Sigmoid Diverticulitis vs hypertensionRegister Today!
- by arenars Jan 25, '10I am a nursing student here in ga. We are todo a nursing care plan for a patient wew were assigned to. He is a 73 yr old male who recently was diagnosed with chronic sigmoid diverticulitis. He just had a laparoscopic sigmoid colectomy, and that was a sucess. But he also suffers from high blood pressure. My question is would my nursing diagnosis focus more on constipation or his high blood pressure since it is still a standing problem. I would appreciate the help, thanks?
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- Jan 25, '10 by Perpetual StudentHow high is his BP? Is it a new condition for him? If it's just a little elevated and it's an ongoing problem for him I'd focus on a NDx r/t why he's in the hospital. You might also consider NDs such as acute pain, risk for infection, etc.
- His bp was 145/90. It is a condition that he had had for a long time. The reason why i am more worried about it than the diverticulitis is because he has had a septal infarct before. he had an abnormal ecg, his hemoglobin was down, he also had a low 02 level, he is actually taking medication for hypertension and anemia, and is using a incentive spirometer.
- Jan 25, '10 by november17I'd probably focus on the diverticulitis.
Are you only allowed to make one nursing diagnosis or something? Why can't both be issues? If you're just doing this for a care plan then pretend the word hypertension doesn't exist for the purposes of the learning exercise. Obviously both are an issue, however the colectomy is more of the acute problem.
Your instructor is probably going to be looking for stuff having to do with the diverticulitis anyways, especially if he just had a colectomy. Guarantee you can fit the low O2, low HGB, the abnormal EKG, and even the elevated bloodpressure into the careplan in the post-surgical context of the colectomy (go read up on post-operative interventions and prevention of complications).
- We have to make three diagnosis, but we will only do a concept map on the highest nursing diagnosis. another reason i was placing the hypertension before the acute problem was that i thought hypertension went before his acute problem in maslow's hierachy of needs.
- Jan 25, '10 by gryphonlerHi there,
This is my 2cents worth. I'm not the best but I strive to be the best.
Look at his reason/s why he's in there for. I would say that you need to look at things on the whole rather than just one, as this will need some experience and skills. I believe you will get there. I would say that always keep a look out for his hypertension (HP), as he may have it as an ongoing condition (secondary to whatever condition it may be). Hmmm, does he have a stoma to begin with? Does he have a drainage? and much more.. As this questions are in a nurses mind once he comes out of Theatre. That's the reason I said, to see things on a wider aspect rather than just one. Assessment of patient is utmost important role for a nurse to do, especially from a start of a shift to the end of the shift.
It's a good question you have there, but we kinda needed a little more info. Remember this, no question is a silly question. It is important to ask. It will take experience to be able to tell a patient's condition by their medication/s, and their overall outlook.
So back to your question... If he is in pain, his HP will increase, if you feel that he'll be constipated, request for a laxative on the second day to help his bowels... that is if it is not contraindicated too. Observer whether does he have a drainage? Observe for internal bleeding from BP, and so on. Therefore, it is an overall view again. See the point?
Don't take everything on your plate for now, do things step by step, as you are still learning. Keep up your good work. You did a great job by asking too. Well done. Keep your head up, be on your toes when patients just came back from the Operation Theatre, and the list goes on.
I hope this help your question. Take care for now. ;P
- thank you gryphonler. and yeah you're right that it will take some time and skills to finally learn how to do it correctly. This is only my second care plan, so im trying hard to get the big picture like you said. Its just that the patient recovered well from his colectomy and was showing no signs of postoperative complications other than a bit of pain in the abdomen which he recieves anelgesics for. Anyways i appreciate the help!!!!
- Jan 25, '10 by gryphonlerNo worries dear, my pleasure.
I love to help anyone who seeks a higher learning to improve oneself. I too for one is forever learning until I die.
If you need any help, we all can do our best to help. I am looking into teaching new nurses too, that will not be too far ahead from me. lol. I guess may be next year. ;P
- The best of luck to you!!