this man has
a cardiac output problem so risk for decreased cardiac output
is a wrong diagnosis. a stroke (cva) is
a cardiovascular event. the man's stroke was a year ago and atrial fib is the usual culprit. it does cause dizziness and syncope.
but now, despite being on two blood pressure medications he still has a b/p of 143/90. he also is on coumadin and has an rbc count of 4.1, which is low, and platelets of 125,000, which are also low, and would suggest to me that there might be some bleeding going on that hasn't been found yet. blood loss anemia also causes dizziness and syncope. add to that that he is also getting lasix. maybe there was some dehydration going on as well, but we can't know since there are no electrolyte results. your scenario does not say that he was admitted this second time with another cva and i think that is important information that wasn't said
. it is very possible that he became dizzy because of an anemia secondary to bleeding and/or dehydration which is what led to this fall and him staying passed out until found by his friend. that is clearly decreased cardiac output
. either or both would have been due to complications as a result of treatment of his cardiac problems.
alteration of any of these factors will affect cardiac output:
- cardiac output
- [font=courier new] heart rate - beats per minute
- stroke volume - amount of blood pumped per beat (this includes anemia, dehydration)
please read the related factors for deficient knowledge carefully.
just because your care plan book says that "r/t emotional state affecting learning (anxiety and depression), which are in the h&p.
" doesn't mean that's exactly how you should write it. people have a knowledge deficit for cognitive (perception) reasons. they don't understand or don't have access to the learning. their emotional state can interfere with the intake and retaining of information, but if the patient has anxiety then they need to be diagnosed with anxiety. depression
is a medical diagnosis and cannot be used in a nursing diagnostic statement. and, you certainly can't indicate in your diagnosis that the information comes via "the h&p
". what you should have is a deficient knowledge (specify the topic) r/t learning affected by emotional state aeb [evidence].
include stuff about the patient's anxiety (ex: poor eye contact, statements that they get nervous about learning new things or learning makes them nervous) in your evidence.
. it's your grade.