Hello, Hello, Hello

  1. I just found this website. Currently in my second semester of a two-year RN course studying OB & Peds. At the present time I am working on a Nursing Care Plan and having a little bit of difficulty coming up with some Nursing Diagnosis for a mother with no apparent problems. (It was a short labor, no problems, no discomfort or pain and it is her second child) In the books that we have to work with there just doesn't seem much to choose from for a diagnosis even if it is an "At risk for diagnosis". The instructor is only giving us two weeks to put this all together, any suggestions/directions would be greatly appreciated.

    I truly envy this mother - if it were me I could probably write my own book on nursing diagnosis and have trouble narrowing it down to two!!

    By the way I will be celebrating my Birthday next week!!
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  2. 3 Comments

  3. by   Tweety
    Good luck in school. Welcome to Allnurses. I hope you have a happy birthday.

    Sounds like a good delivery. Her diagnosises would probably be in the "at risk for........." or "knowledge deficit...........", etc.
  4. by   RB11909
    Welcome and happy birthday. Some possible diagnosis could be something like at risk for depression, trouble bonding, trouble related to birth of 2nd child....phsychological type problems. I know postpartum depression is also possible later on, I think. Oh well, sometimes the best ideas are the ones that happen right before the care plan or the paper is due...and you're scratching your head thinking....wow....that's really good!!!!!! Hope the best for you and don't stress too much in school. Trust me. This is life. Keep school as school.
  5. by   Daytonite
    hi, cccsn!

    before i help you out with this care plan problem you are having, let me point out to you that we have a number of nursing student forums that you should definitely become a frequent visitor to. (here's a listing of them: http://allnurses.com/forums/f196/) there are "sticky" threads (they always appear at the very top of the thread listings) that have good information and helpful weblinks for students within them. for care planning, nursing process and physical assessment which are all crucial to care planning check out these three threads:
    now, to get to your dilemma. . .no newly delivered mother has no problems, believe me. all nursing diagnoses are grounded in your assessment data of the patient and a knowledge of what has occurred. i'm assuming this lady had a vaginal delivery. and, although it seems as though there were no complications, there is a lot that has happened to her body. tissues that you can't see have been traumatized. other tissues are in the process of returning to normal functioning. lochia has to be monitored. there will be afterpains due to the contraction of uterine muscles during labor. the perineal area must be monitored for edema and bruising. was there an episiotomy? if so, you have reason for a diagnosis of impaired tissue integrity. blood needs to be monitored for blood loss. she needs to be monitored for hypotension due to the possibility of continued engorgement of the abdominal blood vessels with blood, even after delivery. temperature needs monitoring as a possible sign of post op infection or dehydration. and, what about the breasts and breastfeeding? nipples can become cracked, reddened and painful. the bladder often becomes the target of problems due to postpartum swelling of local tissues and when the fundus is not reducing as fast as it should. there can be bladder distension and development of utis. hemorrhoids are a complication of the pushing of labor. women are just overall tired and fatigued after labor. some worry about stretch lines. postpartum risks include hemorrhage and infections. even though a mother has previous children and new one added to the family creates a new stressor and bonding situation for all members.

    potential nursing diagnoses include:
    • impaired tissue integrity
    • impaired urinary elimination
    • urinary retention
    • acute pain [due to hemorrhoids, abdominal muscle spasming]
    • effective breastfeeding [this is a wellness diagnosis]
    • deficient fluid volume
    • fatigue
    • sleep pattern disturbance
    • knowledge deficit regarding self care needs, recuperation, possible complications, and infant care
    • disturbed body image
    • readiness for enhanced family coping: potential for growth
    • risk for infection
    • risk for deficient fluid volume
    • risk for fatigue
    • risk for ineffective role performance
    you need to go through your assessment of this patient very thoroughly. there will be abnormal things there to use for a care plan. some of them are being elusive to you because they are so subtle. i've tried to list many of them, so look above. if you are still having trouble, feel free to ask for more help. you will get more response to your care plan questions if you post on either the nursing student assistance forum or the general nursing student discussion forum

    good luck! see you on the student forums. and, welcome to allnurses!

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