Help Me PLEASE

  1. Hi...

    I need 2 nursing diagnoses for tomorrow.. My pts main problem is that he has a pleural effusion in the Rt. lung.. Very diminished breath sounds on that side... He only complains of SOB when he moves around alot.. Right now he is on 2l O2 Via Nasal Cannula.. He is also a Type II diabetic and has hypertension... He has two stents, and has had 3 Angioplastys.. He is 73..

    Any suggestions would be LOVED
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  2. 16 Comments

  3. by   fab4fan
    Don't you have a list of the approved nsg. dx.? I was tempted to jump in and give you two, but you really should think this through for yourself...not trying to be mean, but this is how you develop your critical thinking skills.

    Good luck...it won't be that hard.
  4. by   Ortho_RN
    Well I already have one... Impaired Breathing Pattern RT diminished chest/wall expansion amb pleural fussion on Rt. side...

    The teacher already ok that one... I am just stumpled.. I am not asking for you to do it for me.. Just need a lil "help"... Plus the books we have SUCK!!!!! Carpenito is absolutely the WORST Diagnosis book around...
  5. by   renerian
    I liked Claire Campbell much better. Try to think it through. Does he have cardiac problems with it? How about circulation problems? Does his bloodwork reveal anything? How is his appetite? What about his activity intolerance? Trying to nudge you?

    renerian
  6. by   fab4fan
    Well...think about the diabetes; what kinds of problems could arise from that.

    SOB with exertion...what kinds of problems could result?

    HTN: " "

    What is his educational level; what is his understanding of his diseases; what is his emotional state/coping...does he have a spouse?

    Hints...
  7. by   Ortho_RN
    Well one that obviously comes to me is a Activity Intolerance... He was a very active man, hunts all kind of stuff... And obviously the fluid in his lungs is affecting breathing, which of course affects tolerance.....

    What would you say to one on Pain... The only time he said he had pain was when he coughed or sneezed.. then he said it hurt like hell...

    And please remember this is the "beginning" of my 3rd semester and we are just now getting into major disease processes.. And thanks..
  8. by   fab4fan
    Look at the 4th suggestion I had re: education/coping/understanding of disease process...it's almost a giveaway!
  9. by   fab4fan
    Remeber, lots of us went to nsg school before the internet existed and answers were instantly at hand...you can do it!
  10. by   boggle
    "pleural effusion in the Rt. lung.. Very diminished breath sounds on that side... He only complains of SOB when he moves around alot.. Right now he is on 2l O2 Via Nasal Cannula.. He is also a Type II diabetic and has hypertension... He has two stents, and has had 3 Angioplastys.. He is 73.."

    I think you are closer to a whole bunch of Nsg. diagnoses than you think......

    You have mentioned he is SOB with activity.......
    -how does this impact his: mobility? selfcare? energy level? feeling of emotional well being?

    Diabetic and hypertensive? Surely he has education needs r/t these diagnoses...(hint, hint....tons of meds )


    Get thee quickly to a more student friendly NANDA text!!!! like Ackley or Wilkinson. Also, lots of med-surg texts now include Nsg diagnoses in NANDA format in each chapter.

    Best of luck to you, nurs2b:kiss
  11. by   Ortho_RN
    Thanks to you all... I always look for the harder things.. before I grab the obvious when it comes to diagnoses..
  12. by   Rustyhammer
    hehehe....You guys are too good!

    -Russell
  13. by   fab4fan
    When you hear hooves, think horses, not zebras.:spin:
    Last edit by fab4fan on Jan 15, '03
  14. by   researchrabbit
    Originally posted by fab4fan
    When you hear hooves, think horses, not zebras.:spin:
    Excellent advice!!!

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