i almost missed your post because you posted it in the general nursing discussion forums and i seldom look here! i am usually looking for students looking for help with care plans
, nursing diagnosis and case studies. your assignment pretty much falls into the category of a case study.
i commend you on the information you found on this disease! i have a lot of references available to me here at home and i had a heck of a time finding any reference to poliomyelitis in any of them! i am a baby boomer, so i was around when the sabin vaccine came out and we were given it in grade school. polio was considered a terrible thing to contract back then. now, you hardly ever hear about it. it is still out in the third world countries, however, and i've given you a weblink below to a site dedicated to it.
here are some links to articles on emedicine that give you the pathophysiology and treatment of this disease. these are articles written for doctors, so you kind of have to read through them slowly to digest the information. however, the information in them covers you on your requirement to present the causative organism, description of health problems, prevention, and treatment. it also gives you the signs and symptoms of the disease which is what you need to help you determine the nursing diagnoses, nursing interventions and goals that you need for the paper. you will find the information on medline plus to be the most informative for your paper, i think.
- acute poliomyelitis (focus is on the physical medicine aspect of treatment)
- postpolio syndrome
- post-polio health international - lot of information for you to explore at this site
- information about polio from medline plus' medical encyclopedia
- information on polio vaccine
a couple of observations about your paper. . .the iron lung was the precursor of the modern day ventilator. today, a person with polio who has respiratory problems due to paralysis of the pulmonary muscles would be given a tracheostomy and placed on a ventilator. that technology wasn't available back then and the "iron lung" was what they used. also, you should have someone review your paper for grammatical correctness. you've got a few grammer errors in there.
now, i want to turn the major part of my post to the last two items you are to present in your paper: nursing diagnosis with rationale, nursing goals and interventions. this is an area that i really know a lot about. first of all, i have to tell you that everything you have written under the heading of "nursing diagnosis with rational" is incorrect. what you have put there is information about medical diagnosis
. that belongs in the beginning areas of your paper.
a nursing diagnosis
is something that is very different from a medical diagnosis. a nursing diagnosis is also based upon a patient's signs and symptoms, and is geared more toward their response to them. also, nurses can only independently perform certain nursing actions. we cannot diagnose the same way a physician can. to help you understand this idea of nursing diagnoses much better you can read about them in a care plan book, a nursing diagnosis book
or you can also look through the posts on these two forum threads:
it will be very important for you to come up with nursing diagnoses, goals and interventions (all with rationales) for this assignment. this will be a major grading point that your instructors will focus on, i do believe, because this is what most nursing programs teach. this business of nursing diagnoses, goals and interventions is a written expression of the nursing process and is called care planning.
so, you begin this process by determining what the patient's abnormal signs and symptoms are. in this case, there are so many. you have to make a decision here. as a nurse what kind of a polio patient are you likely to see? someone who has initially contracted the disease? (not likely) or, someone who is experiencing the initial onset of the paralytic form or someone with postpolio syndrome? (i opt for those.)
symptoms of paralytic polio are: (i'm getting this from medline plus' medical dictionary)
- stiff neck and back
- unilateral muscle weakness that can progress to paralysis
- muscle pain
- muscle contraction or spasms
- abnormal sensations
- difficulty urinating
- difficulty swallowing
- difficulty breathing (this can include paralysis of the muscles, sleep apnea)
- irritability or poor temper control
from this list you have something to work with to develop some nursing diagnoses. nanda-i (north american nursing diagnosis association, international) has currently defined and described for nurses 172 nursing diagnoses. each nursing diagnosis has a definition, a list of symptoms (they call them defining characteristics) and an etiology, or cause (they call them related factors). your mission, grasshopper, is to figure out which of the above symptoms (and i'm going to elaborate a bit on the symptoms as well) fit with some of these 172 diagnoses. i'll help you out here because i have care plan/nursing diagnosis references at hand.
the first nursing diagnoses to address are the ones that involve breathing since oxygenation of the brain and the tissues of the body are of most importance. the nursing diagnoses most appropriate to use are:
next problems of importance involve nutrition and food.
let's address elimination next. these patients tend to have two problems in this area: constipation and trouble with urinating.
next, address fever. not all will have fever unless they are in the early stages of the disease.
now, we get to one of the biggies--movement.
this immobility also includes all the self-care deficits for the adls (activities of daily living), so:
there are also what are called anticipatory nursing diagnoses that you could also list. these are problems the patient could develop; things you need to kind of do to prevent them from happening. some nursing instructors don't like students listing those, so you might want to check to see if your instructors are going to have a cow if you bring them up. those are:
- risk for infection r/t chronic disease [i'm talking about uri and uti here]
let me also mention that i didn't even touch on the safety and self-esteem nursing diagnoses. i am sure that there are a few we could throw in there. certainly, depression and the need for the patient's safety are things to consider. you would be very wise to consider investing in a book of nursing diagnoses or care plans. these books are very good resources for listing nursing interventions, especially when your mind is blanking on what to do for a patient. the weblinks that i gave you for each of the nursing diagnoses above are online companion sites for the following nursing diagnosis books:
- nursing care plans: nursing diagnosis and intervention, 6th edition, by meg gulanick and judith l. myers.
- nursing diagnosis handbook: a guide to planning care, 7th edition, by betty j. ackley and gail b. ladwig.
this part of your paper will probably be the biggest part of it. after all, you are in nursing school and your focus should be on nursing care. so, you have a lot more work to do on this paper. here are some weblinks to case studies that were done by students on actual patients they took care of. it will give you an idea of how they wrote up their patient case studies to give you some idea of how these things are written. they generally start with a discussion about the patient's disease, it's pathophysiology (how the normal body physiological process is altered by the disease), diagnostic tests done to diagnose the disease, medical treatment ordered including medications and tests and then the nursing diagnoses and nursing care. good luck with the rest of this assignment. please don't hesitate to ask for more help if you need it.