FUO, PLEASE HELP

[Connie1109]

Hello All,

I need help with a nursing diagnosis for my patient. He is a 22 month old boy with thrush who came in the hospital for fever of unknown origin. He had fever off and on since August which his mother was treating at home but brought him in when his fever would not go down. He recently had his tonsils taken out, as well as tubes put in. When I had him as a patient he was still waiting for tests results in regards to his FUO. If you can help that would be great, thank you in advance.

[tarheelsu]

When you had him as a patient what assessment data did you get?

How was his fluid status? How was he eating? How about his output? Skin turgor? Thrush is basically a yeast infection of the mouth. It is very painful, and probably makes him not want to eat.

If his tonsils were taken out/ tubes put in he, I would guess he has had repeated infections.

How was his mood, interaction with his mother, was his development appropriate for his age. With repeated ear infections, how was his hearing.

So from all that, if you have assessment data that indicate these:

deficient fluid volume

acute pain

imbalanced nutrition less than body requirements

caregiver role strain (if he has been sick on and off since August, that is stressful for a mother)

[Connie1109]

How was his fluid status?

-Fluid was low, he was on D5 0.9% NaCl infusion

How was he eating?

-He didn't eat much

Thank you so much, I really appreciate it, you are a life saver! :)

[tarheelsu]

Then I would look mainly deficient fluid volume, imbalanced nutrition and acute pain. Look up info on the FLACS and FACES pain scale rating for acute pain data. Then for the others look at the defining characteristics for those nursing diagnoses and see how your assessment data compares.

[xtxrn, ASN, RN]

What about the diagnostics for the fever?

Fevers are caused by something.

It's not normal after a Tonsillectomy or tube placement.

What tests have been, or will be done?

[nurseprnRN, BSN, RN]

getting a new admission with a diagnosis is like when you come home and your roof is leaking. "tree fell on roof, rain coming in" is the medical diagnosis. your assessment of things you can do about it are observe where the water is coming (your bedroom) and what that's doing to your possessions (getting them wet with dirty water) , prioritize what things you need to move so they won't be ruined by the water (armoire, bed, carpet), maybe lay down buckets and tarps (risk for more damage), get your things so you can go stay at your sister's (safety), and call for help (consults to other disciplines).

if you are an advanced practice homeowner :) you can go up on the roof, chainsaw the tree outta there, patch the roof, and then rebuild it but if you are a more basic practitioner you have done all you can do at your level and you have to let the more advanced person do the other work.

for fuo you have to assess this child yourself. what do you see is not right? you have data on oral intake, pain, hydration/nutrition, right? what about labs, parent's report, behavior, diagnostic testing results? again, nursing diagnoses do not spring from medical diagnoses. asking "what's the nursing diagnosis for fuo?" is like being outside somebody's house, seeing the tree on the roof, but you haven't done any assessment of the contents of that room. you have to go inside for that.

your nursing diagnoses come from your nursing assessment data. then, if you don't know what they are telling you, you go to your nanda book and find the symptoms/data you discovered, and see what diagnoses they suggest. and then you make a plan .