nursing diagnosis help

  1. Hi. I'm a nursing student and I really need help with coming up with a nursing diagnosis for a pt with hypertension (that is the ony thing to base our diagnosis on so it can be anything). So far, I've found "at risk for altered tissue perfusion" and decreased cardiac output" but I am not sure how those diagnoses came to be and what interventions would go with them. Any help is appreciated. Thanks!
    •  
  2. 13 Comments

  3. by   HyperRNRachel
    NIC interventions related to decreased cardiac output and tissue perfusion
    include;
    circulatory care: arterial insufficiency
    cardiac care
    hemodynamic regulation

    reduce stress, plan appropriate activities, position the client for impoved vascular blood flow.
  4. by   gwenith
    check out this thread for websites linking to NANDA and other nursing diagnosis sites

    http://allnurses.com/forums/showthread.php?t=28203

    you state hypertension so

    Hint: When thinking of hypertension think of potential adverse outcomes i.e. renal failure, MI, stroke

    Think too of the factors that cause it - i.e. high salt in diet, stress, cholesterol intake, renal impairment etc etc

    One of the reasons why you are having trouble is that hypertension is a medical diagnosis - you have to focus on those things a nurse can do i.e. diet, stress reduction/management, medication compliance, education etc - I hope this helps.

    However you included "decreased cardiac output" so did you mean hyper or hypotension???
    Last edit by gwenith on Feb 26, '04
  5. by   ck1o28
    i mean hypertension but it said "decreased cardiac output" in a diagnosis handbook...
  6. by   francine79
    I hate coming up with nursing dx. You could try activity intolerance, knowledge deficient, ineffective therapeutic regimen management, anxiety, fear, noncompliance

    Try not to think to hard about them. That's what I do and I forget about all the simple ones.
  7. by   stsdoc
    Quote from ck1o28
    i mean hypertension but it said "decreased cardiac output" in a diagnosis handbook...
    Chronic Hypertension does cause decreased cardiac output. When you increase blood pressure, the left ventricle has to work much harder (against the elevated pressure) to pump blood into the aorta, thereby decreasing stroke volume and cardiac output.
  8. by   Anniekins
    I agree with what was said above......

    Don't forget the obvious....knowledge deficit is a big one!!!!!!!!!!!!!!! They can be educated on nutrition, physical activity, medications...etc!! The list goes on, and that is just as important as nursing dx, such as decreased cardiac output...and such.

    Hope it helps, and good luck w/ the Care Plan
  9. by   Mithrah
    I purchased a book called Nurse's 3 Minute Clinical Reference and it is wonderful. It lists medical problems, the patho, etiology, complications, assessments a nurse would do, treatment, nursing diagnosis, goals, patient teaching, discharge planning, and resources for the client.

    Nursing diagnosis for hypertension they list: ineffective tissue perfusion: cardiopulmonary, fatigue, ineffective coping, knowledge deficit, risk for noncompliance, and risk for injury.

    I recommend this book to every nursing student. It has helped me a lot, especially with care plans.
  10. by   wonderbee
    Has this individual been diagnosed for a long time and were meds prescribed? Has the patient stated that he/she has not taken the meds? If you ascertain without a doubt that the patient is noncompliant with the plan of care, innefective health management would be another one. I would stay away from the dx of noncompliance because it's pretty judgmental. Either way, an NIC would be to find out why the patient is noncompliant.
  11. by   ManEnough
    You can never go wrong with Knowledge Deficit. One of my favs is "Knowledge Deficit R/T sodium intake." Your interventions are teaching sodium's effects on BP and proper food choices.
  12. by   ck1o28
    thank you everyone!
  13. by   lightgreenwb13
    I'm a student too..so forgive me if I'm wrong:

    alteration in cardiac status, r/t hypertension, aeb uncontrolled bp > 140mm systolic and 90mm diastolic......
  14. by   MMARN
    Quote from Mithrah
    I purchased a book called Nurse's 3 Minute Clinical Reference and it is wonderful. It lists medical problems, the patho, etiology, complications, assessments a nurse would do, treatment, nursing diagnosis, goals, patient teaching, discharge planning, and resources for the client.

    Nursing diagnosis for hypertension they list: ineffective tissue perfusion: cardiopulmonary, fatigue, ineffective coping, knowledge deficit, risk for noncompliance, and risk for injury.

    I recommend this book to every nursing student. It has helped me a lot, especially with care plans.

    Is there a website that you could provide for this book?

close