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Powerlessness — Diabetes Mellitus

 Powerlessness — Diabetes Mellitus Nursing Care Plan

Nursing Diagnosis: Powerlessness
May be 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/influence over situation
  • Apathy, withdrawal, anger
  • Does not monitor progress, nonparticipation in care/decision making
  • Depression over physical deterioration/complications despite patient cooperation with regimen
Desired Outcomes: 
  • 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 Interventions Rationale
 Encourage patient/SO to express feelings about hospitalization and disease in general. Identifies concerns and facilitates problem solving.
Acknowledge normality of feelings.  Recognition that reactions are normal can help patient problem-solve and seek help as needed. Diabetic control is a full-time job that serves as a constant reminder of both presence of disease and threat to patient’s health/life.
 Assess how patient has handled problems in the past. Identify locus of control.  Knowledge of individual’s style helps determine needs for treatment goals. Patient whose locus of control is internal usually looks at ways to gain control over own treatment program. Patient who operates with an external locus of control wants to be cared for by others and may project blame for circumstances onto external factors.
 Provide opportunity for SO to express concerns and discuss ways in which he or she can be helpful to patient.  Enhances sense of being involved and gives SO a chance to problem-solve solutions to help patient prevent recurrence.
 Ascertain expectations/goals of patient and SO.  Unrealistic expectations/pressure from others or self may result in feelings of frustration/loss of control and may impair coping abilities.
 Determine whether a change in relationship with SO has occurred.  Constant energy and thought required for diabetic control often shifts the focus of a relationship. Development of psychological concerns/visceral neuropathies affecting self-concept (especially sexual role function) may add further stress.
 Encourage patient to make decisions related to care, e.g., ambulation, time for activities, and so forth.  Communicates to patient that some control can be exercised over care.
 Support participation in self-care and give positive feedback for efforts.  Promotes feeling of control over situation.