Prioritizing NRS Dx sternal infection post CABG

[nyx1121]

I'm a nursing student working on a care plan for a MSSA bacteremia infected sternal wound following CABG. This is what I've come up with so far. I've tried to break it down from most important to least important.

Would there be anything you would add or delete? I'm mostly looking for input from a professional who handles these type of questions q.d.

Thank you!

Decreased cardiac output r/t dysrhythmia, depressed cardiac function, increased systemic vascular resistance.

Risk for ineffective tissue perfusion: peripheral r/t prolonged immobility, decreased coughing, decreased deep breathing

Risk for infection r/t presence of bacteria (MSSA)

Acute pain r/t open sternal wounds

Excess fluid volume r/t impaired excretion of sodium and water

Impaired tissue integrity r/t wound, presence of infection

Risk for infection; spread of r/t imbalanced nutrition less than body requirements

Ineffective coping r/t hospitalization and disease process

[RN12345656]

I work on a cardiac surgery step-down floor. Unfortunately, I see the sternal wound infx in waves...just curious is this pt a diabetic? Many of these wound infx are diabetics. That might help you..

Also, tell me more specific info about the pt.. I see the first Nursing Dx is Dec Cardiac OUtput R/T arrythmia. Has this pt had post op Afib? How many days out from surgery is the pt? Did they go back to the OR for debridment? You have alot of good diagnoses. I'm not sure if you need general diagnoses R/T CAD or more specific to his current disease process, ie Sternal wound infx

Email [email protected]

[nyx1121]

Thank you for your feedback. This one turned out to be an interesting case.

Thanks,

nyx1121

I work on a cardiac surgery step-down floor. Unfortunately, I see the sternal wound infx in waves...just curious is this pt a diabetic? Many of these wound infx are diabetics. That might help you..

Also, tell me more specific info about the pt.. I see the first Nursing Dx is Dec Cardiac OUtput R/T arrythmia. Has this pt had post op Afib? How many days out from surgery is the pt? Did they go back to the OR for debridment? You have alot of good diagnoses. I'm not sure if you need general diagnoses R/T CAD or more specific to his current disease process, ie Sternal wound infx

Email [email protected]