Amante M. Valencia Jr.

NCEHN05

Personality Disorders

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 deserted her and her
boyfriend doesn’t love her anymore, she slashes her forearms with a sharp knife. She then calls
911, stating, “I am about to die! Please help me!” She is taken by the ambulance to the
emergency room and is admitted to the inpatient psychiatric unit.

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

A. Risk For Self-Mutilation: At risk for deliberate self-injurious behavior causing tissue damage
with the intent of causing nonfatal injury to attain.

B. Ineffective Coping: Inability to form a valid appraisal of the stressors, inadequate choices of

practiced responses, and/or inability to use available resources.

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

A. Risk For Self-Mutilation

 Patient will be free of self-inflicted injury

B. Ineffective Coping

 Patient will have an increased in frequency of expressing needs directly without ulterior
motives.
 Patient will learn and master skills that facilitate functional behavior.

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

A. Risk For Self-Mutilation

 Identify feelings experienced before and around the act of self-mutilation.

 Explore with the client what these feelings might mean.
 Secure a written or verbal no-harm contract with the client. Identify specific steps (e.g.,
persons to call upon when prompted to self-mutilate). Set and maintain limits on
acceptable behavior and make clear client’s responsibilities. If the client is hospitalized
at the time, be clear regarding the unit rules.

B. Ineffective Coping

 Approach the client in a consistent manner in all interactions.

 Identify what the client sees as the behaviors and circumstances that lead to the
hospitalization.
 Ascertain from family/friends how the person interacts with significant people. Is the
client always withdrawn, distrustful, hostile, have continuous physical complaints?