Care plan

How would dysphagia cause decreased cardiac output? What links are you making?

Dysphasia (disordered speech/language) is not a common stand-alone admitting dx.

The previous poster mentions dysphagia (difficulty swallowing) - also not a common stand-alone admitting dx.

Can you clarify the patient's primary admitting diagnosis?

you are in 529d with l.s. elderly male with dysphagia, went for a peg tube, feedings are to start soon, might even be discharged tomorrow, please practice checking residual and admin flush, o2 nia n.c at 2, restraints (practice tying slip knot), meds: aspiring 81 mg gt, colace 100 g gt, lovenox 40 mg sq, folic acid 1 mg gt, metoprolol 12.5 mg gt, protonix 40 mg gt, altace 12.5 mg gt

the night before my professor emails us on the patient we will be taking care of. This is what she emailed and based on this we have to give her a cardiac nanda diagnosis and 3 interventions.

Grrr, it appears that your prof has forgotten the process of care planning in that the first step in ADPIE is assessment.

Nevertheless, what does your info tell you about the patient's cardiac status? Hints: fluid volume status, effects of meds.

As for interventions, well, there are some pretty standard ones for cardiac and fluid volume status, right?

you are in 529d with l.s. elderly male with dysphagia, went for a peg tube, feedings are to start soon, might even be discharged tomorrow, please practice checking residual and admin flush, o2 nia n.c at 2, restraints (practice tying slip knot), meds: aspiring 81 mg gt, colace 100 g gt, lovenox 40 mg sq, folic acid 1 mg gt, metoprolol 12.5 mg gt, protonix 40 mg gt, altace 12.5 mg gt

the night before my professor emails us on the patient we will be taking care of. This is what she emailed and based on this we have to give her a cardiac nanda diagnosis and 3 interventions.

Oh boy. Why in the world do they try to tell you what category of nursing dx to apply to a patient?

Sorry, that is weak info given the assignment.

Oh boy. Why in the world do they try to tell you what category of nursing dx to apply to a patient?

Sorry, that is weak info given the assignment.

So weird! When I first started nursing school we used to go the night before and research our pts and come up with "potential" nursing diagnoses - but mainly we did research and filled out basic info like labs and medical diagnoses and pt info. Then, after doing our assessments and caring for the pt on our clinical day we would come up with diagnoses. So weird to have you come up with diagnoses based on such little info. I guess coming up with just 1 might be possible but still - it defeats the whole purpose of assessment and learning to correlate those findings to the nursing diagnosis!

Since when do they go home on lovenox injections? Is this something new? Or a HH responsibility?

Decreased cardiac output related to increased peripheral vascular resistance secondary to hypertension ( based solely on the fact that patient is on BP med aka metoprolol)

Since when do they go home on lovenox injections? Is this something new? Or a HH responsibility?

I had a pt that was in the hospital getting heparin and he had been in there a while and the only thing keeping him there was the heparin he needed. The doctor wanted to put him on Lovenox and send him home, but the insurance company didn't approve it so he ended up having to stay.

I had a pt that was in the hospital getting heparin and he had been in there a while and the only thing keeping him there was the heparin he needed. The doctor wanted to put him on Lovenox and send him home, but the insurance company didn't approve it so he ended up having to stay.

Mind boggling!

Insurance won't pay for Lovenox, but they'll pay for an extended hospital stay, so he can get his... Lovenox. It drives me crazy that insurance won't pay for what's best for the patient AND their pockets if it doesn't fit into some exact criteria.

Mind boggling!

Insurance won't pay for Lovenox, but they'll pay for an extended hospital stay, so he can get his... Lovenox. It drives me crazy that insurance won't pay for what's best for the patient AND their pockets if it doesn't fit into some exact criteria.

HAHAHA!! I know! When the dr said he was going to discharge him if he could take the Lovenox, I thought for sure he'd be discharged. When the insurance denied it I couldn't believe it!!! I was like that is just the dumbest thing to me...you will pay for him to stay another week in the hospital, but won't pay for little old lovenox to get him home and cost less money?!! Insane!!!!

Did you figure out what your instructor was asking for? I'm curious!