PalmHarborMom 4,589 Views
Joined Jun 18, '11.
Posts: 256 (40% Liked)
There are some nd that can be appropriate for most all patients. Ineffective healthcare maitenence/management, discharge care plans, and ineffective pain managrment. Also, because he has voided so little, look at care plans about fluid as well. In this patient there is a risk of spiritual distress as well.
One of the best things that you can do is to get yourself a nursing diagnosis book. You can also find loads of examples online of care plans. The concept is not easy, however, simply put a nursing diagnosis is how a nurse looks at specific problems with a patient that is something that a nurse can intervene on, and what is the goal? What can you do as a nurse to assist the full function of this patient?
Be sure that you are setting up the plans per the assignment requirements. It usually is problem/intervention/timelined.
I'll go ahead and try to quickly explain what an ND is. It is a tool for developing your critical thinking skills; identifying a patient's primary problems, the evidence supporting your assessment, and you will eventually be expected to identify appropriate interventions for the problem. Quick note of advice, always think your ABC's first, or use Maslow's hierarchy to help you prioritize.
Example: You have a patient with a COPD exacerbation.
Part 1: Ineffective airway clearance- This is your Nursing diagnosis. Not to be confused with a medical diagnosis. Simply put, you are stating the obvious problem but it is beyond your scope of practice to create a medical diagnosis of COPD. But there are many interventions you can do without an MD to help this patient, which we will get to later.
Part 2: Related to COPD- Insert medical diagnosis here. There are probably other variations that I don't remember, but I'm keeping it simple for now. This is where you identify the cause behind your nursing diagnosis.
Part 3: As evidenced by *dyspnea *increased secretion *increasing oxygen requirements etc. - This is where you list the symptoms, or evidence behind your nursing diagnosis. The list could go forever, but you generally list the most pertinent one, individualizing the diagnosis for your particular patient.
When you get to care plans you will be expected to list interventions for your patient. Including titrating oxygen per orders, delivering treatments, pulmonary toileting, keeping the head up 30 degrees. And again my list could go on. This is why you are in school. I have been a nurse for 3 years. I don't make care plans at work. But I can still create a nursing diagnosis off the top of my head because that model is how I learned to identify a problem and treat it within my scope of practice.
I would recommend finding a nursing diagnosis handbook. A quick search on amazon, there were several for $20 or less, if you specify your search for textbooks about 5 years old you can go pretty cheap, and I promise you they haven't changed much! I don't even remember what publisher I used, probably either Mosby or Pearson, but mine was an excellent guide not only for understanding what a nursing diagnosis is, but how to use them for developing care plans etc. It should provide comprehensive lists of accepted NANDA diagnoses and interventions. Unless nursing school has changed drastically in the past 3 years this a resource you will use throughout your schooling. It will save you so much time that you would otherwise spend on google or waiting for people to respond to your posts on AN!! I hope this helps and good luck with school!
Edit: So I thought that you could use a known medical diagnosis in your "related to" part, but apparently might be wrong. That is where using your appropriate textbooks/resources comes in handy
I was accepted!!!!
I too am not an oncology nurse, so I am unsure how the H/O NHL plays in to the clinical picture. Otherwise, given the CP, friction rub, and recent dental work, I'm thinking pericarditis.
I would be asking the patient if position changes change the quality/quantity of the pain. I would also want an EKG and a chest X-ray (yes, I know I will need a doc's order for those).
Definitely want to hear more!
My friends connected me to 'The Wooden Bowl'
The frail old man went to live with his son, daughter-in-law, and four-year old grandson. The old man's hands trembled, his eyesight was blurred, and his step faltered. The family ate together at the table.
But the elderly grandfather's shaky hands and failing sight made eating difficult. Peas rolled off his spoon onto the floor. When he grasped the glass, milk spilled on the tablecloth.
The son and daughter-in-law became irritated with the mess. 'We must do something about father,' said the son. 'I've had enough of his spilled milk, noisy eating, and food on the floor.'
So the husband and wife set a small table in the corner. There, Grandfather ate alone while the rest of the family enjoyed dinner.
Since Grandfather had broken a dish or two, his food was served in a wooden bowl!
When the family glanced in Grandfather's direction, sometime he had a tear in his eye as he sat alone. Still, the only words the couple had for him were sharp admonitions when he dropped a fork or spilled food.
The four-year-old watched it all in silence. One evening before supper, the father noticed his son playing with wood scraps and Elmer's glue on the floor. He asked the child sweetly, 'What are you making?'
Just as sweetly, the boy responded, 'Oh, I am making little bowls for you and Mama to eat your food in when I grow up.' The four-year-old smiled and went back to work.
The words so struck the parents so that they were speechless. Then tears started to stream down their cheeks. Though no word was spoken, both knew what must be done.
That evening the husband took Grandfather's hand and gently led him back to the family table. For the remainder of his days he ate every meal with the family. And for some reason, neither husband nor wife seemed to care any longer when a fork was dropped, milk spilled, or the tablecloth soiled.
PalmHarborMom-Thank you so much for your help. You're an awesome nurse:-). I'll let you know how it goes.
xmadmoizellex- I would contact the advisor's office and the admissions office to check on the status of your admission to USF. If you can, show up at the admissions office and see a transfer advisor. Unfortunately, the nursing advisor's will not meet with you until you are already accepted. (that's why you should see the transfer advisor first) My application took about 4 weeks to be approved because of a hang up with my military credits. However, it was resolved by me going to campus to talk to a transfer advisor.
Hopefully, you hear something soon! Good Luck!
I guess its a sign of the times that everything needs to be in XXXXL sizes now. Maybe if I think about it long enough, I can invent a new style bariatric binder and make my first million?!
One place you can't cut corners is the NANDA-I 2012-2014. You must use the current edition. Oh, they didn't put it on your bookstore list? Get it anyway, $29 and free two-day shipping for students at Amazon or $24 for your Kindle. It will save your butt in care planning and give you a head-start on your peers on learning to think like a nurse. You will thank me later.
When we're all together joking around, we speak in "nursing diagnosis". I have many for myself, but the one I use the most is impaired memory r/t excessive environmental disturbances (school) a.e.b. .........
Maybe he knows her well in that she will refuse anyone who walks in. Maybe the other nurses had their fill of this patient and decided that it was his turn to take her. You're making assumptions about this nurse accompanied by a lack of evidence.
The curtain issue is another matter entirely. However, what time of the day did that occur? Was the patient by the door or window? Did he leave the curtain undrawn every time he was with her? Sometimes people do not want to touch those curtains or have them brushing against them, and I don't blame them. They can be stool-ridden from never being washed and people drawing them with gloves on that they just used to change someone. They are disgusting to run into or have them rub against your hair and back.
Common sense is more important than IQ. If you've got a good head on your shoulders and a willingness to apply yourself, you'll be fine. Book smarts help, but if you can't think on your feet and apply it to real world situations, it doesn't matter how smart you are.
Well, I'm a guy, and only my wife sees me nekkid....
She TRIES not to giggle much......
I'd like to see a national movement towards replacing that "Allergy" on the questionnaire with "Adverse reaction," followed by a space to say what that is. So many people say they are "allergic" to substances that have only had common side effects. I know that lay folks (and apparently a fair number of nurses) don't know the difference between an unexpected/adverse reaction and an allergy, but asking them to describe the effects would allow those of us who do to know what's really going on.
There's a sharp uptick in brain growth and connectivity at about 15 months, coincident with the big incidence of vaccines. There is research looking at whether something goes wrong at that stage of development regardless of vaccines. Association is not causation, no matter how seductive.
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