actual and potential problems:s?

  1. 0
    Have been given a case study. Need to list actual and potential problems and a rationale/statement for each. Am i doing this correctly. Is this right?
    Potenial problems i have so far.....
    * Liver cancer- Patient has underlying problems with the liver, has a fever and has become jaundiced. He is also experiencing chest pain.
    *Pulmunary embolism- Patient displays chest pain, blood in emesis, brathing difficulties(using accessory muscles) Coughing. .............

    ADLS'? the patient is a homeless man....

    Any help would be appreciated!

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  2. 9 Comments...

  3. 0
    When your assignment is asking for actual vs potential problems, are you talking about nursing dx? I am guessing yes, so I will answer with that assumption in mind...

    In that case, you need to find actual nursing dx vs risk for nursing dx. The examples you put are actually medical dx (i.e.pulmonary embolism, liver cancer) and that is outside the scope of nursing.

    Based on the info you provided, I'm not sure exactly what nursing dx would apply. So these are some educated guesses on my part An actual nursing dx based on the info you gave would be more like "Ineffective Breathing Pattern related to (r/t) chest pain (or pulmonary embolism if he has been dx with one) as evidenced by (aeb) coughing and use of accessory muscles.

    A "risk for" nursing dx might be "Risk for impaired skin integrity r/t pruritis (itching)." I'm guessing this one because itching is a common symptom of jaundice. Notice that there is not an 'aeb' part of this nursing dx. That is because it is only a risk, it has not happened yet, so you can't have observed anything that would support this as an actual dx. Now, if the pt was itching so much that he created a skin wound, then you would take away 'risk for' and add "aeb skin infection" or whatever happened.

    Hope that clears things up a little, feel free to post again if you have more questions...
  4. 0
    We had to do this with our case studies this semester (I'm a 1st-semester ADN-RN student) and our instructors wanted actual and potential MEDICAL diagnoses along with other problems that could crop up (e.g. opioid tolerance for a person w/ chronic pain secondary to RA).

    You should probably clarify what kinds of problems and diagnoses your particular instructor is looking for. If I'd done so earlier in the semester, I would have saved myself a lot of headaches!
  5. 0
    Coming up with a medical dx can be a good exercise in critical thinking, too...if that ends up being what your instructor wants, you might want to reconsider liver cancer, and look into hepatitis. If this pt is homeless, which of the hepatitis' might he be most at risk for?
  6. 0
    Thanks alot for all you help!
    @RNTutor - You were alot help.
    I am still a little confused about the actual/potential roblems.
    The patient has hypertension(he stopped taking his anti-hepertensive medication) And his current blodd pressure is 150/90.
    So is hypertension an actual problem?
    He as an enlarged liver(stated in the case study.
    So i i can list enlarged liver as an actual problem?

    Hepatitis- I looked the form up and all sighns symptoms are pretty much the same. I am unable to find the differences.
    I think hepatitis C as it tends to be common in the homeless and those who are dehydated and hv poor living conditions.

    Thank you woman king
  7. 0
    Quote from MissDilini
    I am still a little confused about the actual/potential roblems.
    The patient has hypertension(he stopped taking his anti-hepertensive medication) And his current blodd pressure is 150/90.
    So is hypertension an actual problem?
    If your instructor is looking for actual/potential MEDICAL dx, then I would say that yes, hypertension is an actual problem. I would say that potential problems would include possible complications from the actual problem. So in this pt, hypertension is most likely to effect the heart, brain, peripheral blood vessels, kidney, and eyes. So potential problems might include Myocardial Infarction, peripheral vascular disease, stroke, kidney damage, or retinal damage.

    Quote from MissDilini
    He as an enlarged liver(stated in the case study.
    So i i can list enlarged liver as an actual problem?

    Hepatitis- I looked the form up and all sighns symptoms are pretty much the same. I am unable to find the differences.
    I think hepatitis C as it tends to be common in the homeless and those who are dehydated and hv poor living conditions.
    Yes, I would say the enlarged liver is an actual problem then. Hepatitis A is the one that tends to be more prevelant in less than hygienic living situations. It's route of transmission is fecal-oral (yum!), so poor handwashing is a leading culprit. Hepatitis C, on the other hand, is blood transmission, so usually pt's get it from a previous blood transfusion or sharing needles.

    But you're right, many of the s/sx of the different Hepatitis' are the same. The primary difference between A and C is that A is acute (it will go away after a few weeks), but C is chronic.
  8. 0
    rntutor- thankyou! you helped me alot!
    i am just 3 months into my course so this is all very new to me.
    we have just been asked for assessment and nursing interventions.(communication,breathing and circulation,medications,wounds,spiritual and cultural lifestyle).

    it is also asking for documentation that is likely to be used in during the patients stay in the acute care hospital and a statement as to why.

    it is a health task for analyse health information and is worth 100% of the subject mark:s i have completed most of it but i am unsure about thse parts and what is expected of me.

    the patient needs anti hypertensive medication but he will not be able to afford them as he is homeless, he will not take them either, he needed assistance mobilising, eating and drinking, grooming.as a nursing student in a hospital who would i speak to about these issues?
    it is out of my scope of practice. to whose attention should i bring these issues to?
    it also asks for the significance of his blood test results(levels of haemoglobin,serum billirubin and thrombocyte count(80*10^9/l) how do i work this out?
    thankyou for your help! it means alot.
  9. 0
    If you are unsure what the assignment is asking for on some of the parts, definitely go in and ask your instructor. Especially since it sounds like it's a big part of your grade, you don't want to get a lower score just because you misunderstood the directions.

    Why will he not take the antihypertensives? Is it just the cost, or a personal belief? If it is the cost, then it might be appropriate to refer him to a social worker. If it's his personal belief...well, you can try to find out WHY he has that belief (is it cultural, does he distrust MDs, etc), and address that. In the end, though, you can't make him take a med, you can just document his refusal (if he refuses in the hospital too) and monitor for adverse outcomes of hypertension.

    As for the lab results, the best thing is to look up the normal ranges for each test result. Then, decide whether the pt's test is normal or abnormal. If it is abnormal, you can check your textbook to find out what that means depending if the value is too high or too low.
  10. 0
    OK I am noticing a pattern here -- you seem to post questions prior to making any real attempt at them. Hopefully you understand that by doing this you are not helping yourself. So here is what I suggest (which is what we al had to do at one time or another):

    If you have an assignment and you do not understand it -- discuss it with your instructor (or fellow students). This would mean that you must look over and attempt assignments well before they are due.

    If you are given a scenario/medical diagnosis, and need to know the implications and potential complications, grab your med-surg or pathophysiology book and read up on it. You seem to be loathe to do this and attempt to rely on what is already in your head.

    If you are given symptoms and need a medical diagnosis from them look the symptoms up in the index of your med-surg book or online.

    If you have attempted an assignment, and are stuck, post what you have so far and we can help you out. You don't seem to even attempt an answer and then say "I am only 3 months in" as your reasoning when someone asks what you have so far. In an ADN program 3 months is a lot.

    Please do not think I am beating you up. I guarantee that you have the ability to do these assignments. Perhaps you lack confidence. I would propose that you will gain confidence if you help yourself more.

    Of course you can keep posting and someone will answer eventually.
  11. 0
    excuse me is constipation a actual problem? and can you pls give me some more example of potential problems? Please RNtutor help me with this. I don't have any Idea yet.


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