risk for diagnosis question

nurseprnRN, BSN, RN · Feb 18, 2014

Yes, you are off, but not by much. "Risk for..." diagnoses do not have related factors, they have risk factors. To make a "Risk for..." nursing diagnosis, you must have assessed the presence of one or more of the permitted risk factors in your NANDA-I 2012-2014* on page 417.

"Risk for infection" is defined as "at risk for being invaded by pathogenic organisms."

The risk factors are many, but include inadequate primary defenses, which term includes broken skin (including line placement and invasive procedures) and traumatized tissue.

(Inadequate secondary defenses include decreased hemoglobin, immunosuppression, inadequate vaccination, increased environmental exposure to pathogens, invasive procedures, and malnutrition. Circs don't quite rise to these, in my opinion. You are free to make a case for "invasive procedures," but I don't think circs are invasive in the way they intend.)

The way you would state this is, "Risk for infection secondary to traumatized tissue (circumcision)."

Good job.

*which you must have to make nursing diagnoses properly (and no, the "care plan handbooks" aren't good enough and rarely current)

christina731 · Feb 19, 2014

Yes you are off, but not by much. "Risk for..." diagnoses do not have related factors, they have risk factors. To make a "Risk for..." nursing diagnosis, you must have assessed the presence of one or more of the permitted risk factors in your NANDA-I 2012-2014* on page 417. "Risk for infection" is defined as "at risk for being invaded by pathogenic organisms." The risk factors are many, but include inadequate primary defenses, which term includes broken skin (including line placement and invasive procedures) and traumatized tissue. (Inadequate secondary defenses include decreased hemoglobin, immunosuppression, inadequate vaccination, increased environmental exposure to pathogens, invasive procedures, and malnutrition. Circs don't quite rise to these, in my opinion. You are free to make a case for "invasive procedures," but I don't think circs are invasive in the way they intend.) The way you would state this is, "Risk for infection secondary to traumatized tissue (circumcision)." Good job. *which you must have to make nursing diagnoses properly (and no, the "care plan handbooks" aren't good enough and rarely current)[/quote']
This is slightly off topic to the original post but since you're the NANDA guru around these parts, I figured I might as well ask...we are required to have the Nursing Diagnosis Handbook by Ackley and Ladwig in my program. Would you recommend this book or do you think it would be wise to splurge on the regular NANDA book? I'm in my 3rd of 4 semesters and I've never failed a care plan so I think it's doing the job but I still want to ask your opinion, oh mighty GrnTea :)
To the OP, risk for diagnoses have always been a pain in the rear for me so I tend to avoid them. That and my fundamentals instructor didn't allow them because "every patient is at risk for everything". Her words, not mine. I think I've done one ever so they're definitely not my favorite.

sosleepy · Feb 19, 2014

GrnTea

thank you for the reply and help!! Extremely appreciate it. :) risk for diagnosis are definitly not my strong spot.

I just purchased the NANDA-I and found it very helpful.

thanks again!!

nurseprnRN, BSN, RN · Feb 19, 2014

This is slightly off topic to the original post but since you're the NANDA guru around these parts, I figured I might as well ask...we are required to have the Nursing Diagnosis Handbook by Ackley and Ladwig in my program. Would you recommend this book or do you think it would be wise to splurge on the regular NANDA book? I'm in my 3rd of 4 semesters and I've never failed a care plan so I think it's doing the job but I still want to ask your opinion, oh mighty GrnTea :)
To the OP, risk for diagnoses have always been a pain in the rear for me so I tend to avoid them. That and my fundamentals instructor didn't allow them because "every patient is at risk for everything". Her words, not mine. I think I've done one ever so they're definitely not my favorite.

Just because "everybody is at risk for something/s" doesn't mean we aren't supposed to find out (assess) what it/they is/are, and develop a plan component for minimizing or eliminating the effect of the risk, does it? As I said, "Risk for..." diagnoses dominate the Safety domain (section) in the NANDA-I (and appear elsewhere as well), and I can't think that even the most rigid nursing instructor would argue that safety isn't pretty darned important.

Ahem. In answer to your question, christina731, if you are required to buy a book, you have to buy it, I guess. However, there is no prohibition whatsoever to supplementing your library with a work that will greatly enhance your practice and, more importantly at this point in your education, your understanding. The NANDA-I 2012-2014 is not much of a splurge; it's cheap as dirt compared to most every textbook I've ever seen. If your Ackley is "doing the job" because your faculty accepts the concept of nursing diagnosis as a consequence of a prerequisite medical one and expects your class to go that path, then it's understandable that you're getting good grades based on using it. But I stand by my assertion that developing a nursing plan of care based on nursing assessment requires educational materials that use that as its framework. Get the NANDA-I and see what I mean- $29 in hard cover, or $25 for your Kindle or iPad. At very least it will keep you on the straight and narrow choosing things out of Ackley.

christina731 · Feb 20, 2014

Just because "everybody is at risk for something/s" doesn't mean we aren't supposed to find out (assess) what it/they is/are, and develop a plan component for minimizing or eliminating the effect of the risk, does it? As I said, "Risk for..." diagnoses dominate the Safety domain (section) in the NANDA-I (and appear elsewhere as well), and I can't think that even the most rigid nursing instructor would argue that safety isn't pretty darned important.

Ahem. In answer to your question, christina731, if you are required to buy a book, you have to buy it, I guess. However, there is no prohibition whatsoever to supplementing your library with a work that will greatly enhance your practice and, more importantly at this point in your education, your understanding. The NANDA-I 2012-2014 is not much of a splurge; it's cheap as dirt compared to most every textbook I've ever seen. If your Ackley is "doing the job" because your faculty accepts the concept of nursing diagnosis as a consequence of a prerequisite medical one and expects your class to go that path, then it's understandable that you're getting good grades based on using it. But I stand by my assertion that developing a nursing plan of care based on nursing assessment requires educational materials that use that as its framework. Get the NANDA-I and see what I mean- $29 in hard cover, or $25 for your Kindle or iPad. At very least it will keep you on the straight and narrow choosing things out of Ackley.

I completely agree with you about the risk for diagnoses. I think that since I wasn't allowed to use them in fundamentals (the class I wrote the most care plans in) I tend to avoid them now. I really don't understand why she didn't allow it but that was the rule and I had to abide by it.

I think I will get the book that you recommend. It seems to be a very concise and inexpensive resource to use in addition to my required materials.