Please help me :(

[rosemary_petals]

I have a patient that has a lot going on but I'm having a hard time trying to figure out which diagnosis is most priority.

She is 40 years old and just had her first baby (advanced for maternal age).

She lost her mother the week before she was admitted to the hospital for induction of labor.

She suffers from Anxiety. She smoked during pregnancy.

Her vital signs were stable up until the point where she received an epidural and her bp feel really low.

She was in some pain during the labor process, which is not uncommon.

She is also anemic.

I'm trying to find a diagnosis that kind of incorporates all of these or most of these finding but it's hard. If I chose one component out of all of these problems. I don't have a lot of supporting information that I can use for my care plan.

I hate nursing care plans so much! I've been doing so horrible thus far.

[Esme12, ASN, BSN, RN]

duplicate threads merged

[kjkkm]

"

You are having trouble figuring what diagnosis to use because you shouldn't be picking the diagnosis first then fitting the patient into that diagnosis. You should begin with your assessment...of the patient.

Care plans are ALL about the patient assessment. What the patient NEEDS not what YOU THINK she needs."

Esme, thank you for always being helpful & patient. I appreciate all the insight you take the time to share.

[dudette10, MSN, RN]

Um, not too much.

Risk for Complicated Grieving: Risk for a disorder that occurs after the death of the significant other, in which the experience of distress accompanying bereavement fails to follow normative expectations and manifests in

functional impairment (Domain 9: Coping/Stress Tolerance; Class 2: Coping Responses)

There is no such nursing diagnosis as " Risk for complicated grieving process," so you cannot make it. It doesn't appear in the current NANDA-I 2012-2014, which has the only approved nursing diagnoses. You cannot make this up. I'm not seeing anything in there that relate to a puerperal state. Look around in some of the other coping and fear-related ones to see if their defining characteristics and related factors allow you to make an accurate diagnosis.

Please, please get the book. It's inexpensive and will save you a lot of grief, since you will no longer have to flail around making things up because they sort of sound good to you.

I was looking through the table of contents for the book on Amazon, and I did see a diagnosis titled "risk for complicated grieving".

[OCRN3]

If you are doing priority, the psycho social doesn't need to be priority unless everything else is stable.

For my students I always have them choose what is most pertinent. You mentioned she was anemic? How low was the hemoglobin? Does she need a transfusion? Her BP was low? How low? That would also be a priority.

If those things are not that abnormal then I would go with the post Parton things, such as your BUBBLE HE assessment? Are those all normal??

If everything is still all normal then move on to psycho social things such as bonding, her hx of anxiety, her risk for depression sp loss of her mom,

Just my opinion on how I grade care plans.

[Esme12, ASN, BSN, RN]

I was looking through the table of contents for the book on Amazon, and I did see a diagnosis titled "risk for complicated grieving".

right it is there.....Majmaah University | Faculty Website I also have it in Ackley 2013 edition......however........ is this a priority? If so what actual observations did you see that make this a priority? Is she refusing to see the baby? does she appear distant not interested in seeing the baby? Once the baby is born the "risk" for complications for the baby due to advanced maternal age are really over....in a manner of speaking. What has the patient said to make you believe that this might be a priority problem?

[Esme12, ASN, BSN, RN]

What you wrote makes sense, alot of sense, but the requirments we have to meet is what makes it difficult to actually think like a real nurse. And instead of thinking what is my priority diagnosis, most of us end up going with what give us the most information to use to meet the requirements and make a thorough detailed careplan, that list many assessments, measurable outcomes, and interventions.

This is where you go wrong....

Whether the nursing diagnosis makes sense.

take a look at this thread from a new member who is also faculty......https://allnurses.com/nursing-student-assistance/abundant-rich-assessment-920083.html#post7885355

Also look at my sig line....I have a critical thinking sheet to help you collect Data from another member of AN Daytonite (rip)

[Episteme]

"And instead of thinking what is my priority diagnosis, most of us end up going with what give us the most information to use to meet the requirements and make a thorough detailed careplan, that list many assessments, measurable outcomes, and interventions."

Let me see if I understand this. You and your fellow students are deliberately trying to write convoluted nursing diagnoses so that one diagnosis is full of several concepts that will provide a range of goals, a long list of actions and so on and therefore provide the meat for an entire care plan?

Maybe I have this all wrong. BUT

A nursing diagnosis is a discrete statement of a singular problem that is formulated in a way that drives reasoning in the direction of resolution. The junkier it is the more you are defeating the purpose.

Are patients' problems often messy and overlapped? You bet. But you unwind/simplify/streamline them. You itemize the problems and give each one your time and thought (though in priority of most urgent to least.)

[nurseprnRN, BSN, RN]

There is a nursing diagnosis for "Risk for complicated grieving," which I mentioned in my post #26 (above) when quoting its exact definition in the NANDA-I 2012-2014.

However, what I said was

There is no such nursing diagnosis as " Risk for complicated grieving process,"

which is what you originally suggested as a diagnosis. There is still no such diagnosis.