University Nursing Care Plan: Recovery Focused for Depression Patient

This report details a recovery-focused nursing care plan for a 21-year-old married woman, Rachelle, who is experiencing peripartum depression. The plan outlines her HONOS scoring, consumer priorities, identified goals, and the consumer's strengths. It focuses on addressing symptoms of depression, impaired functioning, and difficulties with activities of daily living. The nursing interventions include crisis counseling, group therapy, medication management, nutritional support, and promoting social engagement. The plan also emphasizes the importance of involving the patient's husband, case manager, and community resources. Assessment tools like the Postpartum Depression Screening Scale are used to monitor progress. The goal is to improve Rachelle's mood, enable her to care for her daughter, and enhance her self-esteem. The report includes references to support the evidence-based practices used in the plan.

Running head: RECOVERY FOCUSED NURSING CARE PLAN
Recovery focused nursing care plan
Name of the Student
Name of the University
Author note

1RECOVERY FOCUSED NURSING CARE PLAN
Table of Contents
Rachelle's HONO Scoring...................................................................................................2
Recovery focused nursing care plan....................................................................................3
References..........................................................................................................................12

2RECOVERY FOCUSED NURSING CARE PLAN
Rachelle's HONO Scoring
DOMAIN Result
1. Overactive, aggressive, disruptive
behaviour.
0 1 2 3 4
2. Non - accidental self- injury. 0 1 2 3 4
3. Substance use and misuse. 0 1 2 3 4
4. Cognitive problems 0 1 2 3 4
5. Physical illness or disability
problems 0 1 2 3 4
6. Hallucinations or delusions. 0 1 2 3 4
7. Depression mood 0 1 2 3 4
8. other mental health issues 0 1 2 3 4
9. Relationship 0 1 2 3 4
10. Activities of daily living. 0 1 2 3 4
11.Problem with living conditions 0 1 2 3 4
12.Problem with occupations and
activities 0 1 2 3 4

3RECOVERY FOCUSED NURSING CARE PLAN
Recovery focused nursing care plan
Consumer
priority
Identifie
d
goals/iss
ues
The
consume
r’s
strength
s to
address
these
issues.
Consumer and Nursing
Interventions
Person/s
Responsibl
e
Timeframe for
next Review
Consumer
Priority#
4
Rachelle, a
married
21-year-
old woman
experienci
ng
symptoms
of
depression
-
HONOS
Score: 4
Issue-
Rachelle
experienc
ing
depressed
mood and
disturban
ce after
the birth
of the 10-
weekold
Patient
has
insight
of
illness,
intact
judgmen
t,
Recent
memory
is intact,
-Encourage Rachelle and
her husband to participate
in crisis counselling when
feeling depressed, helpless
or sad (Townsend &
Morgan, 2017).
-Encourage group talk to
express feelings of
sadness, anger, sad to gain
sense of control using
alternate ways to
overcome feelings
(Herdman &
Case
manager,
maternal
health nurse
and nurse
-Patient
shows
willingness
to attend the
counselling
sessions
when
Weekly review
of Rachelle
using the
“Postpartum D
epression Scre
ening Scale”.
It is the self-
report
instrument,
35-item Likert-
type designed
for new
mothers. This
questionnaire

4RECOVERY FOCUSED NURSING CARE PLAN
peripartum
onset.
-These
symptoms
were
noticed
after 10-
weeks of
giving
birth to her
baby.
-The
presenting
complaint
of the
mother are
—
“not
coping at
all with
the baby”
“sad and
daughter,
Claire.
Goal-
Rachelle
to
overcome
depressio
n for her
and
Claire’s
well
being and
safety
Goal
directed
thinking,
Very
family
oriented,
God
husband’
s support
as 9
years
marriage
was
stated as
good,
Satisfact
ory work
life as
office
manager,
Kamitsuru,2014).
-Advocate Rachelle to take
medicines on time to
overcome depression
(Comtois et al., 2015).
feeling
overwhelme
d
-Rachelle
involves in
communicat
ion with her
husband and
case manger
to
express/verb
alise
irrational
thoughts,
reframe
responses,
encounter
negative
thoughts,
-Rachelle
will be used for
the patients
after every
visit.
This
questionnaire
will help
Rachelle and
her health care
professional to
determine
feelings.
The mothers
respond
through five
point scale that
contains
options from
“strongly
disagree" to
"strongly
agree”.

