poor r wave progression/ student nurse

You wouldn't make a nusing diagnosis just on the basis of poor R wave progression.

The first step is to complete a thorough patient assessment, document your findings and identify the abnormal findings. Once you've done that, I bet that a few nursing diagnoses will jump out at you.

Nursing diagnoses are based upon the responses that the patient has to their illness. Every nursing diagnosis has a list of defining characteristics (signs and symptoms) and the patient must have at least one or more of them as well as fit the definition of the diagnosis.

An electrical disturbance would fall under the diagnosis of Decreased Cardiac Output, but I would caution you to look for other symptoms. See this webpage on the diagnosis: Decreased Cardiac output

There is information on care planning in the General Nursing Student Discussion Forum on this sticky thread:

• http://allnurses.com/forums/f50/help-care-plans-286986.html - Assistance - Help with Care Plans

i agree with the other post. There is no cut and dry NANDA diagnoses for what you have listed. Start with "What is an R wave". The QRS complex is ventricular depolarization. Think about the pathophysiology...what lytes factor into this, will this effect CO, perfusion (i.e. < perfusion to the renal system leading to renal failure etc.), or perhaps a backup in blood to the atria if lets say the pt has a poor EF...lots to think about here. Lab results and a thorough pt assessment will be key here.