Care plans: I have an ND, but I can't find interventions

  1. Care Plans: aren't they lovely?

    Ok, so for my Nutrition part, my ND is
    "Imbalanced nutrition: less than body requirements r/t decreased desire to eat secondary to altered level of consciousness as manifested by decreased serum albumin, pale conjuctivae and mucous membranes and reports of inadequate food intake (less than RDA)."

    In a nutshell, the patient is comatose and needs to be on a feeding tube....

    However, all interventions I come across are for patients that are conscious!
    HELP!!!! Any ideas or websites would be most appreciated as I need to get this assignment done this weekend.

    Why are care plans neccessary anyway? Why can't we just go in and nurse? It seems to me that care palns are more paper work and that means less time away from the bedside (which is where I want to be!)

    Thanking you in advance!
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  2. 7 Comments

  3. by   unknown99
    Do you have a care plan book? If so look under nutrition alteration: less than body requirements, due to inability to ingest foods.
    It should give you interventions. If not, then pm me, and I will pm some to you.
    An excellent care plan book that got me through school, and all 100% on my careplans:
    NURSING DIAGNOSIS REFERENCE MANUAL
    5th edition
    by Sheila M. Sparks and Cynthia M. Taylor
    published by Springhouse
  4. by   wonderbee
    Off the cuff:

    1. Insert NG or parenteral feeding tube as ordered by physician

    2. Monitor pump for rate and tube for patency

    3. Monitor labs for hyperglycemia (depending on the substance fed). Rationale is that hypertonic feeding solutions can cause hyperglycemia over time. Also monitor for electrolyte imbalances and albumin to see if pt. is responding to tx.

    4. Keep head of bed elevated at no less than 30 degrees at all times.
  5. by   orrnlori
    Quote from heather1999
    Care Plans: aren't they lovely?



    Why are care plans neccessary anyway? Why can't we just go in and nurse? It seems to me that care palns are more paper work and that means less time away from the bedside (which is where I want to be!)

    Thanking you in advance!
    They are only there to teach a way of thinking. Once you get out you will rarely if ever see one again. You'll do it in your head and in your head it won't be nearly as convoluted as what you wrote out there. It will just be. I too wish that care plans would be done away with in favor of a more realistic way of thinking. This is something that needs to be re-thought by the nursing educators that teach in the future.
  6. by   Audreyfay
    RD referral prn.
    The initial nursing diagnosis should not be used if the person is comatose. It's not that they don't have an appetite?
  7. by   Mithrah
    As a nurse it is important to assess for correct placement of the feeding tube.

    Weigh the patient daily (hopefully the patient is on a bed that can do this).
  8. by   J Lynn
    Try this website
    http://www.mosby.com/MERLIN/Gulanick

    I haven't tried it, but it was in my care plan book.
  9. by   rpbear
    The initial nursing diagnosis should not be used if the person is comatose. It's not that they don't have an appetite?
    I agree with this. They have an inability to eat, not a lack of appetite.

    Also, care plans are a part of nursing, you either do it in your head as someone else stated or you will have to write it out. I have to do care plans on each of my patients. I work L&D we write, update and change care plans throughout the shift, then the care plan goes to post pardom with the patient and they do the same thing.

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