Help with psychosocial diagnosis

[JustTrying2MakeIt19]

Hello all! First time poster here. I'm in my second semester and for each care plan we need one "physical" and one psychosocial nursing diagnosis. The problem is that I wasn't able to get a lot out of my patient. He has peripheral artery disease and was scheduled for surgery for a bypass on the affected leg. He had an above the knee amputation on the other leg within the last year. He told me he isn't nervous about surgery because he has been through it before, is coping "just fine" and has adapted well to using a prosthetic leg. He also said that he has lots of family support. I woudnt say that he was mean or angry but he definitely did not want to be bothered unless it was for his pain meds. The only thing I can think of is that he seemed disinterested in discussing his condition and like he was just giving me "good" answers to get me off his back, but that is just me making assumptions. I'm really stuck and I'd appreciate any advice or ideas you might have to point me in the right direction!

[amoLucia]

You clued in quite well in that he might be deliberately trying to avoid you for whatever reason (I suspect depression).

But for the physical diagnosis, what did your assessment reveal? You interviewed the pt, not us. We can help you, but you start first.

[OneWhisper]

Hello! Welcome to All Nurses!

As amoLucia said, what did your assessment reveal? What are your ideas for a physical diagnosis?

As for a psychosocial diagnosis, you said he has a prosthetic, how about something r/t body image.

[kaylee.]

Your hunch tells you there might be issues with his coping due to the way he talks about or fails to talk about his dx. Just because he says he is coping you feel as a nurse that something is off.

So in the nursing world if this were the situation, you would still consider this aspect, especially because he says he is fine but his behavior tells you a different story...

Therefore, in the nursing dx/academic world, it would be an astute choice to use ineffective coping as a dx and explore why.

Another one that is important is "readiness to learn". He has an amputation and is having a surgery on the other leg. The way he copes can greatly affect the outcome. If he doesnt mangage properly he could lose the other leg.

Understanding how to prevent a future amputation is key. Him not wanting to discuss implies a lack of readiness.

Dont get hung up on a nursing dx being right or wrong. It is this academic mentality by students and teachers can make the nursing dx care plan a completely useless learning exercise.

[OneWhisper]

Another one that is important is "readiness to learn". He has an amputation and is having a surgery on the other leg. The way he copes can greatly affect the outcome. If he doesnt mangage properly he could lose the other leg.

Understanding how to prevent a future amputation is key. Him not wanting to discuss implies a lack of readiness.

I would also say that it might point out to his lack of understanding the medical regimen or his determination to follow the medical regimen in order to keep his leg healthy and avoid amputation!