5RECOVERY FOCUSED NURSING CARE PLAN
upset all
the time”
“I’m a bad
mother”
-Rachelle
has poor
thought
content
demonstrat
ed by
feeling of
hopelessne
ss,
worthlessn
ess,
helplessne
ss, guilt,
and sense
of being a
failure
- Rachelle
showed
symptoms
High
educatio
nal
attainme
nt,
She has
friends
in school
and
commun
ity
-Engagement of patient in
self help groups and
network of resources to
feel socially engaged.
Maximise the clients
contacts to prevent suicide
ideation followed by
engagement in self help
groups. (Currier et al.,
2015).
Group therapy with other
mother to minimise the
feelings of isolation,
(Gartlehner et al., 2015).
-Refer Rachelle to
nutritionist for well
shows
interest in
taking care
of her
daughter
and improve
relationship
with her
husband
-Rachelle
demonstrate
s
compliance
with
medication
and
communicat
e with
nurse/
physician
regrading
any
The scores falls
in three
categories-
normal
adjustment (≤
59),
Positive screen
of major
depression (≥
80) and
potential
depression
symptoms (60 -
79).
Initially only
seven questions
were asked to
fill and if the
score is greater
than 14, then
the remaining
questions will
be asked to fill

6RECOVERY FOCUSED NURSING CARE PLAN
of
anhedonia,
withdrawn
behavior,
and
impaired
functionin
g,
decreased
appetite,
Loss of
weight,
-Rachelle
engages in
bouts of
crying
and has
wish for
death
-Rachelle
does not
attend
Church
balanced nutrition and
inform client on healthy
eating to minimise weight
loss and dehydration.
To reduce disturb sleep
pattern, encourage
relaxation measures such
as listening soft music,
provide rest periods from
baby care (Werner et al.,
2015).
-Speak to client in simple
concrete words and allow
the clients to slowly frame
the responses
(DiClemente et al., 2016).
complicatio
ns with
medication
-Rachelle
identifies at
least two to
three people
other than
her husband
for support
at the time
of crisis/
suicide
ideation,
and get
emotional
guidance
(Zhao et al.,
2015).
In case of
Rachelle with
each visit a
positive results
may be
observed
showing
improvement
in score
A decrease in
depression may
occur as
Rachelle
engages in her
treatment and
therapy. It will
improve her
mood and help
her enjoy her

7RECOVERY FOCUSED NURSING CARE PLAN
social
groups
-Rachelle
engages in
healthy
eating and
cooks food
recommend
ed by
nutritionist
motherhood.
Rachelle can
better
reconnect with
her husband
and daughter
(Herdman &
Kamitsuru,
2014)
Consumer
Priority #
4
Problem
with
Activities
HONOS
Score: 4
Issues
Rachelle
is poorly
performi
-
Rachelle
has
-Allow client to work with
sufficient time on
activities of daily living to
Nurse,
Rachelle’s
husband,
Initially
Rachelle may
be monitored
every alternate
day and then

