concept map? risk for ineffective breastfeeding r/t knowledge deficient

Nursing Students Student Assist

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new mother first baby

Ok, these have never been my strong suite all through nursing school. Im doing a concept map/care map and have some questions. The goals im going to try and use are

goal 1 the client will state 3 fears or concerns about breast feeding by discharge

interventions: the nurse will talk with client about fears and concerns rational listening to the clients concerns can help prioritize them

The nurse will teach client how to handle difficulties with baby not grasping nipple rational the infant must be relaxed correctly aligned and correct tongue and areolar placement

the nurse will collaborate lactation consultant with specific client fears rational refferals to resources can provide continued support and information

goal 2 The client will discuss 3 breast related problems that can happen from breast feeding by discharge

goal 3 The client will discuss 3 milk expression and/or storage techniques by discharge

this is what i have so far any suggestions on interventions or things to change and so on i would really appreciate it thanks

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There is no such nursing diagnosis as "Risk for ineffective breastfeeding." You can't just make these up. You must use an approved NANDA-I 2012-2014 nursing diagnosis, and you can find those only in the NANDA-I 2012-2014. $29 at Amazon, free 2-day delivery for students; also $24 (I think) for Kindle/iPad download. In it, I find three nursing diagnoses related to breastfeeding (p. 295-297). Making each of them requires you to have assessed at least one of the defining characteristics given as justification. You can't just choose one (or make one up) because it sounds good to you, any more than a physician can make a diagnosis of anemia without doing a CBC.

Check the definitions of "rational" and "rationale," "suit" and "suite," "deficient," and "deficiency," and use the proper ones next time.

Punctuation is your friend. Use it, too.

That should get you started.

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ok how about just ineffective breastfeeding r/t lack of knowledge

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There is no such nursing diagnosis as "Risk for ineffective breastfeeding." You can't just make these up. You must use an approved NANDA-I 2012-2014 nursing diagnosis, and you can find those only in the NANDA-I 2012-2014. $29 at Amazon, free 2-day delivery for students; also $24 (I think) for Kindle/iPad download. In it, I find three nursing diagnoses related to breastfeeding (p. 295-297). Making each of them requires you to have assessed at least one of the defining characteristics given as justification. You can't just choose one (or make one up) because it sounds good to you, any more than a physician can make a diagnosis of anemia without doing a CBC.

Check the definitions of "rational" and "rationale," "suit" and "suite," "deficient," and "deficiency," and use the proper ones next time.

Punctuation is your friend. Use it, too.

That should get you started.

My school has told us to use carpenito-moyet nursing diagnosis book that's the book I have.

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ok how about just ineffective breastfeeding r/t lack of knowledge

"Deficient knowledge" is a related (causative) factor for ineffective breastfeeding. However, you need to diagnose ineffective breastfeeding by assessing at least one of the 17 possible defining characteristics for the diagnosis. I am not seeing your patient assessment data to indicate that she does, in fact, have ineffective breastfeeding. Am I missing something in your assessment?

To make a nursing diagnosis, you must be able to demonstrate at least one "defining characteristic" and related (causative) factor. (Exceptions: "Risk for..." diagnoses do not have defining characteristics, they have risk factors.) Defining characteristics and related factors for all approved nursing diagnoses are found in the NANDA-I 2012-2014 (current edition). $29 paperback, $23 for your Kindle or iPad at Amazon, free 2-day delivery for students. NEVER make an error about this again---and, as a bonus, be able to defend appropriate use of medical diagnoses as related factors to your faculty. Won't they be surprised!

I know that many people (and even some faculty, who should know better) think that a "care plan handbook" will take the place of this book. However, all nursing diagnoses, to be valid, must come from NANDA-I. The care plan books use them, but because NANDA-I understandably doesn't want to give blanket reprint permission to everybody who writes a care plan handbook, the info in the handbooks is incomplete. We see the results here all the time from students who are not clear on what criteria make for a valid defining characteristic and what make for a valid cause.Yes, we have to know a lot about medical diagnoses and physiology, you betcha we do. But we also need to know about NURSING, which is not subservient or of lesser importance, and is what you are in school for.

If you do not have the NANDA-I 2012-2014, you are cheating yourself out of the best reference for this you could have. I don’t care if your faculty forgot to put it on the reading list. Get it now. When you get it out of the box, first put little sticky tabs on the sections:

1, health promotion (teaching, immunization....)

2, nutrition (ingestion, metabolism, hydration....)

3, elimination and exchange (this is where you'll find bowel, bladder, renal, pulmonary...)

4, activity and rest (sleep, activity/exercise, cardiovascular and pulmonary tolerance, self-care and neglect...)

5, perception and cognition (attention, orientation, cognition, communication...)

6, self-perception (hopelessness, loneliness, self-esteem, body image...)

7, role (family relationships, parenting, social interaction...)

8, sexuality (dysfunction, ineffective pattern, reproduction, childbearing process, maternal-fetal dyad...)

