Concept Map help

[ashleyc86]

Hi I was wondering if anyone had any ideas for my NCP and concept map. I'm in third semester PN theory and we were assigned case studies. I got,

Marvin Gardens is admitted for esophageal varicies. His serum bilirubin is 54 and his serum albumin is 29.

This was the only information provided. I got as far as my medical diagnosis which I'm thinking is the esophageal varicies, but I'm stuck at priority assessments. The nursing diagnoses aren't to hard I was thinking pt at risk for bleeding. With a possible intervention being admin beta blockers on time etc. I'm lost any help would be much appreciated.

Thanks,

Ashley

[Daytonite, BSN, RN]

you are going about this the wrong way. nursing diagnosis and interventions should not be done until your assessment of the patient's symptoms is well established. the foundation of every care plan is based on the assessment of the patient and in a case study like this it will be based on the signs and symptoms of the primary medical diagnosis. the first thing you need to do is look up everything you can find about esophageal varices. this is a life threatening problem. if the patient has been hospitalized they will be in the icu. read about it and what the medical/surgical treatment is going to be. the nursing care will be to assist in what the doctors are going to be doing as well as dealing with how the patient is going to be responding to this situation. most of these patients will have liver cirrhosis as a result of alcoholism, secondary to substance abuse or they may have liver cancer. there are other problems that cause cirrhosis, of course. as a nurse, and if this were a real patient and you were to walk into this patient's room, you would want to collect as much of this information as you could:

• a health history (review of systems)
  
• perform a physical exam
  
• assess their adls (at minimum: bathing, dressing, mobility, eating, toileting, and grooming)
  
• review the pathophysiology, signs and symptoms and complications of their medical condition (esophageal varices and how they got them)
  
  • http://www.merck.com/mmpe/sec02/ch010/ch010b.html - esophageal varices
    
  • http://www.fpnotebook.com/gi/esophagus/esphglvrcs.htm - esophageal varices, medical management
    
  • http://emedicine.medscape.com/article/175248-overview - esophageal varices
    

  [*]review the signs, symptoms and side effects of the medications/treatments that will be ordered or that the patient is taking

use that information to determine what your nursing problems are (the nursing diagnoses). then, decide on the nursing goals and interventions. that is how your concept map is meant to be used in putting this information together.