all nursing diagnoses stem from abnormal symptoms that the patient is having. the clue to the patient's symptoms in this exercise the instructor has given you is: uti (urinary tract infection). you need to exercise some critical thinking here. now, this is a medical diagnosis. however, each medical diagnosis also has symptoms. and, it is perfectly kosher for you to use and apply the symptoms that make up a medical condition to formulate your nursing diagnosis for the same patient. so, i went to family practice notebook, one of my favorite sites for getting quick, concise signs and symptoms of medical diseases, and came up with these signs and symptoms of a uti (http://www.fpnotebook.com/uro17.htm
- dysuria (painful, burning urination)
- urinary frequency
- urinary urgency
- suprapubic pain (after voiding)
- hematuria (blood in the urine)
the next order of business is to look these symptoms over and see if any of them can be grouped into one or more nursing diagnoses. sure enough, this is what i come up with (using official nanda nursing diagnoses which i verified in my copy of nursing diagnoses: definitions & classification 2005-2006
published by nanda international):
- impaired urinary elimination r/t urinary tract infection aeb dysuria, urgency and frequency
- risk for deficient fluid volume r/t loss of blood through the urinary tract
the remainder of my care plan will have outcomes, nursing interventions and rationales that address the problems of dysuria, urgency and frequency under the diagnosis of impaired urinary elimination. under the risk for deficient fluid volume my nursing outcomes, interventions and rationales will have to do with the hematuria. remember that any diagnoses beginning with the words "risk for" are anticipatory problems and don't really exist yet. so, they must be listed last.
i just want to point out to you that there is no nursing diagnosis of cystitis
in the nanda nursing diagnosis classification, so that would be an invalid nursing diagnosis to use. risk for urge urinary incontinence is a valid nanda nursing diagnosis, but the "related to" factors, or causes for it, include the effects of medications, detrusor muscle hyperreflexia or instability, involuntary sphincter relaxation, ineffective toileting habits or small bladder capacity. unfortunately, with the scanty information that was given in the scenario and the known symptoms of a uti, i would not jump to any of those conclusions just to use that diagnosis.