teaching process and materials provided. It is also easier to participate in the care plan.
|Provide time for the patient to process changes and to ask questions|
Some of these lifestyle changes can have an enormous impact on the patient’s life. Habituated activities can be challenging to break. Providing time and being open to questions supports the patient in making these changes.
|Discuss the patients reasoning and feelings for non-compliance|
The patient might not have the (financial) resources, the motivation, or the skills to change their health maintenance activities. This information allows the nurse to personalize the care plan further and focus on resolving the specific cause of the non-compliant behavior.
|Assess the patient’s education level|
Adjustments can be made to the teaching material to ensure the patient can understand it.
|Help the patient identify daily habits that prevent him or her from implementing healthy habits|
Unhealthy lifestyle habits can be slowly replaced by healthy activities that improve the patient’s health.
|Discuss the reasons for not seeking help when needed|
The patient might misjudge the severity of the illness or be afraid of possible diagnoses. Another reason might be the patient feeling embarrassed about his or her condition.
|Provide the patient with new techniques to solve problems|
Recent and sudden changes in life might require new coping mechanisms and problem-solving techniques.
|Help the patient with managing medication schedules|
The patient might be willing to do it but finds it to be complicated to accomplish. Use pillboxes and calendars to help keep things organized. Reeducate about indication and schedule times of medications.
|Assist in coordinating appointments and transportation if needed|
Making appointments more accessible helps increase patient compliance.
|Have family and friends participate in the patient’s health and lifestyle changes|
For the patient to make sustainable changes, his or her environment has to be supportive.
|Praise the patient for achieving goals|
Compliments on achievements raise motivation and reinforce that the actions taken are appropriate.
|Assist the patient with stress management|
Often stress factors and other crises worsen unhealthy activities and habits. Reducing stress should reduce the need to engage in unhealthy habits.
|Educate the patient about the health benefits of being compliant with the treatment plan |
It might make it easier to follow through on the treatment plan if the patient knows the “why” behind the treatment regimen.
Education/ Discharge Planning/Continuity of Care
|Provide learning material that is appropriate for the patient’s level of education and learning style|
The patient is more receptive to the material provided if he or she can understand it.
|Format learning material so the patient can take it home or access information at home|
Booklets, flyers, and website addresses are useful resources that the patient can access at home.
|Teach family about necessary changes|
Family members know now how to support the patient healthily and can act as accountability persons.
|Provide individual training to caregivers before discharge|
The situation of an environment might be different in the hospital than at home. The caregiver needs time to adapt to take care of the patient in the home environment adequately.
|Provide resources to support groups|
This might be an effective way to engage the patient in changing efforts long term.
More Care Plans:
Ackley, B., & Ladwig, G. (2014). Nursing diagnosis handbook (10th ed., pp.412-415). Maryland Heights: Mosby Elsevier.
Gulanick, M., & Myers, J. (2014). Nursing care plans (8th ed., pp.92-94). Elsevier.
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