8RECOVERY FOCUSED NURSING CARE PLAN
of daily
living
-Rachelle
finds
difficult to
perform
activities
of daily
living,
Evident by
difficult
concentrati
on and
impaired
parenting
She was
unable to
do do
Serial 7’s
She could
do digit
span of 4
ng her
daily
living
activities,
not
taking
care for
her new
born or
herself.
Goals
intact
memory
and
judgmen
t skills
-
Rachelle
is aware
of her
illness
and s
seeking
intervent
ion
Husband
Martin is
encourag
ing,
-Her
orientati
on to
place,
person
decrease anxiety.
-Encourage client’s
husband to uptake more
responsibility to reduce
pressure on Rachelle
(Dennis, Brown &
Morrell, 2016).
-Educate Rachelle with
theory of self care
(Revello & Fields, 2015).
-Help the family in
designing predictable
routines that is easier to
follow and remember
(Dennis, Brown, &
Morrell, 2016).
-Rachelle. Routine must
involve rest periods to
avoid stress and
appropriate time for daily
activities, sleep, eating,
case
manger,
friends in
community
Rachelle
may consult
her friends
in
community
who are
already a
mother to
learn ways
to handle
new born.
Rachelle
may work
with her
husband on
household
chores
on weekly
basis.
Ability to
perform
activities living
Martin, will
improve with
motivation, and
support from
husband and
guidance from
the case
manger
(Moorhead et
al., 2014).

9RECOVERY FOCUSED NURSING CARE PLAN
forward,
and none
backward
Rachelle
demonstrat
ed
impaired
functionin
g
After
birth of
her
daughter
10 weeks
ago
Rachelle is
unable to
care for
her
daughter
after
depression
and time
is good
Marriage
is a
supporti
ng factor
and for
positive
change
Always
was
motivate
d to
work
well in
office
and was
successf
ul in
becomin
g office
manager
reading and exercise
-Martin to motivate
Rachelle to attend weekly
mass, occasional
confession, attend Church
social groups
-Engagement in
mindfulness activities such
as mediation, yoga or mild
exercise o strengthen
muscle and increase
concentration in work
(Dennis, Brown, &
Morrell, 2016).
-Encourage Rachelle in
cooking independently
and assist in making
healthy meal plan
-Maintain journal to record
thoughts, barriers in
performing activities and
list of achievements
-Martin must praise and

10RECOVERY FOCUSED NURSING CARE PLAN
Rachelle is
inappropri
ately
dressed,
has
unkempt
appearanc
e and does
not cook
healthy
food for
herself,
weight
loss
-Her motor
behaviour
demonstrat
es rigid
posture,
few
spontaneo
us
movement
Supporti
ve
network
from
friends
in
commun
ity,
High
educatio
nal
attainme
nt,
Very
family
oriented
give positive feedback to
Rachelle to increase
interest in daily living
activities
Encourage the client to
brush, use soap,
washcloths, make up,
hygiene etc too increase
self esteem

11RECOVERY FOCUSED NURSING CARE PLAN
s,
slumped
slightly
forward
Consumer
Priority #
4
Rachelle
expresses
her feeling
of
hopelessne
ss and
worthlessn
ess with
her
motherhoo
d after
birth of
her
daughter
Clarie,
Issue:
HONO's
Score #
4
Issue:
Self
esteem
disturban
ce makes
Rachelle
perceive
herself as
bad
mother
and
demonstr
ate self
negative
verbalisat
Spiritual
belief,
support
from
husband,
intact
judgmen
t and
memory
Past
work
achieve
ments
-Help Rachelle learn infant
cues and its meaning.
-Engage in community
group programs or
personal counselling
(Franck et al., 2016).
-Teach visualisation
techniques to have positive
thoughts and more realistic
self image. It will also
prevent suicide ideation
(Comtois et al., 2015).
Group therapy minimise
the feelings of isolation,
-Involvement in activities
Nurse, case
manger,
mental
health
professional
s and
Martin
Rachelle
may consult
nurse for
setting
realistic life
goals.
Rochelle
may take
support of
her husband
Martin to
know the
Review daily
for first few
weeks and then
monthly.
Client needs
can be
evaluated using
“assertiveness
training tools”
to identify the
clients
wants/needs in
life and assess
problem
solving skills
(Townsend, &
Morgan 2017).