Pharm Question

EricJRN, MSN, RN · Aug 23, 2006

I think you've pretty much got it. Nursing diagnosis is confusing because we think of diagnosis in terms of what happens when we go to the doctor - you talk to the doctor, he pokes on your stomach, looks in your ears, and tells you what's wrong.

In reality, nursing diagnosis is also an investigation, but instead of trying to say, 'The patient has X symptom so I bet he has X disease,' we're trying to say, 'The patient has X problem that I can fix or improve (or the patient is at risk for something that I can help him avoid) by using my nursing skills.' An example would be Risk for Injury. If a patient is confused, he's at risk for falling and getting hurt. He's not hurt yet, but he might be if we don't take some safety measures.

tridil2000, MSN, RN · Aug 23, 2006

Hey Guys. I have a quick question about the "Nursing Process". Ive been goin over my notes and re-reading the text but Im still on that great on the the understanding of each Assessment, Nursing Diagnosis, Planning, Implementation, Evaluation thing. Heres my understanding and just let me know if I have it or not. Ok:
Assessment- nurse will assess the patient by getting personal information, med history, collects info (sub. and obj.), any allergic reactions to meds (part of med history), etc. basically just a "getting to know you" type of thing
Nursing Diagnosis (
Planning- nurse will put together a plan to teach the patient about the ailment and the recovery process as well as set up a recovery process
Initiating- putting the "plan" into action
Evaluation- Did the plan work?
I know it seems rough around the edges on how i explained it but do i have it almost right? any suggestions and thoughts are greatly appreciated! thanks! btw, my first pharm exam is next monday! yikes!

let's do an example to help you....

as you're assessing your pt, you learn he has hypertension and he takes no meds. you ask if he is on a special diet and he says no.

you just realized this man doesn't understand htn well. so there's your nsg dx...he has a knowledge deficit regarding htn.

he is started on beta blockers with diuretics and is put on a low sodium diet. you PLAN on teaching the pt exactly how a beta blocker helps the heart (in layman's terms) and discuss pulse taking etc. you also plan to discuss about how salt in his diet retains fluid, further increasing the workload on the heart. you can also PLAN on discussing kidney failure as a long term effect of untreated htn. also you know that beta blockers mask the signs and symptoms of hypoglycemia, so be certain to check if he's a diabetic.

IMPLEMENTING the plan is when you do get around to the discussion, handing him (and his significant other) pamphlets and maybe showing him a video. you can also consult the dietician to further discuss diet with him.

you GOAL is to have the pt take away more of an understanding of this disease and his meds.

you EVALUTE this by asking the pt questions and see how much he took in.

:clown:

see how what we do every day actually comes from well executed plans!

Daytonite, BSN, RN · Aug 23, 2006

Nursing Diagnosis (
I know it seems rough around the edges on how i explained it but do i have it almost right? any suggestions and thoughts are greatly appreciated! thanks! btw, my first pharm exam is next monday! yikes!

You are OK on the everything except the Nursing Diagnosis. You are OK there until I got to your statement "then they go further to explain the risk of injury from the current (?) ailment of the patient or future (?) ailment of the patient." I didn't understand what that was about. The nursing diagnosis is a label on a related group of symptoms which you have gotten from your assessment data and nothing more. In the old days before nursing diagnoses we used to call them the patients "problems" and we listed them out. Today, we group them together and put them into a nursing diagnosis.

When you talk about "risks" you are talking about anticipated problems. There are nursing diagnoses that do begin with the word "risk", although very few, and they are anticipatory problems that do not really exist, and here's the catch, but could exist. The purpose in using them would be to prevent the problem from occuring before it even started. Many of them involve safety issues. It's kind of like you can see the handwriting on the wall that XYZ is going to happen if the nurse doesn't impose some intervention because of something picked up in the assessment that is definitely a risky behavior on the patient's part that could lead to the potential problem. Sometimes it is a prior history of having had the problem that tips you off. Sometimes it's other assessment data that leads you to believe, as I said, that the writing is on the wall.

ashfost, BSN, RN · Aug 24, 2006

Haha. Wow. You are guys are better than my textbook! Thanks so much! I really have a better understanding now thats its been broken down. Yall are the best! God Bless!