ESRD Nursing Diagnosis

Nurses General Nursing

Published

o.k here was another question that I got stumped on...

Your patient has End Stage Renal Disease, with a 30 year HX of Type 1 DM. She has a 2-cm dry, ulcerated circular area on the lateral outer aspect of her right great toe and an AV fistula in the right forearm. You have adminisered her AM NPH insulin at 0730 and you are waiting for her dialysis treatment. At 1130 you do a fingerstick and the results are 236, According to the Sliding Scale you administered 10 units of Regular insulin.

Which of these Nursing Diagnosis is a priority at this time.

Risk for infection

Altered patterns of elimination

Fatique

Excess fluid volume

Deficient Fluid Volume

Imbalance Nutrition:Less than body requirements

I choose Fluid volume excess, because she is now hyperglycemic. Wouldn't there be a fluid shift from intracellular to intravascular because of the high concentration of glucose in the vascular system.

F&E confuses me...Anyone have any ideas. Thanks

i have a pt with esrd and i was wondering if i could use fluid volume excess as a nursing diagnosis but she does not manifest any signs of FVE like bounding pulse instead she has 60 bpm. can i use FVE as a nursing diagnosis?

Specializes in med/surg, telemetry, IV therapy, mgmt.
i have a pt with esrd and i was wondering if i could use fluid volume excess as a nursing diagnosis but she does not manifest any signs of fve like bounding pulse instead she has 60 bpm. can i use fve as a nursing diagnosis?

if the patient doesn't have any symptoms of fve then you can't diagnose her with it. think about this. a doctor wouldn't diagnose you with something like congestive heart failure if you didn't have any of the symptoms of it. so, you can't do the same. any diagnosis is based upon the symptoms the patient has.

a care plan starts with the assessment you do of the patient. from your thorough assessment, abnormal data (symptoms) will become apparent. the care plan is nothing more than problem solving. the problems are based upon the patient's symptoms. the nursing interventions are aimed at the patient's symptoms. the medical diagnosis (in this case esrd) is not particularly relevant except that you should look up the signs and symptoms of esrd to see if you missed any of them in your own assessment of the patient. fluid retention and a bounding pulse are not the only symptoms of esrd!

there are two threads on the student forums to help with writing care plans and you will get better responses if you post care plan questions in a new thread on the student forums.

Specializes in subacute/ltc.

Daytonite Rocks!!!!!

:dncg:

so listen up.......

Tres

thanks..

+ Add a Comment