9, coping and stress (post-trauma responses, coping responses, anxiety, denial, grief, powerlessness, sorrow...)

10, life principles (hope, spiritual, decisional conflict, nonadherence...)

11, safety (this is where you'll find your wound stuff, shock, infection, tissue integrity, dry eye, positioning injury, SIDS, trauma, violence, self mutilization...)

12, comfort (physical, environmental, social...)

13, growth and development (disproportionate, delayed...)

Now, if you are ever again tempted to make a diagnosis first and cram facts into it second, at least go to the section where you think your diagnosis may lie and look at the table of contents at the beginning of it. Something look tempting? Look it up and see if the defining characteristics match your assessment findings. If so... there's a match. If not... keep looking. Eventually you will find it easier to do it the other way round, but this is as good a way as any to start getting familiar with THE reference for the professional nurse.

I hope this gives you a better idea of how to formulate a nursing diagnosis using the only real reference that works for this.

Now, we're going to look at where to go for outcomes and interventions. I think you can probably imagine what you might want to see for an outcome.

I'm going to recommend two more books to you that will save your bacon all the way through nursing school, starting now. The first is NANDA, NOC, and NIC Linkages: Nursing Diagnoses, Outcomes, and Interventions. This is a wonderful synopsis of major nursing interventions, suggested interventions, and optional interventions related to nursing diagnoses. For example, on pages 76-78 you will find "Breastfeeding, ineffective." You will find a host of potential outcomes, the possibility of achieving of which you can determine based on your personal assessment of this patient. Major, suggested, and optional interventions are listed, too; you get to choose which you think you can realistically do, and how you will evaluate how they work if you do choose them. It is important to realize that you cannot just copy all of them down; you have to pick the ones that apply to your individual patient. Also available at Amazon.

The 2nd book is Nursing Interventions Classification (NIC) is in its 6th edition, 2013, edited by Bulechek, Butcher, Dochterman, and Wagner. Mine came from Amazon. It gives a really good explanation of why the interventions are based on evidence, and every intervention is clearly defined and includes references if you would like to know (or if you need to give) the basis for the nursing (as opposed to medical) interventions you may prescribe. Another beauty of a reference. Don't think you have to think it all up yourself-- stand on the shoulders of giants.

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My school has told us to use carpenito-moyet nursing diagnosis book that's the book I have.

Look at the copyright date. If it's before 2012, it's not using the current NANDA-I diagnoses, and, as noted above, they don't give you the complete list of approved defining characteristics in most handbooks, either.

This is not idle carping; each issue is updated to reflect current evidence-based practice in nursing.

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perceived inadequate milk supply aeb " i don't feel like he is drinking enough he just goes to sleep"

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That's in there. See? If she says that, you have something to go on. What would your interventions or further assessments look like after she tells you that? Take a look at "readiness for enhanced breastfeeding," p. 297, too.

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my copy right date is 2010 which once again brings disappointment from my nursing school they are teaching out of all old books and telling us we have to buy this book and theres not even deficient knowledge in my book wasting my money... rant over sorry I'm trying to do the best i can with what i've got that deffining characteristic is in the edition that i have

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I hear you, and I do sympathize. We hear this here a lot.

However. There is no reason at all why you can't buy --and use and reference, and tell your classmates and faculty about-- a supplemental book. As it turns out the definitive one, the NANDA-I 2012-2014, is not expensive, and there's a Kindle/iPad version for people who want to us it that way (I'm a hard-copy kinda gal myself but I do have it on my iPad too). I mean, less than thirty bucks, and you're all set, at least until the new edition comes out late next year ( for 2015-2017).

I hear you about your school wants you to use XYZ text, too. I would like to be charitable about this and say that it's because they don't want students totally blowing smoke about this material while coming from a position of inexperience and lack of knowledge, so they make them read that book. However, I would not take the position that this means you are limited to your use of resources. Do a little prep work showing it around, getting people excited about it, and see if you can lift your peers to a new level. The results could be exciting. I mean it.

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Specializes in Reproductive & Public Health.

NANDA is crap. This whole nursing diagnosis thing is CRAP. You will use it in school, and then when you enter the real world, you will probably only ever see a "nursing" diagnosis on preprinted care plans.

Risk for ineffective breastfeeding is a perfectly acceptable problem outside of nclex-land. I understand the importance of developing care plans in nursing school because it helps to develop critical thinking and get you thinking in "nurse" mode, but limiting ourselves to crappy NANDA "diagnoses" (eyeroll) does a disservice to everyone except for NANDA's bottom line.

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I feel sorry that someone is so uninformed about the scientific basis for our profession, and has such a constricted view of the hard work of the nurses who make up NANDA-I (and any RN can join and make a difference). I can tell you that the legal world takes a much different view when it comes to defending nursing practice-- or identifying deficiencies in it. You just go right on making it up as you go along. Sure, go ahead.

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