Abdominal Pain

[rnez67]

Help! Please! I have been up all night working on this care plan and finally thought to ask for help here - duh.

I need 5 dx for a 3 yr old with abdominal pain -- vomit x1, diarrhea, NPO. Parents reported a fever at home of 103, but pt had been treated with acetaminophen since then and temperature remained normal. After I left the floor, stool culture came back positive for Salmonella. Having much difficulty with the r/t and AEB, of course. Here's what I have so far :

Acute Pain r/t abdominal cramping AEB guarding, cries, (?) positive Salmonella culture

Fluid Volume Deficit r/t NPO status AEB (?) vomiting, diarrhea, abdominal pain

Risk for vascular Trauma r/t (?) IV D5 1/2 NS + 20mEq KCL AEB (?)

Risk for Injury r/t (?) cognitive development of patient AEB (?)

? Need another one (or two)

Thank you so much!

[ms_sgr, BSN, NP]

I could only think of one. Dysfunctional gastrointestinal motility r/t ingestion of contaminates

[mrscoozy]

How about Fear...R/T hospitalization....most kids are scared to be in the hospital.

[Double-Helix, BSN, RN]

Anxiety/Fear

Risk for imbalanced nutrition (NPO, diarrhea, vomiting)

Nausea

Hyperthermia or risk for imbalanced body temperature.

Impaired communication (age/development of pt)

"Acute Pain r/t abdominal cramping AEB guarding, cries, (?) positive Salmonella culture" - Not AEB + salmonella culture.

"Fluid Volume Deficit r/t NPO status AEB (?) vomiting, diarrhea, abdominal pain" - The fluid volume deficiet is not related to the NPO status because the pt is receiving IV fluid. The fluid volume deficit would be related to the vomiting/diarrhea. But do you have evidence for fluid volume deficit? Dry mucous membranes, slow cap refill, thirst, poor skin turgor, etc? If you don't, then the patient doesn't have fluid volume deficit. The might have a risk for it though.

"Risk for vascular Trauma r/t (?) IV D5 1/2 NS + 20mEq KCL AEB (?)" - If it is a RISK diagnosis, you do not have an AEB section. You can't have AEB if the patient doesn't actually have the diagnosis, just a risk for it. Also, does the IV fluid alone give you a risk for vascular trauma? Look up the safe amount of KCl to give peripherally. However, the pt might be at risk for vascular trauma related to possible complications with the IV (phlebitis, infiltration, etc.)

"Risk for Injury r/t (?) cognitive development of patient AEB (?)" - Again, you don't need an AEB if it's a risk diagnosis. However, I'm not sold on this. How does the patient's cognitive development place him at risk for injury? You've got to be more specific with the r/t here, but I'm not sure this diagnosis works.

[rnez67]

Thank you all for the replies! Wish I had thought to ask earlier, as they would've been very useful in my care plan. They absolutely made sense, and I felt a little "duh" moment when I read them. How is it that I can provide care for these issues, but can't name them when it is time to do a care plan?!

Thank, Ashley, for the pointers. We were told to write 5 dx with r/t and AEB. No one has really addressed the AEB part before, we were simply told to include it. Just trying to give the instructors what they ask for. sigh.