Question about choosing interventions

[simply_viki]

Can I use interventions that address the etiology of the diagnosis, not just the diagnosis directly? For example: "Ineffective Breathing Pattern R/T Pain and Fatigue AEB RR 24, BP 145/89, pain (2), 'used to feeling tired, falling asleep everywhere', not slept since admission 6 hours ago"

I could probably improve the wording of my diagnosis, but I don't have the scenario handy to type out for critiquing. I just need to know if it's acceptable to address the pain and the fatigue in my interventions for this diagnosis (like ask the doctor for pain medications, sleep medications, etc). From memory, this is what I know:

"A 59-year-old female was admitted to the emergency room for a fracture related to a VMA. Vital signs are: Resp 24, Temp 98.8, Pulse 95, Blood Pressure 145/89. She reported pain of 8, received medication, and reported the pain brought down to a 2. The nurse noticed the patient was still awake at 1 AM after being admitted 6 hours ago, and asked the patient about it. The patient said that was common for her, saying she's "used to it, feeling tired, falling asleep everywhere". The patient works with heavy machinery at a shoe manufacturing plant, and admitted to drinking "Cuban coffee" to stay alert."

I'm probably making this too lengthy now, but anyway, my thinking is that the patient had the car accident because she is fatigued, and the constant coffee is why she is fatigued, but since her respiratory rate and blood pressure are high, that needs to be addressed first. I think that I can address all of that at once with that nursing diagnosis, though, since the pain is probably contributing to or causing the elevated vital signs, and fatigue happens to also be one of the defining factors of the diagnosis... I'm just wondering if it's correct to tie everything together like that. I'm just trying to come up with one priority diagnosis and some interventions so that I'll have something intelligent to say when we go over this scenario in class. How am I doing?

[Daytonite, BSN, RN]

yes, you can focus your interventions on the etiologies of a problem. be very sure that your outcomes reflect this because if you successfully manage to overcome this pain and fatigue, then the problem (inadequate ventilation) should disappear and the patient will no longer have any more breathing problems.