help c rationale

[studentnurse_02]

hi. i am having trouble finding a good rationale for my nur dx of peripheral neruvovascular dysfunction r/t disruption in circulation secondary to clotted dialysis graft. actually, i need a rationale for my interventions of assessing movement of extremity to detect signs of impared circulation regarding how circulation affects nerves. i have looked all over on the net. i didnt realize this would be so hard. thanks for the help!!!!

[ERNurse752, RN]

Hi,

You might try going to http://www.mosby.com and doing a search for nursing diagnosis, as well as some of the other key words in your nursing diagnosis. They have many reference books available that can be ordered online. Not sure if this will help, so good luck!

[nilepoc]

I second the mosby reference, I liberally applied their cards to the bulk of my care plans in school.

Always did well, though I probably stretched the limits of plagarism.

cheers.

[hoolahan, ASN, RN]

Do you think the diagnosis alteration in tissue perfusion would work better? A nursing diagnosis has 3 components PES= Problem, etiology, and symptoms. You can sometimes leave out the symptoms. Carpenito is the best resource for this that I have found. Sorry, gave my book to the nursing school though.

Alteration in tissue perfusion to R arm r/t occluded dialysis graft, as evidenced by loss of palpable thrill, loss of audible bruit, cool extremity, diminished pulses, delayed cappilary refill, and dimished sensation.

Or alteration in safety r/t occluded dialysis graft with associated diminished sensation.

Now, you need a ref for the relationship of nerves needing/being perfused by a blood supply. Well, all my books are upstairs, and I am too lazy to run up there tonight. I would suggest you look in your big ol med-surg text. Check for the nursing interventions after neurovascular and ortho surgeries. Part of the routine nursing care is to check for temp, movement, sensation, and perfusion, (as I am sure you already know), so maybe they will have a rationale already listed there. Why work so hard to re-invent the wheel? Get the Carpenito book, you can try for a used one from your school book store, or try Snoozys.com . I always got used books from them. Or try the hospital or school library.

That is a bugger though isn't it. We KNOW that nerves are nourished by a blood supply, but where to find the reference. How about your anatomy and phys book? Betcha there's even a cool little picture! Good luck!!