Nursing Dx

  1. We came across a question today in class & everyone has a different opinion for the correct answer, so I thought I might get more opinions. Here goes:
    A client reports not feeling well & c/o having angina for several days. He states he has not taken a nitrate because is causes headaches. Which is the most appropriate diagnosis?

    a. Knowledge deficit r/t side effects of NTG.
    b. Knowledge deficit r/t need for nitrates
    c. Alteration in comfort: headache r/t side effects of vasodilator
    d. Noncompliance r/t side effects of NTG.

    Any help/opinions are greatly appreciated. TIA.:spin:
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  2. 6 Comments

  3. by   shock-me-sane
    my vote is for B
  4. by   leslie :-D
    i vote for noncompliance.
    if the client c/o having angina x sev'l days, i question any knowledge deficit in his dx.
    based on the data presented, it sounds like he's being noncompliant r/t the ha's he gets.
    one thing i learned in nsg school, is not to read into something that isn't there.

    leslie
  5. by   Daytonite
    A client reports not feeling well & c/o having angina for several days. He states he has not taken a nitrate because is causes headaches. Which is the most appropriate diagnosis?

    a. Knowledge deficit r/t side effects of NTG.
    b. Knowledge deficit r/t need for nitrates
    c. Alteration in comfort: headache r/t side effects of vasodilator
    d. Noncompliance r/t side effects of NTG.
    By assessment he has angina (chest pain). However, none of your answer choices really addresses the actual problem which is chest pain. The other problem you know from your assessment is that he won't take his nitrate because it causes a headache. We know that is an expected side effect of the medication, but does the patient? So, that narrows the answer choices to a choice between "A" and "D". There is a problem with the patient's knowledge of the side effects of the medication here. The stem of the questions doesn't indicate that the patient knows that the headache is an expected side effect of the medication which I believe makes a big difference between choosing noncompliance and knowledge deficit here. Knowledge Deficit has to do with a lack of cognitive information. My choice would be "A" because the stem of the question is indicating that he isn't taking the nitrate since it causes him headaches. I see Noncompliance as being a behavior choice that deliberately and with attitude goes against medical advice. Answer choice "C" is out of whack because it presumes the patient has a headache which, by the assessment information given, he does not--he has chest pain.
  6. by   Diary/Dairy
    My vote is also with A - seems to be unaware of potential side effects.
  7. by   jjjoy
    I'm thinking "D." The patient hasn't been taking his med (noncompliance) because of the headaches (side effect). The answer for D is more or less a translation of what the patient presented with, thus it would seem "most appropriate" at this point without any further information.

    I would think for the diagnosis of knowledge deficit, you'd need to assess his knowledge, which we don't have any info on. At this point, we're just speculating about what he might not know.

    Of course it's so difficult to get high scores on nursing tests!!! Even with time and resources and experience, there is disagreement over the correct answer. I tend to think that's why they write such vague questions... to make it more difficult to get high scores regardless of how well a student may know the material.
  8. by   LadyQT
    My choice is "D".... I chose that answer because, "He states he has not taken a nitrate because is causes headaches". Which is clearly noncompliance.

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