The following NANDA-I nursing diagnostic stem was developed for a client on an inpatient unit: Risk for injury. What assessment data most likely led to the development of this problem statement?
1. The client is receiving ECT and is diagnosed with Parkinsonism.
2. The client has a history of four suicide attempts in adolescence.
3. The client expresses hopelessness and helplessness and isolates self.
4. The client has disorganized thought processes and delusional thinking.
1
Rationale: The nurse should identify that a client receiving ECT and who is diagnosed with Parkinsonism is at risk for injury. History of suicide, hopelessness, and disorganized thoughts would not lead the nurse to formulate a nursing diagnostic stem of Risk for injury.
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