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Care Plan Help- Priority/Infection

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Cara_SN Cara_SN (New) New

Need help with a care plan for pediatrics. My pt was a 10 y/o 1 day-post for ethmoidectomy, initial dx cellulitis of the l.orbit with secondary sinusitis. The surgery was successful, swelling reduced by mid-day, normal vitals and no complaints of pain. I wrote up my care plan as #1 disturbed body image and #2 disturbed visual sensory perception.

My pts main complaint was that she did not want to get out of bed bc she was nervous about opening her eye and hurting it more. She asked for an eye-patch to help, but we could not provide it since we wanted to encourage the opening of the eye. And, of course, wanted it open to the air to help with the infection. My second thought was to put anxiety as #1 and disturbed visual sensory perception as #2.

My question is...my instructor said my #1 dx should be actual infection, but I can only find risk for infection. Should I keep my original care plan, should I change it to anxiety and disturbed sensory perception, or am I missing something??

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

"initial dx cellulitis of the l.orbit with secondary sinusitis" -- there's the infection. ;) It's the reason for her surgery, not merely a potential risk of surgery.

I'm confused about the disturbed body image too...I don't see evidence of that in your post

nursej22, MSN, RN

Specializes in med/surg,CV. Has 30 years experience.

I don't have a nursing diagnosis book in front of me, but as I recall "infection" is a medical, not a nursing diagnosis.

I rather like anxiety, and disturbed sensory perception.

I am surprised she has not pain, this makes me wince just reading about it.

She didn't want to get up out of bed and leave the room b/c of her eye, so I thought that diagnosis might have been the best fit for the scenerio.

My alternative to disturbed body image was anxiety í ½í¸Š, bc i was torn between the two. When I showed my instructor, she told me to put actual infection as #1. Ive looked through every book and thought the same as you mention...that its the medical diagnosis. I think I might just make it anxiety, bc the actual infection doesnt make sense to me.

My pt was beyond awesome! I didnt know what to expect at first, but she was probably one of my best out of every clinical experience. This kid was a trooper and her family was great!