Fifth Disease NANDAs

[tammy_zeidan09]

I am to write up three-five dx for fifth disease, otherwise known as erythema infectiosum.

Based on my research and readings, I know it is a mild virus and is generally not a threat to children unless he/she is immunocompromised such as those with sickle cell, cancer, HIV, etc...

So there isn't much I came up with, but let me know if anyone has any input:

Listed by priority:

1. Disturbed body image related to a mild rash illness caused by parvovirus B19 as evidenced by patient refusing to see visitors, admitting rash makes her feel "ugly", covering body when trying to assess rash, and not wanting to leave room.

2. Fear related the unkown of mild rash illness as evidenced by patient showing apprehension, expression of fear that her illness will not go away, increased alertness and worrying when assessing rash. (**I know, my R/T was weak!**)

3. Deficient knowledge related to the unfamiliarity of a rash illness caused by a virus as evidenced by patient and family admitting to not knowing of Fifth disease, worry and apprehension shown by patient and family that illness will worsen

I have thought maybe, perhaps, possiblyyyyy hyperthermia R/T illness AEB high fever (of course modified to sound better)

I seen fluid volume deficiet (Risk for); but was unsure how?

Fifth disease is mild, only causes cold like symptoms such as runny nose, mild fever, and headache. only lasts a couple days and dissappears. red rash appears on face that SHOULDN'T be itchy but may be mild.

Im not sure where fluid volume may alter?

[nurseprnRN, BSN, RN]

Your nursing diagnoses, defining characteristics, and and R/T must appear in the NANDA-I 2012-2014 to be valid. Since yours do, I mention this mostly to other people who are reading this.

Your #1 is perfect, hitting all points as given (p.291, for those following along at home)

Your #2 R/T is a little weak-- approved ones are innate origins, e.g., sudden noise, height, pain, loss of physical support (nope), neurotransmitter release (maaaaaybe), language barrier (?), learned response, e.g., conditioning or modeling from or identification with others (this might be your closest bet, if she's afraid she'll always look "bad"), a few others, and perhaps separation from support system (if it applies). Your defining characteristics are perfect, as defining characteristics for the diagnosis of "Fear" includes such things as reporting apprehension, being scared, tension, etc. You might want to look at the words you use to see if these are congruent, but I think you should be OK there.

Your #3, Deficient knowledge, isn't so bad, since it's defined as "absence or deficiency in cognitive info related to a specific topic," and it sounds like you have assessed that in your patient. It sounds like this is related to unfamiliarity or info misinterpretation (did she/family hear something from somewhere else? cultural influence? confusion c some other look-alike condition that is more serious, e.g., scarlet fever or measles?), which are approved R/T. Defining characteristics include exaggerated behaviors, inappropriate behaviors, or that the patient/family reports the problem, all of which seem to apply by your description.

If she has a fever, you could mention it, but it doesn't sound like that's going to be much of an issue. I'm not seeing any evidence of fluid volume problems unless you note decreased po intake, decr BP, and scanty concentrated urine, but not likely.

I think you've done just fine on this. Gold star for best-thought-out nursing diagnoses seen today, and probably this week.:) Now, what are your nursing interventions? :)

:flwrhrts:

[Esme12, ASN, BSN, RN]

Good job!

[tammy_zeidan09]

Thank you both!!

We were only required to post interventions for two of our nandas so i chose fear and hyperthermia (i added that)

my fear interventions:

•Assess source of fear with patient and family.

--Stay with patient when she is expressing fear and emotions.

•Provide verbal and nonverbal reassurance such as tough and hug if acceptable.

•Teach parents to use cognitive behavioral strategies such as positive coping statements like, “I am a brave/big girl.”

•Teach relaxation techniques such as deep breathing to induce calmness (Ackley & Ladwig, 2011).

hyperthermia:

--Measure and record patient temperature ċ oral or rectal temperature every 2 hours.

--Notify physician if temp is above 100.5° or per facility protocol.

--Using cold compresses over patient’s body may help to reduce body temperature.

--Preventing excessive covers such as heavy blankets may also help to prevent elevation of body temperature.

--Administer antipyretic, as ordered.

[nurseprnRN, BSN, RN]

Could you do me a personal favor -- and improve terminology in your class-- and stop calling nursing diagnoses "nandas"? The North American Nursing Diagnosis Association used to be called NANDA, but since going international they have dropped the "North American ..." and their name is NANDA-I.

A nursing diagnosis is not a nanda. As far as I know, there is no such thing as a nanda. :)