Impaired Social Interaction

(_)Actual (_) Potential

Related To:
[Check those that apply]
(_) Mental illness
(_) Other:_____________________________
____________________________________
____________________________________

 

As evidenced by:
[Check those that apply]
Major:
(
Must be present)
(_) Reports inability to establish and/or maintain stable, supportive relationships.
Minor:
(
May be present)
(_) Lack of motivation. (_) Sever anxiety.
(_) Dependent behavior. (_) Hopelessness.
(_) Delusions/hallucinations. (_) Disorganized thinking.
(_) Lack of self care skills. (_) Poor impulse control.
(_) Distractibility/inability to concentrate.
(_) Social isolation. (_) Superficial relationships.
(_) Difficulty holding a job. (_) Lack of self esteem.

 

Date &
Sign.
Plan and Outcome
[Check those that apply]
Target
Date:
Nursing Interventions
[Check those that apply]
Date
Achieved:
  The patient will:(_) Identidy problematic behavior that deters socialization.

(_) Describe and utilize strategies to promote effective socialization.

(_) Other:

  (_) Assess patients feelings relative to social isolation.(_) Help to identify precipitating factor(s)/stressors.

(_) Help to identify alternative courses of action.

(_) Assist in analyzing approaches which work best.

(_) Provide supportive group therapy when indicated.

(_) Encourage to validate perception with others.

(_) Identify strengths and areas of improvement.

(_) Role model certain accepted social behaviors:____________
_______________________
_______________________

(_) Hold accountable for own actions.

(_) Other:________________
________________________
________________________
________________________

 

 

__________________________
Patient/Significant other signature

 

__________________________
RN signature