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Discussion

Confused

I am preparing a care plan on hypothyroidism. I do have 5 nursing diagnosis;

1) Fatigue

2)constipation

3)imbalance nutrition:mtbr

4)risk for decreased cardiac output

5)deficient knowledge

however, i m not too sure about "risk for decreased cardiac output"

I choose it based on low HR

I also need to place them in priority order

i feel like puting Risk for decreased CO first since it is cardiac related and can help prevent myxedema but also i do know it is a "risk" . It is not yet a real problem.

Please HELP

Featured Replies

I'm also not sure about decreased CO, however, you might look into a risk for dysrhythmia...

  • Expert

the order of priority using maslow is:

  1. imbalanced nutrition: more than body requirements (physiological need for food)
  2. constipation (physiological need for elimination)
  3. fatigue (physiological need for rest)
  4. deficient knowledge, specify (self-actualization need for growth)
    • you must specify the knowledge (or teaching subject)

[*]risk for decreased cardiac output (potential physiological need for oxygen)

  • decreased cardiac output has to do with oxygenation and functioning of the heart. a low heart rate isn't enough to be diagnosed with a cardiac output problem. if there is low cardiac output then the heart isn't getting enough oxygen and the patient is getting chest pain and shortness of breath and i don't think that is what you think is going to happen here.

i cannot determine if these are the correct diagnoses for this patient because there is no supporting data listed with them. diagnosing is a logical problem solving activity. it requires the use of the nursing process when it is done correctly. to diagnose one must break down the information obtained from a patient's medical history, physical examination, and laboratory test results and reassemble it into a pattern that fits a well-defined group of symptoms that collectively describe a nursing diagnosis. if that is done properly, there is little question that the diagnosis is correct. every diagnosis has a definition and defining characteristics which you can check. a nursing diagnosis reference will have this information for each diagnosis. if you have your own copy of taber's cyclopedic medical dictionary you will find that information in the appendix.

  • Author

I know i didn't put enough information but your posts help me figure out what exactly i have to do to complete my care plan. the reason why i wanted to include risk for decreased cardiac output is because pt has low hgb and hct.

pt has hypothyroidism, weakness, anorexia, constipation,weight gain, cold intolerance

HR = 45bpm; low hgb level, low hct level, high cholesterol 240 mg/dl,

I came up with

1) imbalance nutrition MTBR

2) constipation

3) fatigue

4) deficient knowledge

5) risk for decreased cardiac output

I hope those diagnoses are right

  • Expert

With a heart rate of 45 and a low H&H I would say a decreased cardiac output is no longer a risk, but an actual problem. Heart rate and blood volume are both components of cardiac output. Is the B/P low?

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