the heart problem is to be determined. if the doctors don't know what is going on, how can you? i would have no problem care planning for either acute pain
or risk for acute pain
. if using one of these diagnoses is a problem for you, discuss it with your instructors.
you determine diagnoses from the patient's symptoms. to diagnose the medical conditions the doctor would have picked up on all the patient's symptoms. the question is, did you? the way you double check yourself is to look up information about emphysema, particularly the signs and symptoms, and compare it with what you got with the physical assessment you did.
based on what you posted this patient has no known perfusion problem in the heart. if you look at the defining characteristics (symptoms) for decreased cardiac output
they just are not there. decreased cardiac output
is generally associated with congestive heart failure and this patient has not been diagnosed with that. you prove any diagnosis by showing that the patient has the symptoms of that diagnosis. that is why you assess a patient. during assessment you are always looking for what is abnormal about the assessment because what is abnormal is evidence of a problem
. do you have a care plan or nursing diagnosis book
? if not, here is the nursing diagnosis page for [color=#3366ff]ineffective tissue perfusion specify type: renal, cerebral, cardiopulmonary, gastrointestinal, peripheral
from nursing diagnosis handbook: a guide to planning care
, 7th edition, by betty j. ackley and gail b. ladwig and the one from nursing care plans: nursing diagnosis and intervention
, 6th edition, by meg gulanick and judith l. myers: http://www1.us.elsevierhealth.com/me...ex.cfm?plan=55
. each one lists the nanda taxonomy information including the defining characteristics (symptoms) for a cardiopulmonary perfusion problem. look at them and see if your patient doesn't have a lung perfusion problem. from the ackley/ladwig page you can get to other nursing diagnosis pages by clicking on the "diagnoses) links at the top right of the page. to view the other diagnoses on the gulanic/myers site click on "add new diagnosis" at the left side of the page.
you yourself said "my patient was admitted for unstable angina
, however they are addressing her lung issues
before sending her for a cardiac cath. the day i took care of her however, she had no chest pain
." obviously, the respiratory problems are a priority. other than chest pain you have no other cardiovascular symptoms listed. you did not list her blood pressure reading. blood pressure is classified as severe at 180/110 and the patient is not having any of these symptoms of severe hypertension: claudication in the legs, weakness, fatigue, shortness of breath, dizziness, headaches upon arising in the morning, visual disturbances. nosebleeds, lightheadedness when changing positions. there would also be risk factors: coronary artery disease, angina, heart failure or stroke, a history of smoking, family history of hypertension, atherosclerosis, heart disease, diabetes, cerebrovascular or kidney disease, patient is of african or asian descent. where is that information on this patient other than they have been having angina? i suspect a history of smoking because of the emphysema.