HELP! My first concept map!

  1. Ok I am a first semester nursing student and I have my first concept map due tomorrow. The scenario is....
    A 55 yr old man came into the ER with syncope episodes and weakness. Patient lives at home alone. Patient had difficulty voiding in the last few days. After assessment the physician consulted urology.
    The patient has a medical background of HTN, BPH, chronic constipation, and DM.
    Patient is alert and oriented, breathing regular unflavored on room air, king sounds crackles throughout all loves. Normal sinus rhythm on monitor, pulses palpable, last BM yesterday, patient stated did not urinate but once yesterday and it was dark in color. Patient is unsteady.
    Labs in admission BUN 21, Cr 1.6, Na 135, K 3.8, Cl 100, Ca 8.5, Hct 28, Hgb 8
    VS: HR 100, BP 135/60, RR 18, Temp 98.7, POx 93% on room air
    Urology has completed a TURP. Patient urinary output at 1000 was 100mL with scant blood clots
    Meds: Flomax 0.4 mg daily, Lactulose 15mL daily, Lisinipril 40 mg daily, Metformin 500 mg

    My problem is the nursing diagnosis. I have came up with one, impaired urinary elimination, but can't find another. The diagnosis for my concept map is syncope/weakness. I really want to say one diagnosis is risk for injury but my teacher doesn't lol "risk for..." diagnosis so I can't use those. Someone please help me! Thanks in advance!
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  2. 8 Comments

  3. by   Lindsi1987
    Oh my....my phone wrongly auto corrected me....it is supposed to say "Patient is breathing regular UNLABORED on room air, LUNG sounds crackles throughout all LOBES" sorry about that...
  4. by   Sour Lemon
    Quote from Lindsi1987
    LUNG sounds crackles throughout all LOBES
    What could be causing that?
  5. by   Lindsi1987
    Possible fluid in the lungs. Maybe pneumonia...
  6. by   AngelKissed857
    Quote from Lindsi1987
    Possible fluid in the lungs. Maybe pneumonia...
    And what NURSING diagnosis would match up with that?
  7. by   amoLucia
    Not only pneumonia, but what else can cause lung fluid backup?

    Oh, this guy is so ripe full of nsg diagnoses!

    One clue - think nephrology before urology.
  8. by   nursej22
    What is his glucose? Hx dm, taking metformin...
    Fluid balance? Has he been NPO?
    Did he have a spinal for the TURP?
    Pain?
    Pulse ox is not the only determinate for adequate tissue perfusion, hint, hint
  9. by   dianah
    Moved to Nursing Student Assistance. Keep at it!
  10. by   GENJEN
    Just a thought, the Lisinipril may be contributing factor as well.

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