Help- care plan for a code?

  1. Hey guys, I need some help. I went to the ER the other day, and there was a code. The patient had stopped breathing, pulseless..sent to ER. I helped with the code, performed compressions (it was awesome),etc... I need to make a care plan for this patient. He was worked on for awhile, then sent to ICU on a ventilator. I'm trying to think of a nursing diagnosis. I'm thinking decreased cardiac output...but the patient was essentially dead. I'm not sure, any ideas?
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    About chilloutrelax

    Joined: Oct '04; Posts: 46; Likes: 1
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    10 Comments

  3. by   2ndCareerRN
    Wow, a care plan for a code. Now I think I have heard just about everything.

    As a long term ER nurse, and having had to work more than a couple of codes, I think this is just a little overboard.

    The ODD part of me says this is a perfect time to whip out the ole........



    "Disturbed energy field" diagnosis.

    Which is defined as " "A disruption of the flow of energy surrounding a person's being which results in a disharmony of the body, mind and/or spirit".

    If a code doesn't qualify for this nursing diagnosis then nothing does. A patient becoming pulseless and apneic would be a major disruption of the energy flow. IMO

    Good Luck.

    bob
  4. by   chilloutrelax
    Well, the interventions would be the medications he was given and the compressions,etc... but what would the diagnosis be? I don't think she'd go for disturbed energy field He was worked on for an hour. He kept losing his pulse, but towards the end he had a pulse..so he was transfered to icu. I just don't know!
  5. by   Altra
    Quote from 2ndCareerRN
    Wow, a care plan for a code. Now I think I have heard just about everything.

    As a long term ER nurse, and having had to work more than a couple of codes, I think this is just a little overboard.

    The ODD part of me says this is a perfect time to whip out the ole........

    "Disturbed energy field" diagnosis.

    Which is defined as " "A disruption of the flow of energy surrounding a person's being which results in a disharmony of the body, mind and/or spirit".

    If a code doesn't qualify for this nursing diagnosis then nothing does. A patient becoming pulseless and apneic would be a major disruption of the energy flow. IMO
    Beautiful!
  6. by   barefootlady
    Altered Cardiac output r/t unknown cause
    Emergency Intervention r/t Altered Cardiac Output of unknown cause
    Altered Respirations r/t possible obstruction of airway

    Is this what you are referring to?
  7. by   chilloutrelax
    Quote from barefootlady
    Altered Cardiac output r/t unknown cause
    Emergency Intervention r/t Altered Cardiac Output of unknown cause
    Altered Respirations r/t possible obstruction of airway

    Is this what you are referring to?
    Yes barefootlady. Thanks a lot. I just couldn't think!
  8. by   Mariposa19
    If you need more, you could have a million "risk for" or PC diagnoses.

    Examples:
    PC: acute renal failure r/t impaired perfusion of the kidneys
    PC: pneumonia r/t mechanical ventilation
    PC: organ ischemia r/t impaired perfusion
    Risk for impaired skin integrity r/t impaired tissue perfusion

    You might be able to use some psychosocial ones as well, depending on how much you know about the patient and their family. Think about whether the patient has any social support, if they had chronic illness that wasn't properly managed or if this was a sudden, acute event. Think about diagnoses of powerlessness, fear, death anxiety, confusion, knowledge deficit, etc.

    I can't tell you for sure that any of these will work because again I don't know how well you know this patient, but I hope this atleast gives you more ideas. I know in my classes, the more diagnoses the better!
  9. by   chilloutrelax
    Quote from LaMariachita
    If you need more, you could have a million "risk for" or PC diagnoses.

    Examples:
    PC: acute renal failure r/t impaired perfusion of the kidneys
    PC: pneumonia r/t mechanical ventilation
    PC: organ ischemia r/t impaired perfusion
    Risk for impaired skin integrity r/t impaired tissue perfusion

    You might be able to use some psychosocial ones as well, depending on how much you know about the patient and their family. Think about whether the patient has any social support, if they had chronic illness that wasn't properly managed or if this was a sudden, acute event. Think about diagnoses of powerlessness, fear, death anxiety, confusion, knowledge deficit, etc.

    I can't tell you for sure that any of these will work because again I don't know how well you know this patient, but I hope this atleast gives you more ideas. I know in my classes, the more diagnoses the better!
    Thanks, those look good. I went with altered cardiac output for the main one and just wrote in the interventions as what all I saw during the code. So, I think it'll be fine.
  10. by   Aneroo
    You mean there's no NANDA thingie for "dead, related to bad heart AEB v-fib"
    Seriously....
    Start with ABC's, just like always. Oxygenation (brain anoxia), airway (risk for infections r/t vents), circulatory (decreased blood flow to organs) Think brain, heart, lung and kidney fx. What caused the code? Drug OD, history of funky rhythms, shock...then go from there with something for that. Think about family (ineffective coping, anticipatory greiving)... -andrea
  11. by   meownsmile
    Decreased cardiac output r/t cardiovascular collapse m/b cessation of respiration,cardiac failure.???
  12. by   PamRNC
    Quote from 2ndCareerRN
    Wow, a care plan for a code. Now I think I have heard just about everything.

    Good Luck.

    bob

    I don't know... I think the professor may need a little refresher. After all if we had to stop and write out a care plan for a code, the patient might not actually get coded. I laughed so hard, I now have hiccoughs


    OOPS! I forgot, that's why we have ACLS protocols, CareMaps, Critical pathways, etc.

    Seriously, though you've gotten a great start on the NANDAs you'll need for your careplan. Best of luck!

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