What are some appropriate nursing interventions for a patient with borderline personality disorder?

Share this:

• Facebook
• Twitter
• Google
• Pinterest

Definition

• Is defined as the totality of a person’s unique biopsychosocial and spiritual traits that consistently influence behavior.
• The following traits are likely in individuals with a personality disorder:
  1. Interpersonal relations that ranges from distant to overprotective.
  2. Suspiciousness
  3. Social anxiety
  4. Failure to conform to social norms
  5. Self-destructive behaviors
  6. Manipulation and splitting

• Prognosis is poor, and clients experience long term disability and may have other psychiatric disorders.

Cluster A: The Eccentric and Mad group

1. Paranoid – suspicious, jealous, short tempered.
2. Schizotypal – superstitious, believes in magic, ideas of reference.
3. Schizoid – doesn’t want to socialize, prefers to be alone, detached.

Cluster B: The Erratic and Bad group

1. Antisocial – irresponsible, display lack of guilt, good at manipulation.
2. Borderline – intense relationship, self-mutilation, impulsiveness.
3. Histrionic – attention-seeking, self-centered, seductive, dramatic.
4. Narcissistic – grandiose view of self lacks empathy for others.

Cluster C: The anxious and Sad group

1. Obsessive compulsive – preoccupied with perfection, conscious of rules, self-critical, controlling.
2. Avoidant – fearful of criticism and rejection, negative self-esteem, few social interactions.
3. Dependent – submissive, clinging to others, unable to make decision by self.

Signs and Symptoms

1. Inappropriate response to stress and inflexible approach to problem solving.
2. Long term difficulties in relating to others, in school and in work situations.
3. Demanding and manipulative.
4. Ability to cause others to react with extreme annoyance or irritability.
5. Poor interpersonal skills.
6. Anxiety
7. Depression
8. Anger and aggression
9. Difficulty with adherence to treatment.
10. Harm to self or others.

Nursing Diagnoses

• Ineffective individual coping
• Social isolation
• Impaired social interaction
• High risk for violence to self or others
• Anxiety

Nursing Interventions

1. Work with the client to increase coping skills and identify need for improvement coping.
2. Respond to the client’s specific symptoms and needs.
3. Keep communication clear and consistent.
4. Client may require physical restraints, seclusion/observation room, one to one supervision.
5. Keep the client involved in treatment planning.
6. Avoid becoming victim to the client’s involvement in appropriate self-help groups.
7. Require the client take responsibility for his/her own behavior and the consequences for actions.
8. Discuss with the client and family the possible environment and situational causes, contributing factors, and triggers.

Related Posts

• Psychiatric Nursing Mnemonics Yesss you know you’ve read about it and yes, you know that you got those signs memorized last n...
• General Nursing Interventions for Mental Health Clients Forming a one-to-one relationship with the client It will help the client to enhance com...
• How to Manage Anger with Aggressive and Violent Behavior Anger is an emotional response, which can be expressed in a healthy manner to solve probl...
• Nursing Interventions and Diagnoses for Obsessive Compulsive Disorder (OCD) Definition Characterized by persistent thought and urges to perform repeated acts or rit...
• Special Safety Precautions of Patients With Psychiatric Problems Safety is frequently considered as a human need wherein a person is free from injury both psychol...

Share this:

• Facebook
• Twitter
• Google
• Pinterest

The symptoms associated with BPD are seen in a variety of cultures across the world (APA, 2013). About 75% of those diagnosed are females (APA, 2013). The core features of BPD are (APA, 2013):

• Fear of abandonment
• Intense interpersonal relationships
• Unstable self-image
• Self-damaging impulsivity
• Affective instability

Those with BPD tend to avoid both real and imagined abandonment uncontrollably. They exhibit intense and inappropriate anger when faced with realistic separation from someone who is important to them. For example, someone with BPD might panic when a clinician announces the end of their hour appointment. They have a deep intolerance for being alone, and their impulsivity can lead to self-mutilation and suicidal behaviors (APA, 2013).

Those with BPD display unstable and intense interpersonal relationships. They frequently idealize potential caregivers or romantic partners at first; however, this infatuation rapidly shifts to hatred, believing that the other person does not love them enough. Those with BPD are prone to dramatic and quick changes in their views of others, which in turn often leaves them isolated and abandoned (APA, 2013).

Individuals suffering from BPD display a persistent, unstable self-image. Their goals, values, and career choices may change day to day. They alter between playing the role of a needy victim to that of a righteous avenger. Those with BPD tend to view themselves as either all good or all evil, and when undergoing severe stress, they may feel as though they do not exist at all (APA, 2013).

Furthermore, people with BPD exhibit marked impulsivity that is potentially self-damaging. For example, they may gamble, irresponsibly spend money, binge eat, abuse harmful substances, engage in unsafe sex, or drive recklessly. Furthermore, these individuals may repeatedly self-mutilate or make suicidal threats or gestures. Around 8%-10% of those with BPD complete suicide (APA, 2013).

Finally, individuals with BPD present with marked reactivity of mood that usually manifests as intense episodic dysphoria, irritability, and anxiety. They also tend to report chronic feelings of emptiness, panic, anger, and despair. When they feel as though they are being abandoned, they may exhibit extreme sarcasm or verbal outbursts that then leave them feeling guilty. During times of extreme stress, those with BPD tend to report paranoid ideation or dissociative symptoms (APA, 2013).

How to care for a patient with borderline personality disorder?

What are the 5 nursing interventions?

What are interventions for personality disorder?

What are appropriate nursing interventions for any client?