Nursing Care Plan for Low Self-Esteem Low self-esteem is a person rejects as something precious and is not responsible

for their own lives. If the individual often fails it tends to lower self-esteem. Low self-esteem if it loses the love and appreciation of others. Self-esteem derived from self and others, the main aspect is to be accepted and received awards from other people. Low self-esteem disturbance described as negative feelings about themselves, including the loss of confidence and self esteem, sense of failure to reach the desire, self-criticism, reduced productivity, which is directed destructive to others, feelings of inadequacy, irritable and withdrawn socially.

Nursing Care Plan for Low Self-Esteem Nursing Assessment for Low Self - Esteem Subjective Data: Clients say: I can not afford, can not, do not know anything, stupid, self-criticism, expressing feelings of shame about themselves. Objective Data: Clients looked more like himself, confused when asked to choose an alternative action, want to injure himself / want to end life. Nursing Diagnosis for Low Self - Esteem Risk for Social Isolation : withdrawing associated with low self-esteem. Self-Concept Disturbance : low self-esteem associated with dysfunctional grieving. Nursing Intervention for Low Self - Esteem Goal Clients can build a trusting relationship with nurses. Action:

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Construct a trusting relationship: Greetings therapeutic, self introduction, Explain the purpose, Create a peaceful environment, definition of contract (time, place and subject.) Give clients the opportunity to express his feelings. Take time to listen to the client. Tell the client that he is someone who is valuable and responsible and able to help themselves. Clients can identify the skills and positive aspects that are owned. Action:

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Discuss the capabilities and the positive aspects of client owned. Avoid giving negative assessments of each meet clients, give praise a realistic priority. Clients can assess the ability and positive aspect owned. Clients can assess the capabilities that can be used. Action:

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Discuss with the client's abilities can still be used. Discuss also the ability to continue after returning home. Clients can define / plan activities appropriate capabilities. Action:

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Plan your activities with a client that can be done every day according to ability. Increase activities in accordance with client's tolerance condition. Give examples of how implementation of activities that clients should do.

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Clients can perform activities according to the conditions and capabilities. Action:

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Give a chance to try activities that have been planned. Give praise for success Discuss the possibility of implementation at home. Clients can utilize the existing support system. Action:

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Give health education to families about how to care for clients. Helps families provide support for client care. Help prepare the family environment at home. Give positive reinforcement for family involvement.

Nursing diagonsis: situational low Self-Esteem related to Traumatic injury, situational crisis, forced crisis Possibly evidenced by Verbalization of forced change in lifestyle Fear of rejection or reaction by others Focus on past strength, function, or appearance Negative feelings about body Feelings of helplessness, hopelessness, or powerlessness Actual change in structure and function Lack of eye contact Change in physical capacity to resume role Confusion about self, purpose, or direction of life Desired Outcomes/Evaluation CriteriaClient Will Psychosocial Adjustment: Life Change Verbalize acceptance of self in situation. Recognize and incorporate changes into self-concept in accurate manner without negating self-esteem. Develop realistic plans for adapting to role changes and new role. Nursing intervention with rationale: 1. Acknowledge difficulty in determining degree of functional incapacity and chance of functional improvement. Rationale: During acute phase of injury, long-term effects are unknown, which delays the clients ability to integrate situation into self-concept. 2. Listen to clients comments and responses to situation.

Rationale: Active listening provides clues to clients view of self, role changes, needs, and level of acceptance. 3. Assess dynamics of client and SOs, including clients role in family and cultural factors. Rationale: Clients previous role in family unit is disrupted or altered by injury. Role changes add difficulty in integrating selfconcept and level of independence. 4. Encourage SO to treat client as normally as possible, such as discussing home situations and family news. Rationale: Involving client in family unit reduces feelings of social isolation, helplessness, and uselessness and provides opportunity for SO to contribute to clients welfare. 5. Provide accurate information. Discuss concerns about prognosis and treatment honestly at clients level of acceptance. Rationale: Open discussion of treatment and prognosis may focus on current and immediate needs. Ongoing updates enable assimilation. 6. Discuss meaning of loss or change with client and SO. Assess interactions between client and SO. Rationale: Actual change in body image may be different from that perceived by client. Distortions may be unconsciously reinforced by SO. 7. Accept client and show concern for individual as a person. Identify and build on clients strengths; give positive reinforcement for progress noted. Rationale: Genuine concern and regard for the client as an individual establishes therapeutic atmosphere for self-acceptance and encouragement. 8. Include client and SO in care, allowing client to make decisions and participate in selfcare activities, as possible. Rationale: Encouraging client participation in care decision making recognizes that client is still responsible for own life and provides some sense of control over situation. It sets the stage for future lifestyle, pattern, and interaction required in daily care. Note: Client may reject all help or may be completely dependent during this phase. 9. Be alert to sexually oriented jokes, flirting, or aggressive behavior. Elicit concerns, fears, and feelings about current situation and future expectations. Rationale: Anxiety develops because of perceived loss and change in masculine or feminine self-image and role. Forced dependency is often devastating, especially in light of change in function and appearance. 10. Be aware of own feelings and reaction to clients sexual anxiety. Rationale: Personal reactions to clients sexual anxiety may be as disruptive as the behavior itself, creating conflicts between client and staff, and can potentially eliminate clients willingness to work through situation and participate in rehabilitation.