quick ND/STG question!

Nurses General Nursing

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Specializes in Trauma, Emergency.

Hey awesome nurses. Just wanted to ask since i'm having a little trouble with ND/STG stuff...okay my ND is "Pt at risk for activity intolerance r/t constant moderate-to-severe pain secondary to metastasized appendiceal CA." For STG (after MUCH hair pulling and nail biting) i've got "Pt will tolerate 15 minutes of mild-to-moderate activity as indicated by normal VS, SpO2 no lower than 93%, and pain level no greater than 4 by dd/mm/yy." how "off" am i on this STG? i swear this stuff sounds like greek to me sometimes...thanks for any feedback you've got time to give :nurse:

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Specializes in LTC, Nursing Management, WCC.

Your goal kinda implies that this is an actual nursing diagnosis. Can she/he not do an activity for more than 15 minutes a day d/t pain?? Also 15 minutes out of a whole day is not much.

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Specializes in LTC, Nursing Management, WCC.

Risk for Activity Intolerance r/t pain secondary to ...

Goal: Patient will maintain current level of activity as evidenced by normal heart rate, blood pressure and pain level of 4 or less during activity for the next three months. You could put... for the next 30 days, or next 2 weeks or whatever you think is warranted

If I would put Patient will maintain current level of activity as evidenced by normal heart rate, blood pressure and pain level of 4 or less during activity by MM/DD/YY. It implies that this is an actual nursing diagnosis and is that the patient is currently having problems with activity intolerance and you are hoping that it improves by MM/DD/YY.

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Is this patient already terminal??? Then goals should be comfort related, or related to skin integrity. How long are we looking at with metastasizing CA???

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Specializes in LTC, Nursing Management, WCC.
Is this patient already terminal??? Then goals should be comfort related, or related to skin integrity. How long are we looking at with metastasizing CA???

That's what I was kinda wondering. If they are terminal and they are declining, then it would be an actual. I would still say a terminal person could have an activity intolerance care plan, but the goal would be totally different.

I would totally go a different route and use an actual nursing diagnosis of Pain. But you could have multiple nursing diagnoses with pain as a r/t or an AEB.

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I would also probably use pain as the diagnosis. I don't think that risk for activity intolerance is a NANDA approved diagnosis. Some courses/instructors don't require for diagnoses to be NANDA approved, though. (I once wrote a careplan for risk for pain......goofy, huh?).

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Specializes in family practice.

You are defintely on the right track. Instead of risk for this would actually be the diagnosis. i.e activity intolerance due to pain AEB... also the 15minutes of activity might be several times instead of just once and i might put it down to 5mins instead of 15 cos those terminal pt (if she is) cant do much at a time

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Here are the steps of the nursing process and what you should be doing in each step when you are doing a written care plan:

  1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
  2. determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
  3. planning (write measurable goals/outcomes and nursing interventions)
  4. implementation (initiate the care plan)
  5. evaluation (determine if goals/outcomes have been met)

https://allnurses.com/help-care-plans-t204278/

I hope these help.....

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Specializes in Trauma, Emergency.
Is this patient already terminal??? Then goals should be comfort related, or related to skin integrity. How long are we looking at with metastasizing CA???

pt has a poor prognosis but doc says still has a small chance at survival. activity intolerance is problem because pt is severely constipated r/t opiate use to treat pain. ps takes colace BID and miralax daily and recently tried fleets enema with no success but going to try oil retention enema soon. main reason activity intolerance is so troublesome is reduced peristalsis. pt spends every moment that he is not using the restroom to void sitting indian style in bed hunched forward to alleviate CA pain and constipation discomfort.

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Specializes in Trauma, Emergency.
I would also probably use pain as the diagnosis. I don't think that risk for activity intolerance is a NANDA approved diagnosis. Some courses/instructors don't require for diagnoses to be NANDA approved, though. (I once wrote a careplan for risk for pain......goofy, huh?).

hah! no risk for pain isn't goofy!! i'm sure i've done WAY goofier (um, is that a word?). Risk for act. int. is on my NANDA list so i think it is approved...

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sounds like a good diagnostic statement not sure about the goal maybe it should be maintain current activity level or a specific goal related to self care/activity tolerance. such as patient will be able to perform all adls etc

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