A client with three children (11, 9, and 6 years of age) seeks preventive treatment at a mental health clinic
She states, "I'm here before I go crazy! The kids don't listen. I yell at them and then, rather than argue constantly, I give in. What a great mom, huh? My mom and dad were very permissive with me, but I was more cooperative and willing to behave." Which of the following diagnoses is best?
A) Health-Seeking Behaviors related to desire for a more stable home environment as evidenced by statement, "I'm here before I go crazy!"
B) Situational Low Self-esteem related to ironic statement "What a great mom" as evidenced by desire for help
C) Ineffective Coping related to inability to effectively discipline children and evidenced by statements about disciplining patterns
D) Impaired Parenting related to a lack of knowledge about parenting skills as evidenced by statements about feelings of ineffectiveness
Ans: D
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The nurse chooses the appropriate diagnosis from the North American Nursing Diagnosis Association (NANDA) list by examining definitions, considering related and risk factors, and choosing a diagnostic concept that fits the assessment data. The nurse adds a descriptor (ie, impaired) and an etiology, or a "related to" phrase, to provide a precise representation of the patient's needs. Defining characteristics, the third part of the nursing diagnosis, are the subjective and objective data (signs and symptoms) that must be present to substantiate use of the diagnoses. The client's perceived deficits in her parenting ability are central to her statement.
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