Self-Esteem/Disturbed Body Image | Nursing Care Plan for Liver Cirrhosis

Nursing diagnosis: Self-Esteem/disturbed Body Image related to Biophysical changes, altered physical appearance, Uncertainty of prognosis, changes in role function, Personal vulnerability
Self-destructive behavior—alcohol-induced disease

Possibly evidenced by
Verbalization of change or restriction in lifestyle
Fear of rejection or reaction by others
Negative feelings about body and abilities
Feelings of helplessness, hopelessness, or powerlessness

Desired Outcomes/Evaluation Criteria—Client Will
Self-Esteem
Verbalize understanding of changes and acceptance of self in the present situation.
Identify feelings and methods for coping with negative perception of self.

Nursing intervention with rationale:
1. Discuss situation and encourage verbalization of fears and concerns. Explain relationship between nature of disease and symptoms.
Rationale: Client is very sensitive to body changes and may also experience feelings of guilt when cause is related to alcohol or other drug use.

2. Support and encourage client; provide care with a positive, friendly attitude.
Rationale: Caregivers sometimes allow judgmental feelings to affect the care of client and need to make every effort to help client feel valued as a person.

3. Encourage family/SO to verbalize feelings, visit freely, and participate in care.
Rationale: Family/SO may feel guilty about client’s condition and may be fearful of impending death. They need nonjudgmental emotional support and free access to client. Participation in care helps them feel useful and promotes trust between staff, client, and family/SO.

4. Assist client/SO to cope with change in appearance; suggest clothing that does not emphasize altered appearance, such as use of red, blue, or black clothing.
Rationale: Client may present unattractive appearance as a result of jaundice, ascites, and ecchymotic areas. Providing support can enhance self-esteem and promote client’s sense of control.

5. Refer to support services, such as counselors, psychiatric resources, social service, clergy, and alcohol treatment program.
Rationale: Increased vulnerability and concerns associated with this illness may require services of additional professional resources.