Desperately Need Help With Care Plans

Nursing Students Student Assist Nursing Q/A

Any help with care plans will be appreciated?

I could use some help- for some reason I'm having trouble with outcome criteria. My patient's medical dx was hypercalcemia d/t hyperparathyroidism. My nursing dx is Acute confusion rt electrolyte imbalance and dehydration aeb increased calcium level and hypovolemia.

These are my outcomes:

pt will demonstrate restoration of cognitive status to baseline

pt will obtain adequate amount of sleep

pt will maintain optimal hydration and nutrition

I don;t think this looks very good, and I can;t even come up with a short term goal to go along with it.:trout: I really didn;t do well on my last care plan due to this, so I'd like to at least make some progress. Can anyone give me some hints? Please?

DX prioritization....Desperately need help with careplans

HELP!

I have a pt admitted for interstitial pneumonia, and has anemia- low H&H and metastatic cancer of unknown origin, he has low prealbumin, protein malnutrition, hyponatremia, crackles in RLL, inspiratory wheezes in RUL, LUL, and LLL. He is on 12L O2 NC and has a O2 sat of 90-93%.

I have some nursing dx's thought of but not sure about the r/t part and which ones to use and in which order I need 3.

impaired gas exchange - What is the r/t part that I should include ?

Ineffective airway clearance- What is the r/t?

imbalanced nutrition less than body requirements- What is the r/t part? the man has a normal bmi but has protein malnutrition!

deficient knowledge r/t ? aeb pt asking why he is on steroids,

activity intolerance r/t ?

Chronic pain is r/t chronic disease process okay? he has met Ca in his bones- high WBC, low RBC, low H&H barely low Na+, and slightly high glucose- non fasting.

Can I use infection as a nursing dx or only risk for infection?

Any help would be greatly appreciated!

Specializes in med/surg, telemetry, IV therapy, mgmt.
HM3 S. Collins, SPN said:

HELP!

I have a pt admitted for interstitial pneumonia, and has anemia- low H&H and metastatic cancer of unknown origin, he has low prealbumin, protein malnutrition, hyponatremia, crackles in RLL, inspiratory wheezes in RUL, LUL, and LLL. He is on 12L O2 NC and has a O2 sat of 90-93%.

I have some nursing dx's thought of but not sure about the r/t part and which ones to use and in which order I need 3.

impaired gas exchange - What is the r/t part that I should include ?

Ineffective airway clearance- What is the r/t?

imbalanced nutrition less than body requirements- What is the r/t part? the man has a normal bmi but has protein malnutrition!

deficient knowledge r/t ? aeb pt asking why he is on steroids,

activity intolerance r/t ?

Chronic pain is r/t chronic disease process okay? he has met Ca in his bones- high WBC, low RBC, low H&H barely low Na+, and slightly high glucose- non fasting.

Can I use infection as a nursing dx or only risk for infection?

Any help would be greatly appreciated!

I gave you an extensive answer to your questions and put it into it's own thread. You can view the answer here:

I am a working mom who is going to school to become lpn, I need some case study for neuro, gu, endocrine....I am busy and I don't have time to research, if someone has and wants to share I will appreciate, thank you

anyone here has or have NCP's for pneumonia...? thankz!!!

Specializes in Med/Surg, Tele, IM, OB/GYN, neuro, GI.
homieboi said:
anyone here has or have NCP's for pneumonia...? thankz!!!

You wouldn't be able to use one if someone did because you have to format the careplan for your patient. If you don't hve a care plan book I recommend getting one because it'll make writing them out much easier.

I was asked to do NCP's for pneumonia even without a patient. So any NCP's for pneumonia will do. Thankz in advance.

Specializes in Med/Surg, Tele, IM, OB/GYN, neuro, GI.
homieboi said:
i was asked to do NCP's for pneumonia even without a patient. So any NCP's for pneumonia will do. Thankz in advance.

OH. I don't have one but if you have or can get your hands on a care plan book there should be some in there.

Thankz Tampagirl... but if somebody has or have NCP's of Pneumonia can u post it here.. thankz...

Specializes in Emergency Room.

When doing your care plans, always the priority one's should be addressing the pt's. physiological needs, then address their psychosoical needs (EX. knowledge defecit, anxiety, and so on).

Also when doing your outcomes, always make sure they are measurable.

-Pt. will maintain adequate oxygention throughout shift as evidence by: skin warm and pink, Oxygen saturation > 90%, PaO2 between 80-100, no shortness of breath, no cyanosis, etc.........

Hope this helps, I know when I was just starting nursing school, care plans were an entire new language. Feel free to message me if you have any further questions.

Specializes in Emergency Room.
hm3 s. collins, spn said:

I have a pt admitted for interstitial pneumonia, and has anemia- low h&h and metastatic cancer of unknown origin, he has low prealbumin, protein malnutrition, hyponatremia, crackles in rll, inspiratory wheezes in rul, lul, and lll. He is on 12l o2 nc and has a o2 sat of 90-93%.

I have some nursing dx's thought of but not sure about the r/t part and which ones to use and in which order I need 3.

Impaired gas exchange - what is the r/t part that I should include ?

Ineffective airway clearance- what is the r/t?

Imbalanced nutrition less than body requirements- what is the r/t part? The man has a normal bmi but has protein malnutrition!

Deficient knowledge r/t ? Aeb pt asking why he is on steroids,

Activity intolerance r/t ?

Chronic pain is r/t chronic disease process okay? He has met ca in his bones- high wbc, low rbc, low h&h barely low na+, and slightly high glucose- non fasting.

Can I use infection as a nursing dx or only risk for infection?

Any help would be greatly appreciated!

Okay, don't get too stressed here! This is an easy one. If you learn anything from nursing school, please let it be airway breathing circulation!!!!!! I can't emphasize that enough. This applies to everything you do, assessment, care plans, prioritizing care, prioritizing which pt. To see first, test questions, and even your interventions.

You're on the right track, you just have to trust your intuition here. By what you have here I would go in this direction.....

#1 ineffective airway clearance (remember airway!:nmbrn:) r/t unable to remove secrections effectively

#2 impaired gas exchange r/t the secretitions

#3 imblanced nutrition: less than body requirements

#4 what about an infection diagnosis? The pt. Does have an elevated wbc, what about his temp? Was it high as well??? Go with the infection diagnosis here.

#5 chronic pain r/t disease processes

I also noticed that your pt. Is on 12 liters of o2 per nasal canula. That is way too much. It sounds like to me that he needs to be on a non-rebreather mask. His sat's should be much higher than that, with that much oxygen. You really have to be careful with administering oxygen, you can cause oxygen intoxication in some pts., especially ones with copd. What about his abg's, did he have any? That will tell you if this pt. Is compensating for his defecit. Also, a slightly high fasting glucose is normal in someone that has an infection. It is the body's natural way to react to an insult.

I hope this helps, if you have any other questions please feel free to message me. I try to answer messages as soon as I can. Stay with it, it will come to you, just takes some practice.

I have a patient a 63 years old woman conscious, coherent, cold and clammy, with a temperature of 95 deg.F. She had a foley catheter in place with concentrated urine of 25cc per hour, and an IV of 5% dextrose in water. Her lips were cracked and her skin was dry and scaling. She has a pneumonia and she had already been in the hospital for 9 days. She also refused to eat for the past 2 days and had not a bowel movement for 5 days. Can somebody help me to make a Nursing Care Plan for this problem? I'm really having a hard time to make a NCP for this one. Thanks.

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