Care Plan Help: Diverticulitis

[niicolex]

I had a pt w/ recurrent Diverticulitis who was on antibiotic therapy for a week now. She has been having 5-6 watery BMs. Her WBC is 17,500. A stool culture was obtained for potential C.diff (no results yet). She is on contact precautions. She is on Levaquin, Flagyl, prednisone, Invanz, and other drugs.

My nursing dx so far is:

Diarrhea R/T adverse effects of medications AEB 5-6 loose stools

Is that dx good? My assignment is to choose the #1 priority nursing dx, and I'm torn b/w that and deficient fluid volume r/t ? aeb low hct/hgb/diarrhea?

I also have to state all the data that supports that dx and so far I have:

-pt had 5-6 watery BMs

-Hgb 10.5 (normal 12-18)

-Hct 34.1 (normal 40-55%)

-Intake= , Output=

-On antibiotic therapy for a week now, has been on antibiotic therapy in the past

Is there any other data that I should include?

For expected outcomes, I have:

• Hgb and Hct will be WNL
  

• Pt will have a formed BM
  
• Pt's I&O will be balanced
  

For interventions, I have:

A. Keep pt hydrated

B.Monitor WBC

C.Obtain stool culture

Are there any other interventions you recommend?

Please help! Thank you

[Summer Days]

First off, diarrhea is a medical dx, not nursing dx. So deficient fluid volume is correct. Refer to your nanda book for examples of supporting evidence for deficient volume. Since this pt is female, you do have to take into account the age. Is she still having menses? If so when was her last menses? Hgb 10.5 is not uncommon for a female pt who is still menstruating. Check trend of hgb to help r/o active bleeding. You do have a priority problem with that WBC. Find in your nanda book a nursing diagnosis along with supporting evidence and interventions. Good luck.

[Scottishtape]

Agree with above.

Also, with that much diarrhea, another priority would definitely be Risk for altered skin integrity!

[AliNajaCat]

Diarrhea IS a nursing diagnosis (p. 220 in your NANDA-I 2015-2017).

Its defining characteristics re abdominal pain, bowel urgency, cramping, hyperactive bowel sounds, or loose liquid stools > 3/24 hours.

Its related factors include (among many others), "treatment regimen."

So, you have correctly made this nursing diagnosis: Diarrhea r/t antibiotic use AEB 5-6 loose stools per day.

You don't PICK or CHOOSE a nursing diagnosis, you MAAKE a nursing diagnosis based on data. The NANDA-I tells you what data constitute evidence for making a nursing diagnosis-- and there you are, beginning to think like a nurse and making nursing diagnoses so you can plan care to deliver or delegate. That is precisely why you're in school.