First Care Plan. HELP!!!

[Dawn Vylet]

I'm having a hard time with my first care plan. I'm stuck on my psychological diagnosis.

Noncompliance of dietary regimen r/t obesity aeb a BMI >30 and reported undesirable eating habits

Is this even a good diagnosis?

Any help would be appreciated.

Thanks!!

[Daytonite, BSN, RN]

you want something that is psychosocial and you are leaning heavily toward the physiological.

i try to be very careful in using the word "noncompliance". the nanda diagnosis of noncompliance is defined as behavior of person and/or caregiver that fails to coincide with a health-promoting or therapeutic plan agreed upon by the person (and/or family and/or community) and healthcare professional. . .and there is more to the definition. but what is important in the definition is that the patient and the nurse agreed on a plan of care and the patient for some reason (which will become the related factor/s) doesn't follow it making it behavioral issues. also notice that the word behavior appears in the definition.

there is an alternative diagnosis to noncompliance and that is ineffective health maintenance. the nanda diagnosis of ineffective health maintenance is defined as the inability to identify, manage, and/or seek out help to maintain health. notice that the important word of note in this definition is help.

so, which on does you patient get classified to?

noncompliance of dietary regimen r/t obesity aeb a bmi >30 and reported undesirable eating habits

i don't have a problem with your wording of the diagnosis. however, obesity can't cause a person to be noncompliant with a dietary regime. noncompliance is a behavior and obesity is a physical condition. the person's brain/mind does that for them. the r/t part of the diagnostic statement always has to be the underlying cause of the problem (nursing diagnosis). if noncompliance is the problem here (dictionary definition of "noncompliance" - failure to comply; refusal to yield; obstinate) and it is a behavior, then the cause of this problem cannot obesity, which is the state of being fat. being fat causing a person to be obstinate makes no sense.

a bmi >30

is evidence of obesity. to be in this diagnostic statement it must be evidence of

noncompliance of dietary regimen. a bmi >30

is not evidence of

noncompliance of dietary regimen.

what are

reported undesirable eating habits

?

evidence that someone isn't being compliant of a dietary regime would be not following diet they said they were going to follow, gaining or not losing weight, not keeping scheduled checkups, not reaching set goals. these are all

behaviors

. and that is what gives you your psychosocial part to this care plan.

construction of 3-part diagnostic statements

• p (problem) - e (etiology, or cause of the problem) - s (symptoms of the problem)
  

[Dawn Vylet]

Thanks for the help.

I need to have a psychosocial diagnosis and I'm completely stuck.

My pt was admitted for a stomach blockage r/t a previous(12 yrs ago) gastric bypass surgery. Her BMI is over 30 and she admitted to eating candy bars. That's about all I have to go on.