Care Plan...not quite Hospice

Nursing Students Student Assist

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I don't know how to do a care plan for someone who seemed to be in pretty bad shape. 80 yr old female who had been in CCU for 2 weeks (came in coherent and had been gardening and mobile days earlier) she was transferred to med/surg and the family was trying to decide on hospice care. I am not sure how to write a care plan for this pt.

She obviously had ineffective breathing (15/ml O2 with mask) tissue perfusion problems (gangrene on all fingers and toes) she was on antibiotics and morpheine with rectal acetominophen (but she had a colostomy) this was all very confusing to me.

I mostly just felt horrible for the family and am having a hard time trying to digest my experience today. Please be gentle , i am a first year student and trying to do my "homework". I almost feel disrespectful to my pt. but I learned a lot today, just have not really processed it yet.

thanks for any insight- i wanted to go with comfort dx but the NANDA list options don't seem right either. she was obviously in pain d/t the gangrene, therefore the morphine...etc. but i am not sure i want to focus on chronic vs acute pain. I wanted to write one along the idea of "comfort care" /end stage. I know I can't make those choices - i am just confused !

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Specializes in Telemetry/Med Surg.

How about something along the lines of:

Ineffective Coping

Caregiver Role Strain

Relocation Stress Syndrome (or risk for)

Anticipatory grieving

Powerlessness

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How about something along the lines of:

Ineffective Coping

Caregiver Role Strain

Relocation Stress Syndrome (or risk for)

Anticipatory grieving

Powerlessness

THanks ..funny how my instructor did not mention any of these..perhaps too advanced for first semester...probably not?

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Specializes in med/surg, telemetry, IV therapy, mgmt.

there are a couple of different types of nursing diagnoses. the ones that are easier to figure out are the physiological ones. these are the nursing diagnoses based on abnormal physical assessment things. those are the breathing and perfusion problems you mentioned. doing a physical exam will elicit these symptoms. another type of diagnosis are the ones pertaining to the patient getting their adls done. these are things like mobility, toileting, bathing, safety, etc. the last group is the psychosocial ones. these are the ones such as coping, self-esteem and learning needs that involve behavior. i find the psychosocial diagnoses difficult to use primarily because they are difficult to assess and develop interventions for.

here are some websites on end-of-life care that might give you some ideas on what areas to focus your assessment on:

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