Help with ineffective renal perfusion nanda

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Hello all,

I would appreciate any help with my nanda.

Patient had sepsis from ruptured appendix, did appendectomy, on bedrest NPO, has hx of stage 3 kidney disease, htn, dm 2. BUN is in 40's creat above 2. I want to do a nanda for ineffective renal perfusion r/t ?? but I'm just not sure what to put for the r/t. The patient's output is fine, no edema, cardiovascular and respiratory are fine, specific gravity is fine, protein is 1+, occult blood 1+, urine rbc 4, urine wbc 1. I'm not sure if I should write r/t anything about gfr since I don't have that info. I would appreciate any help, thank you!!

--danbi

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My favorite was r/t complex factors AEB "insert evidence here"

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Thank you. Would 'complex factors' be lab values as well?

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Complex factors is a term I used when there were multiple possibilities

your labs would be your evidence

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Doesn't NANDA I only have a risk for diagnosis for this? YOu have evidnece that the patient is at risk but so far have no real symptoms of renal failure.

Care plans are all about what the patient needs....what is your assessment?

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Thank you. Overall the patient seemed to be okay. Some of her labs were high like mentioned above. Urine output was fine. So I guess she is at risk for. For the patient goal would something about education be appropriate? Like patient will improve knowledge about her condition in order to maintain renal integrity. Or something like patient will demonstrate lifestyle changes to prevent complications. Then my interventions would be based on the patient's goal correct?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

If it is an at risk diagnosis that would be appropriate....what does your NANDA I say about this diagnosis.

But is there something that your patient might really NEED? What else about your assessment of this patient that might be important for you to think about while caring for this patient?

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1) There is no such thing as "a NANDA." Well, there is, but it's an organization and its proper name is NANDA-I. You have been asked to make a nursing diagnosis, the current list of which is to be found in the NANDA-I 2012-2014.

2)

Patient had sepsis from ruptured appendix, did appendectomy, on bedrest NPO, has hx of stage 3 kidney disease, htn, dm 2. BUN is in 40's creat above 2. I want to do a nanda for ineffective renal perfusion r/t ?? but I'm just not sure what to put for the r/t. The patient's output is fine, no edema, cardiovascular and respiratory are fine, specific gravity is fine, protein is 1+, occult blood 1+, urine rbc 4, urine wbc 1. I'm not sure if I should write r/t anything about gfr since I don't have that info.

All nursing diagnoses have-- must have-- defining characteristics and related/causative factors as defined by NANDA-I. (Exception: "Risk for.." diagnoses have risk factors.) This is nonnegotiable. You can't just make them up (this means, you cant just say, "related to complex factors" because you don't know what to say).

A nursing diagnosis statement translated into regular English goes something like this: "I think my patient has ____(nursing diagnosis)_____ . He has this because he has ___(related factor(s))__. I know this because I see/assessed/found in the chart (as evidenced by) __(defining characteristics) ________________. "

You must use the NANDA-I 2012-2014, the most current edition. 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. Sometimes they're out of date, too-- NANDA-I is reissued and updated q3 years, so if your "handbook" is before 2012, it may be using outdated diagnoses.

Since it's clear that you didn't have a copy of the NANDA-I 2012-2014 when you were doing this assignment, you're in luck: It's Friday, and with the free 2-day shipping Amazon gives students you can have it by Monday, and instantly if you have a Kindle or other electronic reader (I have a copy on an iPad). :) What are the defined risk factors for "risk for ineffective renal perfusion"? Hint: There is a list as long as your arm on page 238, and the answer you seek is right there.

And never let anyone tell you that "risk for" diagnoses aren't "real" or cannot be priorities. If you go to the section on Safety you'll see that almost all of them are "risk for" diagnoses, and what do nurses do if not promote safety as a priority?

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