I had a pt who war 35 years old had one two year old daughter and gave birth to twins. She is breastfeeding them along with alternating bottle. they latch well and and are eating fine but I need a nursing diagnosis that involves breastfeeding I am kind of stumped can anyone help me. I know there is effective and ineffective but none seem to fit.
thanks for any help
Nov 8, '12
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How about.....effective breastfeeding.
Mother-infant dyad/family exhibits adequate proficiency and satisfaction with breastfeeding process
Adequate infant elimination patterns for age; appropriate infant weight pattern for age; eagerness of infant to nurse; effective mother-infant communication patterns; infant content after feeding; maternal verbalization of satisfaction with the breastfeeding process; mother able to position infant at breast to promote a successful latching-on response; regular suckling at the breast; regular swallowing at the breast; signs of oxytocin release; sustained suckling at the breast; sustained swallowing at the breast; symptoms of oxytocin release
Related Factors (r/t)
Basic breastfeeding knowledge; infant gestational age >34 weeks; maternal confidence; normal breast structure; normal infant oral structure; support source
Sometimes it's easy to over think.....
Nov 8, '12
My friend Esme has helpfully given you the answer. This is why and what to do about it next time .
You wouldn't think much of a doc who came into the exam room on your first visit ever and announced, "You've got leukemia. We'll start you on chemo. Now, let's draw some blood." Facts first, diagnosis second, plan of care next. This works for medical assessment and diagnosis and plan of care, and for nursing assessment, diagnosis, and plan of care. Don't say, "This is the patient's medical diagnosis and I need a nursing diagnosis," it doesn't work like that.
There is no magic list of medical diagnoses from which you can derive nursing diagnoses. There is no one from column A, one from column B list out there. Nursing diagnosis does NOT result from medical diagnosis, period. This is one of the most difficult concepts for some nursing students to incorporate into their understanding of what nursing is, which is why I strive to think of multiple ways to say it.
Yes, experienced nurses will use a patient's medical diagnosis to give them ideas about what to expect and assess for, but that's part of the nursing assessment, not a consequence of a medical assessment.
For example, if I admit a 55-year-old with diabetes and heart disease, I recall what I know about DM pathophysiology. I'm pretty sure I will probably see a constellation of nursing diagnoses related to these effects, and I will certainly assess for them-- ineffective tissue perfusion, activity intolerance, knowledge deficit, fear, altered role processes, and ineffective health management for starters. I might find readiness to improve health status, or ineffective coping, or risk for falls, too. These are all things you often see in diabetics who come in with complications. They are all things that NURSING treats independently of medicine, regardless of whether a medical plan of care includes measures to ameliorate the physiological cause of some of them. But I can't put them in any individual's plan for nursing care until *I* assess for the symptoms that indicate them, the defining characteristics of each.
If you do not have the NANDA-I 2012-2014, you are cheating yourself out of the best reference for this you could have. I don’t care if your faculty forgot to put it on the reading list. Get it now. Free 2-day shipping for students from Amazon. When you get it out of the box, first put little sticky tabs on the sections:
1, health promotion (teaching, immunization....)
2, nutrition (ingestion including breastfeeding, metabolism, hydration....)
3, elimination and exchange (this is where you'll find bowel, bladder, renal, pulmonary...)
4, activity and rest (sleep, activity/exercise, cardiovascular and pulmonary tolerance, self-care and neglect...)
5, perception and cognition (attention, orientation, cognition, communication...)
6, self-perception (hopelessness, loneliness, self-esteem, body image...)
7, role (family relationships, parenting, social interaction...)
8, sexuality (dysfunction, ineffective pattern, reproduction, childbearing process, maternal-fetal dyad...)
9, coping and stress (post-trauma responses, coping responses, anxiety, denial, grief, powerlessness, sorrow...)
10, life principles (hope, spiritual, decisional conflict, nonadherence...)
11, safety (this is where you'll find your wound stuff, shock, infection, tissue integrity, dry eye, positioning injury, SIDS, trauma, violence, self mutilization...)
12, comfort (physical, environmental, social...)
13, growth and development (disproportionate, delayed...)
Now, if you are ever again tempted to take a medical diagnosis first and cram facts into it second, at least go to the section where you think your diagnosis may lie and look at the table of contents at the beginning of it. Something look tempting? Look it up and see if the defining characteristics match your assessment findings. If so... there's a match. If not... keep looking. Eventually you will find it easier to do it the other way round, but this is as good a way as any to start getting familiar with THE reference for the professional nurse.
Nov 8, '12
A nursing diagnosis.....Did you or another nursing teach her on how to breastfeed twins? If you had to teach her something, there is a ND that talks about the mother "learning." If a pt is learning, they are addressing their ************* through our education. Make sense?
Nov 9, '12
GrnTea, thanks so much! I have NANDA on it's way. We are just starting in on nursing diagnosises and your post is a great help
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