[sweets15232]

I am doing a careplan on my patient who is 82 years old and was admitted with a right knee contusion due to a fall..she has a history of fibromyalgia and restless leg syndrome and also peripheral neuropathy. My instructor wants me to make up a careplan about her neurovascular...Help cause I am stuck.

Symptoms are
BP 178/80
weak dorsalis pulse
irregular hear beat
numbness in feet
tingling in feet


knee swollen from fall
lightheadedness
short term memory loss
pain on movement



Thanks so much...This helped me alot

[Daytonite]

Hi, sweets15232!

Is this a real patient? Have you seen this person and done a physical assessment of them? If so, you need to list the symptoms that patient is having in order for me to help you get started with this care plan. If not, I need to know so I can tell you how to proceed.

Welcome to allnurses!

[Daytonite]

OK. The symptoms relating to the peripheral neurovascular problems are:

• weak dorsalis pedis pulse
• numbness in the feet
• tingling in the feet

These three symptoms fit the profile for the nursing diagnosis of Ineffective Tissue Perfusion, peripheral R/T either impaired transport of oxygen or interruption of blood flow AEB weak dorsalis pedis pulse, numbness in the feet and tingling in the feet.

Is the pain on movement in the leg or the knee? Is it related to the right knee contusion? If the pain is in the leg and feet and not part of the knee injury, then it should also be included as a symptoms of the Ineffective Tissue Perfusion. If you have any information on tests that were done that would indicate that the cause of the tissue perfusion is truly related to blood flow and impaired oxygen transport it would clarify whether one or both of those etiologies can be used as your "related to" factors in the nursing diagnostic statement.

I'm curious. . .with the irregular heart beat, lightheadedness (syncope?) and short term memory loss, does this patient have any arteriosclerosis or atherosclerosis? If so, you should add cardiac and cerebral to the above nursing diagnoses as well as those symptoms. That would make the diagnosis Ineffective Tissue Perfusion, cardiac, cerebral and peripheral R/T interruption of blood flow AEB irregular heart beat, lightheadedness, short term memory loss, weak dorsalis pedis pulse, numbness in the feet and tingling in the feet. Here are two websites where you can get information about this particular diagnosis including outcomes and nursing interventions: http://www1.us.elsevierhealth.com/MERLIN/Gulanick/Constructor/index.cfm?plan=55 http://www1.us.elsevierhealth.com/Evolve/Ackley/NDH7e/Constructor/careplan_072.php

Hope that is helpful. You can find information on writing care plans within these two threads on the nursing student forums:

• http://allnurses.com/forums/f205/desperately-need-help-careplans-170689.html - Desperately need help with careplans (in Nursing Student Assistance Forum)
• http://allnurses.com/forums/f50/careplans-help-please-r-t-aeb-121128-7.html - CAREPLANS HELP PLEASE! (with the R\T and AEB) (in General Nursing Student Discussion Forum)

By the way, the restless leg syndrome is often related to renal problems. Any of those? How are you dealing with the pain of the fibromyalgia?