why do your patient's priorities
have to be dislocation, infection, venous thromboembolism, bleeding, or infection? where did those come from? they are complications of arthroplasty. potential complications are never
more important than the actual problems
the patient has. on a care plan (concept map) your priorities should be focused on the actual
evidence/data/symptoms that the patient has:
- pain is 9/10, in the knee, low back
- edema (where?)
- redness, warmth (where?)
- skipping meals (in the hospital?)
- hgb 7.4
- hct 21.4
- mpv 6.9
- co2 19
- gluc 118
priorities don't get turned into nursing diagnoses; data becomes the basis for the nursing diagnoses that you choose. your concept map will clearly show this. that's the beauty of concept maps.
every nursing diagnosis has a set of signs and symptoms (nanda calls them defining characteristics). a patient must have at least one or more of these defining characteristics before you can assign any nursing diagnosis to the patient. for example, a doctor would never assign a medical diagnosis of pneumonia to someone without having the evidence to back it up and support it. nursing diagnosing is no different.
so, for the nursing diagnosis of acute pain
you have the data of pain of 9/10 in the knee and low back
to support it.
ineffective tissue perfusion (specify)
is not normally used for patients who have had this procedure. ineffective tissue perfusion, peripheral
has to do with constricted capillaries (you gotta know and understand the pathophysiology behind the etiologies of these physiological based nursing diagnoses!) and that is not what is going on with this patient, is it? the cause of his edema is because of inflammation (pathophysiology of inflammation: http://allnurses.com/forums/f50/hist...ct-244836.html
) due to manual manipulation of the tissues by the surgeon and the healing process. you need to read the pathophysiology of tissue damage to understand this. their incisions and bone at the site of surgery, however, are at risk for infection
(skin infection, sepsis, osteomyelitis).
now, you just had a patient who had their whole hip joint replaced. how many cartwheels can he now do? none? well, can he run down the hall now? no, to that too? does he have a continuous passive motion machine connected to the operative limb? an abduction pillow? is he getting physical therapy? don't you think there's enough evidence (which you failed to list) for a diagnosis of impaired physical mobility
another student a week ago was working on a care plan for a patient who also had a hip arthroplasty. you might want to see that thread since i discussed the care planning with the student, including the diagnoses and interventions to use as well as weblinks to information about the surgery and nursing diagnosis webpages: