Powerlessness | Nursing Care Plan for Diabetes Mellitus

Nursing diagnosis: Powerlessness related to Long-term, progressive illness that is not curable Dependence on others

Possibly evidenced by
Reluctance to express true feelings, expressions of having no control or influence over situation
Apathy, withdrawal, anger
Does not monitor progress, nonparticipation in care or decision making
Depression over physical deterioration or complications despite client cooperation with regimen

Desired Outcomes/Evaluation Criteria—Client Will
Health Beliefs: Perceived Control
Acknowledge feelings of helplessness.
Identify healthy ways to deal with feelings.
Assist in planning own care and independently take responsibility for self-care activities.

Nursing intervention with rationale:
1. Encourage client and SO to express feelings about hospitalization and disease in general.
Rationale: Identifies concerns and facilitates problem-solving.

2. Acknowledge normality of feelings.
Rationale: Recognition that these reactions are normal can help client problem-solve and seek help as needed. Diabetic control is a full-time job that serves as a constant reminder of both presence of condition and threat to client’s health and life.

3. Assess how client has handled problems in the past; identify locus of control.
Rationale: Knowledge of individual’s style helps determine needs for treatment goals. Client whose locus of control is internal usually looks at ways to gain control over own treatment program. Client who operates with an external locus of control wants to be cared for by others and may project blame for circumstances onto external factors.

4. Provide opportunity for SO to express concerns and discuss ways in which he or she can be helpful to client.
Rationale: Enhances sense of being involved and gives SO a chance to problem-solve solutions to help client prevent recurrence.

5. Ascertain expectations and goals of client and SO.
Rationale: Unrealistic expectations and pressure from others or self may result in feelings of frustration or loss of control and may impair coping abilities. Note: Even with rigid adherence to medical regimen, complications and setbacks may occur.

6. Determine whether a change in relationship with SO has occurred.
Rationale: Constant energy and thought required for diabetic control often shifts the focus of a relationship. Development of psychological concerns and visceral neuropathies affecting self-concept, especially sexual role function, may add further stress.

7. Encourage client to make decisions related to care, such as ambulation, time for activities, and so forth.
Rationale: Communicates to client that some control can be exercised over care.

8. Support participation in self-care and give positive feedback for efforts.
Rationale: Promotes feeling of control over situation.