Does this nursing diagnosis sound right?

[luvnhim]

my patient has had below the knee amputation on her left leg due to diabetes and is obese. she says she is unable to bear weight on her right leg. i tried to see if she could & she said she wasn't able to but the cna's said she would do it for her daughters every now and then. a lift is used in order to transfer the patient to her shower chair or the chair she likes to sit in during the day. she also has limited rom.

nursing diagnosis:

impaired physical mobility related to left below the knee amputation secondary to diabetes mellitus as evidenced by limited range of motion, the inability to bear weight on her right leg, and the inability to move in her environment, including bed mobility and transfers.

does this nursing diagnosis sound right? i just need to know if i'm doing it right.

thanks in advance! :)

[Double-Helix, BSN, RN]

You've got most of it right. However, all parts of your diagnosis need to be inter-related. Your related to has to directly relate to the diagnosis. The AEB has to directly tie to the diagnosis and the related to.

Impaired physical mobility related to left below the knee amputation secondary to Diabetes Mellitus as evidenced by limited range of motion, the inability to bear weight on her right leg, and the inability to move in her environment, including bed mobility and transfers.

This is a good diagnosis for your patient.

Impaired physical mobility related to left below the knee amputation secondary to Diabetes Mellitus as evidenced by limited range of motion, the inability to bear weight on her right leg, and the inability to move in her environment, including bed mobility and transfers.

People don't need BTK amputations just because they have diabetes. Rather, the untreated or long-term diabetes can cause nerve damage and poor circulation in the extremities, leading to decreased sensations, poor perfision. greater risk for injury and infection, pain, etc. The reason that diabetic patients need amputations is because if limb injury or infection or painful nerve pain. So, more accurately, your diagnsis should state: Left below the knee amputation due to (limb injection or uncontrollable nerve pain) secondary to peripheral diabetic neuropathy.

Impaired physical mobility related to left below the knee amputation secondary to Diabetes Mellitus as evidenced by limited range of motion, the inability to bear weight on her right leg, and the inability to move in her environment, including bed mobility and transfers.

This is where you need to make sure that your evidence relates to both your diagnosis AND your related to. How does inability to bear weight on the RIGHT leg related to a LEFT amputation? You're absolutely right that her inability o bear the weight contributed to the impaired physical mobility, but since it doesn't go with the related to section, you need to add more to your related to. Consider adding muscle weakness secondary to prolonged sedentary lifestyle to your related to section.

Impaired physical mobility related to left below the knee amputation secondary to Diabetes Mellitus as evidenced by limited range of motion, the inability to bear weight on her right leg, and the inability to move in her environment, including bed mobility and transfers.

This isn't really specific enough. State specifically what she can't do. For example: inability to reposition self in bed without assistance, inability to move from laying to sitting or sitting to standing without assistance, Hoyer lift required for transfers, inability to dress self without assistance, inability to perform own hygiene care, inability to toilet self, etc.

Just remember to make sure all parts of your nursing diagnosis tie together. You did a good job coming up with all the pieces, now you just need to adjust your phrasing and add some specifics. I think you'll find that being specific in your evidence makes it easier to come up with appropriate interventios. Good luck on you're care plan.

[luvnhim]

Thank you so much, this was a huge help! :)

[honeykrown, MSN, NP]

I thought Diabetes Mellitus was a medical diagnosis. While in school we werent suppose to use medical diagnosis in the nursing diagnosis but if your teachers have never mentioned this to you then go ahead cos finding a replacement is usually ...

[nurseprnRN, BSN, RN]

it is perfectly acceptable to say she had her bka d/t diabetic peripheral vascular disease. that's a act. the nursing diagnosis is not the diabetes, it's there is that she has limited mobility related to (because she has) an amputation. i think you might also want to list some other reasons she has limited mobility.

as the above poster clearly explains, you want to be assessing (looking for) causes for her lack of mobility that relate to her just having one remaining leg-- might not be strong enough to support her, she might be deconditioned and weak, she might have heart disease and be short of breath, she might be fearful of falling, she might very well have diabetic neuropathy so she can't feel the floor well, balance might not be good, vision might not be good, she might be refusing pt for a number of reasons or not following their program for safe mobility; all of these would contribute to why she doesn't get around too well. nursing tries hard to see the big picture (holistic model), where medicine mostly just sees a medical diagnosis (disease model) and stops right there.