Need help with nursing diagnosis..

  1. Hey everyone. I need help figuring out 3 nursing diagnosis for my patient. She's a 69 yr old female with acute renal failure secondary to hypercalcemia. She had 3 out of the 4 parathyroids removed a few years ago which has contributed to her hypercalcemia. Nothing is physically wrong w/ her. What kind of nursing diagnosis can I write for her. Any help would be great! Thanks
  2. Visit CocoChanel profile page

    About CocoChanel

    Joined: May '06; Posts: 65; Likes: 17
    Specialty: Health Clinic, Ortho-Neuro


  3. by   DjMiG
    Hey CocoChanel,

    I was looking at your posting. Since your saying that there is nothing wrong per say with the client. Couldn't you use a "At risk for" diagnosis?

    Right off the bat I was thinking of:

    1) "At risk for" Disturbed Thought processes r/t elevated calcium levels that cause paranoia, decreased level of consciousness

    2) "At risk for" Imbalanced Nutrition: Less than body requirements r/t gastrointestinal manifestations of hypercalcemia (Nausea, anorexia, ileus)

    Not sure if these would help you. Thats a tough question. If anyone disagrees with these two, could you please correct me? I wasn't too certain with all the care plan diagnosis's.

    Good Luck!
  4. by   Daytonite
    you will find care plan help on these two threads:
    potential nursing diagnoses for acute renal failure and hypercalcemia are listed below. remember that you must have the supporting defining characteristics (symptoms) in order to validly use any of them. that will come from your clinical assessment of the patient and data collection from the patient's medical record. there are specific instructions and information on the process of how to go about choosing nursing diagnoses for patients on the "desperately need help with careplans" thread (link is above). if you have a care plan book it should have information on the process of how to choose a nursing diagnosis in the first chapter(s). your composition of every nursing diagnostic statement should follow the format of p-e-s (problem-etiology-symptoms) and each of these elements (problem, etiology and symptoms) must be related to each other. it would also be a good idea to review the pathophysiology and signs/symptoms of both medical conditions to reaffirm that you didn't inadvertently overlook one or more of these symptoms in your patient.

    here is a list of possible nursing diagnoses that may be applicable to this patient. i have also included some possible etiologies with some of the nursing diagnoses that may be present or fit with some of your patient's symptoms. you will have to determine that by reviewing and analyzing the assessment data that you collected. my signature now includes a link to a critical thinking flow sheet that you can print out to help you in developing your nursing diagnoses related to a specific medical disease.
    • decreased cardiac output r/t elevated potassium levels interfering with the conduction system of the heart secondary to acute renal failure
    • imbalanced nutrition: less than body requirements r/t nausea, vomiting, anorexia secondary to the hypercalcemia and acute renal failure
    • excess fluid volume r/t decreased urine output and sodium retention secondary to the acute renal failure
    • impaired urinary elimination r/t decreased urine output
    • impaired physical mobility r/t decreased muscle tone secondary to the hypercalcemia
    • acute pain r/t chemical imbalances [headaches due to cns symptoms of the acute renal failure and hypercalcemia; bone pain from calcium loss]
    • decreased thought processes r/t elevated calcium levels and azotemia (paranoia and decreased level of consciousness as a result of the hypercalcemia and acute renal failure)
    • risk for trauma r/t risk for skeletal fractures, bone changes, muscle weakness secondary to the hypercalcemia and electrolyte imbalances of the acute renal failure
    • risk for infection r/t alteration in immunity
    • risk for fluid volume deficit r/t anemia and platelet dysfunction
    • risk for acute confusion r/t metabolic abnormalities (azotemia, decreased hemoglobin, electrolyte imbalances, increased bun and creatinine, dehydration)